Statistical Clearing House

Allied Health Industries Survey, (Stage 2) Financial Year 1997/1998

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• Overview *** You are here ***
• Contact Information
  
• Summary
  
• Reference Period & Frequency
  
• Response Rates
  
• Clearance Information
• Quality Framework
• A. General Information
• B. User Requirements, Survey Objectives and Budget
• C. Alternative Sources of Data
• D. Data Outputs
• E. Questionnaire Design and Data Collection
• F. Respondent Load
• G. Population / Frame
• H. Sample Design
• I. Estimation and Analysis

Overview

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Contact Information

	Portfolio:	Treasurer
	Agency:	ABS - Australian Bureau of Statistics
	Contact Person...	Name:	Paul Sullivan
		Email:	paul.sullivan@abs.gov.au
		Phone:	02 6252 5635 (International +61)

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Summary

After a lengthy period of consultations in early 1993, the ABS received a detailed proposal from the (then) Department of Human Services and Health for an extensive range of health-related industries to be included in the Service Industries program. Additional consultations were undertaken with Commonwealth and State organisations and departments, research units and a wide range of industry and professional associations in early 1994. User needs were for quality data, primarily in respect of private sector practices/businesses (and some data about individual practitioners) in the various health professional industries. The industries initially considered were those involved in providing general practice or specialist medical services, dental, optometry, pharmaceutical, physiotherapy, chiropractic and a number of related health services. Development of these surveys identified many conceptual and methodological problems which resulted in increased workloads and necessitated a cut-back in the scope for the 1994-95 surveys of health professional industries. The Department of Human Services and Health's main priority was private practice medical industries, for which they partially funded a survey in respect of 1994-95 (see catalogue 8685.0 for results). The other health professional industries were rescheduled for reference year 1997-98. In preparation for surveys of the other health professional industries, meetings have been held in early 1997 with the Department of Health and Family Services (DH&FS), Department of Veteran's Affairs (DVA), Australian Institute of Health and Welfare (AIHW) and various allied health industry associations. It was evident from these user consultations that the allied health industries are well serviced in respect of workforce statistics by studies/collections mainly undertaken by the AIHW. However, there are no comprehensive data on the size and financial structure of these industries. In particular, users are interested in the income and expenditure structures of the major allied health industries. Such data would be very useful to DH&FS. Internal ABS user demand also exists for data on allied health industries. The Economic Activity Survey (EAS) collects employment and detailed financial data from a wide range of industries, including allied health industries. To avoid duplication, the Allied Health Industries Survey collects some employment and financial data from a subset of its sample at a level of detail that meets various EAS needs. Further information on this cooperative arrangement are provided in Section C. Data collected will be used by both internal and external clients. The main Internal client is EAS. External users include the Department of Health and the Australian Institute of Health and Welfare (AIHW), together with key industry bodies such as the Australian Dental Association (ADA); Australian Physiotherapy Association (APA); Australian Chiropractic Association; Australian Osteopathic Association; Australasian Dispensing Opticians Association (ADOA) and the Optometry Association of Australia (OAA). The survey will meet these needs by collecting details on the following broad topics: Allied health activity (including types of goods sold, types of services rendered) Fine level business (industry and legal status) description; Employment data by tenure, sex and occupation; Detailed income items including source of service payments (govt, medical funds, private payments); Detailed expense items; Profit or loss; Assets and liabilities details; and Capital expenditure and disposal of assets. An appropriate frame of allied health businesses was not readily available. Therefore, the Allied Health Survey will be conducted in two stages. The information requirements of the Stage 1 survey of the Allied Health collection fall into two broad groups. The first set of requirements are for profiling the workforce in the industries (in conjunction with information from the Stage 2 survey) and the second set are for coverage information to build the frame for the Stage 2 survey, which primarily collects the financial data.

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Reference Period & Frequency

	Reference Period:	(Stage 2) Financial Year 1997/1998
	Frequency:	3-yearly

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Response Rates

			As planned	Actual
	Number of businesses...
	Contacted:		5500	4445
	Live and in scope:		5500	4189
	Responding:		5225	3962
	Average time to complete questionnaire:		94 mins	135 mins
	Statistics...
	Response rate:		95%	95%

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Clearance Information

	Survey reviewed by
	Stat. Clearing House:	(Stage 2) Financial Year 1997/1998
	Status:	Approved
	Approval period:	1997/1998
	For additional clearance information, please contact the Statistical Clearing House by phone, fax, post or email.

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Allied Health Industries Survey, (Stage 2) Financial Year 1997/1998

Quality Framework
This data quality framework has been published internationally (Brackstone G., Managing Data Quality in a Statistical Agency, (1999) Survey Methodology, Vol. 25, no. 2, Statistics Canada) and has been recommended by the ANAO as 'better practice' in specifying performance measures (ATO Performance Reporting under the Outcomes and Outputs Framework, Australian Taxation Office, Audit Report No.46 2000-01, pp63-64.) on advice from the ABS Statistical Consultancy Unit.

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Relevance

The relevance of statistical information reflects the degree to which it meets the needs of the clients. It is usually described in terms of key user needs, key concepts and classifications used, the scope of the collection and the reference period.

Why do you need to conduct a survey? (B1)

After a lengthy period of consultations in early 1993, the ABS received a detailed proposal from the (then) Department of Human Services and Health for an extensive range of health-related industries to be included in the Service Industries program. Additional consultations were undertaken with Commonwealth and State organisations and departments, research units and a wide range of industry and professional associations in early 1994. User needs were for quality data, primarily in respect of private sector practices/businesses (and some data about individual practitioners) in the various health professional industries. The industries initially considered were those involved in providing general practice or specialist medical services, dental, optometry, pharmaceutical, physiotherapy, chiropractic and a number of related health services.

Development of these surveys identified many conceptual and methodological problems which resulted in increased workloads and necessitated a cut-back in the scope for the 1994-95 surveys of health professional industries. The Department of Human Services and Health's main priority was private practice medical industries, for which they partially funded a survey in respect of 1994-95 (see catalogue 8685.0 for results). The other health professional industries were rescheduled for reference year 1997-98.

In preparation for surveys of the other health professional industries, meetings were held in early 1997 with the Department of Health and Family Services (DH&FS), Department of Veteran's Affairs (DVA), Australian Institute of Health and Welfare (AIHW) and various allied health industry associations. It was evident from these user consultations that the allied health industries are well serviced in respect of workforce statistics by studies/collections mainly undertaken by the AIHW. However, there are no comprehensive data on the size and financial structure of these industries. In particular, users are interested in the income and expenditure structures of the major allied health industries.

How will the survey meet this need? That is, what are the objectives of the survey in terms of content and constraints? (B2)

The survey will meet these needs by collecting details on the following broad topics:

Allied health activity (including types of goods sold, types of services rendered)
Fine level business (industry and legal status) description;
Employment data by tenure, sex and occupation;
Detailed income items including source of service payments (govt, medical funds, private payments);
Detailed expense items;
Profit or loss;
Assets and liabilities details; and
Capital expenditure and disposal of assets.

An appropriate frame of allied health businesses was not readily available. Therefore, the Allied Health Survey will be conducted in two stages. The information requirements of the Stage 1 survey of the Allied Health collection fall into two broad groups. The first set of requirements are for profiling the workforce in the industries (in conjunction with information from the Stage 2 survey) and the second set are for coverage information to build the frame for the Stage 2 survey, which primarily collects the financial data.

Relative standard errors from the Stage 2 survey of no more than 5% for the main aggregates at the Australian level and 10% at the State level are the design objectives (design variables include income, expenses and wages & salaries).

What are the principal outputs or data items to be produced? (D1)

There will be five publications produced from the survey. (Dental Services, Australia 1997/98; Optometry and Optical Dispensing Services, Australia 1997/98; Physiotherapy Services, Australia 1997/98; Chiropractic and Osteopathic Services, Australia 1997/98; and Audiological and Audiometrical Services, Australia 1997/98). Each of these contain summary employment, income, and expenses tables covering the relevant ANZSIC classes.

The five publications contain broadly the same core tables with some sub-industry specific tables. The core tables include:
business characteristics
sources of income
items of expenditure
characteristics of employment
main occupation of persons employed
selected performance ratios

Some sub-industry data will be made available for the Dental Services, Optometry and Optical Dispensing Services, and Chiropractic and Osteopathic Services publications.

All tables will contain data at the Australian level, with one state table showing broad aggregates by state.

How are the results of the survey to be analysed? (I6)

Comparison with other ABS collections of other professions, in particular, comparison with previous medical survey.

What consideration has been given to the use of standards? Please specify. (D2)

Classifications are summarised as follows:-
State:- State of management unit (MU)
Industry:- The Allied Health Industries Survey collects data classified according to the Australian and New Zealand Standard Industrial Classification (ANZSIC).
Subindustry:-Dental, General Practitioner/Specialist, the classification of General Practitioner or Specialist Dentistry is determined by the range of treatments a practitioner is able to provide (specifically measured by the range of Medicare claim codes available to a practitioner). Dental businesses will be coded according to the range of services providing the predominant source of income.
Optical/Optical Dispensing, Optometry services are medicare rebateable and rendered by a tertiary qualified, state registered practitioner and generally involve the provision of "eye testing" (refraction). Optical Dispensing services refer to the provision of optical appliances (ie. lenses and frames). Businesses will be coded to either of these sub-industries according to the predominant income earning activity.
Chiropractic, Chiropractic and osteopathic services sub-industries are self defined by the business according to the range of treatments offered.

The Allied Health Industries Survey uses ABS standard data items for economic collections.

What is the target population for the survey? (G1)

Dental Services businesses, Optical services businesses and Optical Dispensers, Physiotherapy service businesses, Chiropractic service businesses, Osteopathic service businesses and Audiology and Audiometry Services businesses.

How is the frame for the survey to be obtained? (G2)

The frame source was lists of practitioners from Medicare (Optometrists) and Medibank (Dentists, Physiotherapists, Chiropractors, Osteopaths and Optical Dispensers) for stage 1. A sample of practitioners was then selected and asked to identify businesses which formed the frame for stage 2.

The Audiology/Audiometry frame was constructed by merging lists provided by the Office of Hearing Services, the Australian College of Audiologists, the Australian Society of Audiologists and the Hearing Aide Audiometrists Society of Australia.

What is the type of unit on the frame to be used for the survey? (G3)

The type of unit to be used for the survey is the management unit.

What is (are) the method(s) of collecting the data (eg self-completion, telephone interviewing, face to face interviewing, etc)? Why was it (were they) chosen? (E2)

Data will be collected from selected management units via direct mailout/mailback questionnaires.

This method was found to be the most cost-effective, considering the size of the questionnaires.

To what reference period(s) does the survey refer? (A7)

Financial Year

This is the standard reference period. However, if a business has a different financial year to 1998-99, they are asked to report for a 12 month period which ends between 1 October 1998 and 30 September 1999.

Is the survey going to be conducted once only or repeated? (A8)

Not known at this stage

With what frequency is the survey to be repeated? (A9)


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Accessibility

The accessibility of statistical information refers to the ease with which it can be referenced by users. It includes the ease with which the existence of information can be ascertained, as well as the suitability of the form or medium through which the information can be accessed.

How are the results of the survey to be made available to the major users? (I7)

The following publications will be released as standard products.

Dental Services, Australia 1997/98
Optometry and Optical Dispensing Services, Australia 1997/98
Physiotherapy Services, Australia 1997/98
Chiropractic and Osteopathic Services, Australia 1997/98
Audiological and Audiometrical Services, Australia 1997/98

Special data services are also available giving more detailed breakdowns of income and expenses.

Which agency and area is responsible for the survey? (A2)

ABS
Service Industries

Who is the survey manager and principal contact person for survey clearance? (A3)

Director: Paul Sullivan
Principal Contact Officer: Paul Taylor

What commitments have been made to preserve the confidentiality of respondents? How will these be implemented? (F3)

The confidentiality of information collected by the Australian Bureau of Statistics is protected by the secrecy provisions of the Census and Statistics Act 1905. Rules on minimum number of contributors per output cell, and concentration of particular respondent contribution to the cell, apply.

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Timeliness



The timeliness of statistical information refers to the delay between the reference point to which it pertains and the date on which the information becomes available.

To what reference peiod(s) does the survey refer? (A7)

Financial Year

This is the standard reference period. However, if a business has a different financial year to 1998-99, they are asked to report for a 12 month period which ends between 1 October 1998 and 30 September 1999.

What is the timetable for the survey? (B3)

Development Period:
Start: 01/07/97
End: 30/06/98

Frame Creation: 21/03/98

Sample Selection: N/A

Enumeration Period:
Start: 14/08/98
End: 31/01/99

Input Processing Period:
Start: 07/09/98
End: 31/01/99

Output/Tabulation Period:
Start: 31/01/99
End: 30/06/99

Release Date: There will be five publications released between 31/03/99 and 30/06/99.

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Accuracy



The accuracy of statistical information is the degree to which the information correctly describes the phenomena it was designed to measure. It includes measures of both sampling and non-sampling error.

What is the total sample size and how has it been set? (H2)

The total sample size for stage 2 will be approximately 5,500. The two main constraints are costs and the requirement that we achieve 5% RSEs at the Australia level and 15% RSEs at the state level to meet users' needs.



Form Title, Identifier, Reference Period	Number of Frame Units (Stage 1)	Expected number of Frame Units Stage 2)
Dental Services	11,140 (Sampled - 1688)	2026
Optometry	2,737 (Sampled - 847)	1016
Optical Dispensers		400
Physiotherapy Services	7,926 (Sampled - 966)	1159
Chiropractic Services,	2,934 (Sampled - 656)	748
Audiology/Audiometry		200
Totals	24,737 (Sampled - 4024)	5549

What sources of non-sampling error could have a significant impact on survey results and what is being done about them? (I4)

It is likely that the treatment will follow that of the 94/95 Private Practice Medical Business Survey where the differing practioner-business structures made it difficult to impute data for non-respondents. Suitable imputation techniques were chosen for different types of situations.
Appropriate techniques for imputation will be evaluated when the type and level of non-response is available.

Of the total sample size reported in H2, how many units are expected to respond, and how many units are expected to be defunct (ie no longer in business) or out of scope? (H6)

Ninety-five percent of units are expected to provide a live response.

What allowances have been made for known frame deficiencies in the sample design? (H7)

The sample sizes were formulated allowing for a 5% cancellation rate.

What allowances have been made for expected non-response in the sample design? (H8)

The sample sizes have been selected allowing for the non-response factor.

In what ways does the coverage provided by the frame differ from the target population? (G6)

A 5% cancellation rate was expected, based on the 1994/95 Medical survey which used the same source. The deficiencies in the Medibank frame were that the address information was out of date and there wasn't any systematic deathing procedure for the frame. Hence cancellation rates were higher than expected (ie. between 10 and 30 percent). This lead to supplementation of the sample.

What quality control procedures will there be for data entry and coding? (I2)

The data will be entered using Optical Character Reading technology, editing and processing systems are being developed within the Melbourne office.

Other than the normal input editing process the major businesses will be checked in detail to ensure that the largest contributors to the estimates are correct. Where significant amounts have been reported in other income/expenses an investigation is carried out and if appropriate the items recorded are redistributed back into the major items.

Where respondents were EAS respondents in 1996/97, historical comparisons will be made.

What testing of the questionnaire(s) has (have) taken place? (E4)

The questionnaires have undergone two pilot tests with businesses in the industry. Approximately 12 units were approached on the first occasion and 40 on the second. The questionnaires were modified in response to issues raised during the first pilot test and then tested again to check on the changes made. The testing has indicated that there will be no significant problems for businesses completing the revised forms.

What other consultations have taken place with businesses or business associations regarding availability of data items and data collection methods? (E5)

Prior to designing the forms there were discussions with relevant policy makers in government, industry associations, governing bodies, major players in the industry and other potential users of the output.

Discussions with industry bodies and major players in the industry included questions regarding the availability of data items and data collection methods.

How many units are there on the frame? (G4)

Form Title, Identifier, Reference Period	Number of Frame Units (Stage 1)	Expected number of Frame Units Stage 2)
Dental Services	11,140 (Sampled - 1688)	2026
Optometry	2,737 (Sampled - 847)	1016
Physiotherapy Services	7,926 (Sampled - 966)	1159
Chiropractic Services,	2,934 (Sampled - 656)	748
Audiology/Audiometry		200
Totals	24,737 (Sampled - 4024)	5149

What evidence is there that the expected respondents will be representative of non-respondents? (H9)

None

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Interpretability



The interpretability of statistical information reflects the availability of the supplementary information and metadata necessary to interpret and utilise it appropriately. It includes appropriate presentation of data such that it aids correction interpretation.

How are the results of the survey to be made available to the major users? (I7)

The following publications will be released as standard products.

Dental Services, Australia 1997/98
Optometry and Optical Dispensing Services, Australia 1997/98
Physiotherapy Services, Australia 1997/98
Chiropractic and Osteopathic Services, Australia 1997/98
Audiological and Audiometrical Services, Australia 1997/98

Special data services are also available giving more detailed breakdowns of income and expenses.

What sample design will be used, eg stratified simple random sample? (H1)

Most industries in this collection will be sampled using the two-stage sampling technique employed in the 1994/95 Survey of Private Medical businesses. In stage one practitioners are surveyed using a stratified simple random sample and asked to provide details of their business arrangements and in stage two a census of the business entities and related administrative entities identified in stage one is approached.

What stratification has been used in the sample design? (H3)

Dental Services, & Physiotherapy Services
The sample sizes detailed above have been based on the simple stratification of industry by state. The stratification will be refined in the final design for Dentist General Practitioners and Oral Surgeons to industry x state x size.

The size variable will consist of two groups only: high activity practitioners and others.
Practitioners with the number of medicare requests greater than 1000 will be classed as high activity practitioners.

Chiropractic & Osteopathic Services
The sample sizes detailed above have been based on the stratification industry x state x subindustry. The sub-industries include Chiropractic services and Osteopathic services.

As for Dental Services and Physiotherapy services, Chiropractic services will be stratified by size. The final stratification will therefore be industry x subindustry x state x size. Size groupings will be as described above.

Optometrists
The sample size for Optometrists detailed above will be stratified by industry x state.

Optical Dispensers
Optical dispensers will be completely enumerated (CE'd)

Audiology Services
The population will also be CE'd.

What allowances have been made for known frame deficiencies in the sample design? (H7)

The sample sizes were formulated allowing for a 5% cancellation rate.

What allowances have been made for expected non-response in the sample design? (H8)

The sample sizes have been selected allowing for the non-response factor.

Will outliers be identified, and, if so, how will they be handled? (I3)

It is anticipated that surprise outliering will be used if investigations identify outliers

Will data be aggregated into statistical tables, and if so what are the estimation formulae for the principal output data items? (I5)

Estimation is the same as for the Private Practice Medical Business Survey 1994/95.

In order to estimate stage 2 output, such as income and expenditure of the population of the medical businesses, selected businesses output is apportioned to those practitioners who are involved in the business (it is assumed that each practitioner had a chance of selection in stage 1). Selected practitioners are then extrapolated to represent the rest of the practitioners on the frame, thus representing the complete population of businesses which would have been identified by the practitioners on the Stage 1 frame.

What sources of non-sampling error could have a significant impact on survey results and what is being done about them? (I4)

It is likely that the treatment will follow that of the 94/95 Private Practice Medical Business Survey where the differing practioner-business structures made it difficult to impute data for non-respondents. Suitable imputation techniques were chosen for different types of situations.
Appropriate techniques for imputation will be evaluated when the type and level of non-response is available.

How are the results of the survey to be analysed? (I6)

Comparison with other ABS collections of other professions, in particular, comparison with previous medical survey.

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Coherence



The coherence of statistical information reflects the degree to which it can be successfully brought together with other statistical information within a broad analytical framework and over time. The use of concepts, classifications and target populations promotes coherence, as does the use of common methodology across surveys.

Is the survey a new survey or a cycle of an existing repeated survey? (A6)

This is the first time that the Allied Health Industry has been surveyed.

Is the survey to be conducted once only or repeated? (A8)

Not known at this stage

With what frequency is the survey to be repeated? (A9)

How will the frame be updated for future survey cycles? (G7)

What consideration has been given to making data items consistent between survey cycles or across surveys? (D3)

The data items have been developed using ABS standards. The survey development has also been conducted with a specific view to being able to produce time series data, hence great care has been taken in maximising data item consistency across forms, and across surveys.

What alternative sources of data have been considered? (C1)

The various associations have conducted some minor studies done by private consultants based on relatively small samples. The data collected was demographics and basic income and expenses data.

Also the AIHW carry out a demographic study of the industries every three years.

In what respects are these alternative sources insufficient? (C2)

The surveys by the various associations do not provide the fine detail or the full picture of the industry that will be available from this survey.

The AIHW studies do not provide the same detail on business structure and business finances.

What consideration has been given to the use of standards? Please specify. (D2)

Classifications are summarised as follows:-
State:- State of management unit (MU)
Industry:- The Allied Health Industries Survey collects data classified according to the Australian and New Zealand Standard Industrial Classification (ANZSIC).
Subindustry:-Dental, General Practitioner/Specialist, the classification of General Practitioner or Specialist Dentistry is determined by the range of treatments a practitioner is able to provide (specifically measured by the range of Medicare claim codes available to a practitioner). Dental businesses will be coded according to the range of services providing the predominant source of income.
Optical/Optical Dispensing, Optometry services are medicare rebateable and rendered by a tertiary qualified, state registered practitioner and generally involve the provision of "eye testing" (refraction). Optical Dispensing services refer to the provision of optical appliances (ie. lenses and frames). Businesses will be coded to either of these sub-industries according to the predominant income earning activity.
Chiropractic, Chiropractic and osteopathic services sub-industries are self defined by the business according to the range of treatments offered.

The Allied Health Industries Survey uses ABS standard data items for economic collections.

What consideration has been given to working with other agencies to make their data more suited to your needs? (C3)

There were some discussions with AIHW, however at this stage our objectives are too far apart.

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