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4839.0 - Patient Experiences in Australia: Summary of Findings, 2012-13 Quality Declaration 
Latest ISSUE Released at 11:30 AM (CANBERRA TIME) 21/11/2013   
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EXPLANATORY NOTES

INTRODUCTION

1
This publication contains results from the Patient Experience Survey, a topic on the Multipurpose Household Survey (MPHS) conducted throughout Australia from July 2012 to June 2013. The MPHS, conducted each financial year by the Australian Bureau of Statistics (ABS) as a supplement to the monthly Labour Force Survey (LFS), is designed to collect statistics for a number of small, self-contained topics.

2
The Patient Experience Survey collected information from individuals about their experiences with selected aspects of the health system in the 12 months before interview. Information on labour force characteristics, education, income and other demographics were also collected.


SCOPE


3
The scope of the Patient Experience Survey was restricted to people aged 15 years and over. It excluded the following people:

    • members of the Australian permanent defence forces
    • certain diplomatic personnel of overseas governments, customarily excluded from Census and estimated population counts
    • overseas residents in Australia
    • members of non-Australian defence forces (and their dependants)
    • persons living in non-private dwellings such as hotels, university residences, boarding schools, hospitals, nursing homes, homes for people with disabilities, and prisons
    • persons resident in Indigenous Community Frame (ICF) Collection Districts (CDs).
4 As in 2011-12, the 2012-13 survey included households residing in urban, rural, remote and very remote parts of Australia, except ICF CDs.


COVERAGE


5
In the LFS, coverage rules are applied which aim to ensure that each person is associated with only one dwelling, and hence has only one chance of selection in the survey. See Labour Force, Australia (cat. no. 6202.0) for more detail.


DATA COLLECTION

6
ABS interviewers conducted personal interviews during the 2012-13 financial year for the monthly LFS. Each month, one eighth of the dwellings in the LFS sample were rotated out of the survey. The MPHS sample was selected from these dwellings that were rotated out of the survey. From July to November 2012, approximately 85% of this outgoing rotation group were selected for inclusion in the MPHS sample, while from December 2012 to June 2013, this proportion increased to 100%.

7
In these dwellings, after the LFS had been fully completed for each person in scope and coverage, a usual resident aged 15 years or over was selected at random (based on a computer algorithm) and asked the additional MPHS questions in a personal interview. If the randomly selected person was aged 15 to 17 years, permission was sought from a parent or guardian before conducting the interview. If permission was not given, the parent or guardian was asked the questions on behalf of the 15 to 17 year old (proxy interview).

8
Data was collected using Computer Assisted Interviewing (CAI), whereby responses were recorded directly onto an electronic questionnaire in a notebook computer, usually during a telephone interview.

9
The publication Labour Force, Australia (cat. no. 6202.0) contains information about survey and sample design, scope, coverage and population benchmarks relevant to the monthly LFS, and consequently the MPHS. This publication also contains definitions of demographic and labour force characteristics, and information about telephone interviewing.


SAMPLE SIZE

10
After taking into account sample loss, the response rate for the Patient Experience Survey was 78.9%. In total, information was collected from 30,749 fully responding households. One person aged 15 years or over from each household was asked questions in relation to their own health. This includes 475 proxy interviews for people aged 15 to 17 years, where permission was not given by a parent or guardian for a personal interview.


WEIGHTING, BENCHMARKS AND ESTIMATION


Weighting

11
Weighting is the process of adjusting results from a sample survey to infer results for the total 'in scope' population. To do this, a 'weight' is allocated to each enumerated person. The weight is a value which indicates the number of persons in the population represented by the sample person.

12
For the MPHS, the first step in calculating weights for each unit is to assign an initial weight, which is the inverse of the probability of being selected in the survey. For example, if the probability of a person being selected in the survey was 1 in 600, then the person would have an initial weight of 600 (that is, they represent 600 people).

Benchmarks

13
The initial weights are then calibrated to align with independent estimates of the population, referred to as benchmarks. The population included in the benchmarks is the survey scope, for example, the estimated civilian population aged 15 years and over living in private dwellings in each State and Territory excluding persons out of scope. This calibration process ensures that the weighted data conform to the independently estimated distribution of the population described by the benchmarks rather than to the distribution within the sample itself. Calibration to population benchmarks helps to compensate for over- or under-enumeration of particular categories of persons which may occur due to either the random nature of sampling or non-response.

14
The survey was benchmarked to the estimated resident population (ERP) in each state and territory at 31 March 2013.

Estimation

15
Survey estimates of counts of persons are obtained by summing the weights of persons with the characteristic of interest.


RELIABILITY OF ESTIMATES


16
All sample surveys are subject to error which can be broadly categorised as either:
    • sampling error
    • non-sampling error.
17 Sampling error is the difference between the published estimate, derived from a sample of dwellings, and the value that would have been produced if all dwellings in scope of the survey had been included. For more information refer to the Technical Note.

18
Non-sampling error may occur in any collection, whether it is based on a sample or a full count of the population such as a census. Sources of non-sampling error include: non-response; errors in reporting by respondents or recording of answers by interviewers; and errors in coding and processing data. Every effort was made to reduce the non-sampling error by: careful design and testing of the questionnaire; training and supervision of interviewers; follow-up of respondents; and extensive editing and quality control procedures at all stages of data processing.


DATA QUALITY


19 Information recorded in this survey is 'as reported' by respondents, and may differ from that which might be obtained from other sources or via other methodologies. This factor should be considered when interpreting the estimates in this publication.

20
Information was collected on respondents' perception of their health status and experiences with services. Perceptions are influenced by a number of factors and can change quickly. Care should therefore be taken when analysing or interpreting the data.

21
The definition of 'need' (in questions where respondents were asked whether they needed to use a particular health service) was left to the respondents' interpretation.

22
For some questions which called for personal opinions, such as self-assessed health or whether waiting times were felt to be unacceptable, responses from proxy interviews were not collected.

23 A small proportion of respondents were resident in areas with no Socio-economic Indexes for Areas (SEIFA) scores allocated. For the purposes of the Patient Experience Survey, these records have had a SEIFA decile imputed, based on the deciles of the surrounding areas. For information on SEIFA, see the Socio-economic Indexes for Areas (SEIFA) section below.


DATA COMPARABILITY


Comparability of Time Series

24 The ABS seeks to maximise consistency and comparability over time by minimising changes to surveys. Sound survey practice, however, requires ongoing development to maintain and improve the integrity of the data. The Patient Experience Survey, as a relatively new survey, is subject to a comparatively high level of change from this ongoing development. When comparing data from different cycles of the survey, users are advised to consult the questionnaires (available from the Downloads tab of cat. no. 4839.0), check whether question wording or sequencing has changed, and consider whether this may have had an impact on the way questions were answered by respondents.

25 The wording, position in the questionnaire or population of some questions in this 2012-13 Patient Experience Survey publication differ from the previous cycles of the survey. In some cases, this may mean that it is not possible to make valid comparisons between the resultant data items from one cycle to the next. ABS recommends that the following data items used in this publication are not comparable with equivalent items in the 2011-12 cycle of the Patient Experience Survey:
    • Long term health condition (mental health condition category only) - this category was worded as 'mental illness' in the question in 2011-12. All other categories remain unchanged. This change has minimal impact on the data item as aggregated for publication, because it is a multiple response question.
    • Whether waited longer than felt acceptable to get an appointment with a GP - the question from which this item is derived has moved within the questionnaire and is subject to a context effect from the preceding questions.
    • Type of dental clinic visited - in 2012-13, this referred to all dental visits in the last 12 months, while in 2011-12, the question only asked about the most recent dental visit.
    • Whether delayed seeing or did not see GP in last 12 months due to cost. The questions from which these items are derived have moved within the questionnaire and this may have created a context effect.
    • Whether delayed seeing or did not see a dental professional due to cost in the last 12 months - the population of this item has changed. In 2012-13, for the first time, people who did not see a dental professional were asked whether they also delayed going.
    • Self assessed health - this question was the first in the 2011-12 questionnaire, but in 2012-13, it was asked after the questions on private health insurance. It is therefore subject to a context effect from the preceding questions. This change has minimal impact on the data item as aggregated for publication.
    • Whether seen three or more health professionals for the same condition (and all other questions relating to this item, as shown in tables 19 and 20) - the wording of the question used to derive this item changed. The question previously asked 'have you seen three or more health professionals... for a single condition'. This change also changes the populations for all other items relating to this item. These items were last collected in 2009.
26 The questions that contribute to the data items listed below have changed in minor ways between cycles of the survey. ABS advises that these changes do not affect comparability between cycles:
    • Type of private health cover - in 2012-13, additional response options were available in this question. These were not read out by the interviewer, but allowed a respondent to volunteer that they had ambulance cover only or other arrangements such as cover from the Department of Veterans' Affairs. Respondents who fell into these two categories were coded as not having private health insurance.
    • Number of times visited a GP for own health in last 12 months - in 2012-13, respondents could nominate any number from 1 to 99 in answer to this question. In previous cycles, responses were grouped into categories.
    • Whether had a referred pathology test - the questions used to derive this data item have changed in a minor way between cycles.
    • Whether had a referred imaging test - the questions used to derive this data item have changed in a minor way between cycles.
    • Main reason went to hospital emergency department instead of GP on most recent occasion - response categories are not read to the respondent in this question, but two extra response categories were available in 2012-13. These were 'GP does not have required equipment / facilities' and 'closer than GP when needed'.
27 All time series tables ensure that the data items are comparable between the survey cycles presented.

Comparability with other ABS surveys

28
Caution should be taken in comparisons across ABS surveys and with administrative by-product data that address the access and use of health services. Estimates from the Patient Experience Survey may differ from those obtained from other surveys (such as the Australian Health Survey, General Social Survey and Survey of Disability, Ageing and Carers) due to differences in survey mode, methodology and questionnaire design.


CLASSIFICATIONS

29
Remoteness areas are classified according to the Australian Statistical Geography Standard (ASGS): Volume 5 - Remoteness Structure, July 2011 (cat. no. 1270.0.55.005). The 2012-13 survey is the first Patient Experience Survey to use the ASGS remoteness structure.

Socio-economic Indexes for Areas (SEIFA)

30
The 2012-13 survey is the first Patient Experience Survey to use the 2011 Socio-economic Indexes for Areas (SEIFA).

31 SEIFA is a suite of four summary measures that have been created from 2011 Census information. Each index summarises a different aspect of the socio-economic conditions of people living in an area. The indexes provide more general measures of socio-economic status than is given by measures such as income or unemployment alone.

32
For each index, every geographic area in Australia is given a SEIFA number which shows how disadvantaged that area is compared with other areas in Australia.

33
The index used in the Patient Experience publication is the Index of Relative Socio-economic Disadvantage, derived from Census variables related to disadvantage such as low income, low educational attainment, unemployment, jobs in relatively unskilled occupations and dwellings without motor vehicles.

34
SEIFA uses a broad definition of relative socio-economic disadvantage in terms of people's access to material and social resources, and their ability to participate in society. While SEIFA represents an average of all people living in an area, it does not represent the individual situation of each person. Larger areas are more likely to have greater diversity of people and households.

35
For more detail, see the following:
PRODUCTS AND SERVICES

Data Cubes

36
A Data Cube containing all tables in Excel spreadsheet format can be found on the ABS website (from the Downloads tab of cat. no. 4839.0). The spreadsheet presents tables of estimates and proportions, and their corresponding relative standard errors (RSEs).

Customised data requests

37
Special tabulations of the data are available on request. Subject to confidentiality and sampling variability constraints, tabulations can be produced from the survey incorporating data items, populations and geographic areas (including state and territory level data), tailored to individual requirements. These are provided in electronic form. A list of data items from the 2012-13 Patient Experience Survey is available from the Downloads tab. All inquiries should be made to the National Information and Referral Service on 1300 135 070.


ACKNOWLEDGEMENTS


38
ABS surveys draw extensively on information provided by individuals, businesses, governments and other organisations. Their continued cooperation is very much appreciated and without it, the wide range of statistics published by the ABS would not be available. Information received by the ABS is treated in strict confidence as required by the Census and Statistics Act 1905.


NEXT SURVEY


39
The Patient Experience Survey is conducted annually, with the next survey occurring in 2013-14.


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