What constitutes benefit from health care interventions for Indigenous Australians?

The health of Indigenous Australians is poor compared to that of their counterpart Australians. Further, their health is worse by international standards. The Australian Government recently made a commitment to improving the health status of Indigenous Australians through the 'closing the health gap' initiative. Achieving this requires an improvement in the priority setting process through the use of evidence. Central to this is the need for a concept of 'benefit' from services that reflects the needs and aspirations of Indigenous Australians. The purpose of this paper is to develop an Indigenous-specific health metric that captures individual and community benefits for improving the priority setting process. A workshop-based approach identified four dimensions of benefit in Indigenous health: individual health gain, community health gain, equity and cultural security. The individual health gain dimension accounted for 42 per cent of the total perceived benefit from health care interventions, while the remaining three dimensions each weighted between 19 per cent and 21 per cent. The individual health gain had two sub-dimensions: a DALY consistent attribute and a non-DALY attribute. The DALY attributes were by far the most influential, but while the DALY as a measure of health gain in economic evaluation is desirable, alone it grossly underestimates the overall benefit from interventions in Indigenous health.