Personalised welfare services

1. Personalised Welfare Services
Towards better metrics
Stefan Hajkowicz

2. Evicted 1887, Blandford Fletcher
Queensland Art Gallery

3. 7000
6000
5000
4000
3000
2000
1000
0
1980 1985 1990 1995 2000 2001 2002 2003 2004 2005
Total OECD (2005 USD Billions).
120
100
80
60
40
20
0
Total Australia (2005 USD Billions).
OECD (30 countries)
Australia

4. Double income,
one child, stable
family - gets baby
bonus
Customer Centric Welfare Services
The national queue of 7 million customers
85% of customers ? 15% of customers ?
Unemployed, homeless, 2 kids, no
support network – gets crisis payments,
disability support pension …

5. Trigger Points

6. Quality Adjusted Life Years
0.46
0.61
0.61
0.58
0.56
Speech
Hearing
Vision
Ambulation
Dexterity
Pain
Emotion
Most important
Utility (year i) = 1.371(b1b2b3b4b5b6b7b8) - 0.371
Preferences
for HUI13
drawn from
a random
sample of
adults living
in the City of
Hamilton,
Canada.
0.42
0.55
0.68
Cognition
QALY = Net present value of utilities in each year
Least
important
0.0 (Death) 1.0 (Perfect Health)

7. WSBI
Welfare Services Benefits Index
Education and skills
Employability
Accommodation security
Personal security
Mental health
Physical health
Personal relationships
Social inclusion
Social cohesion

8. The Research Team

9. Dr Stefan Hajkowicz Dr Claire Mason
Dr Dana Bradford
Dr Anneleise Spinks Dr Sharon Dane Dr Liz Hobman
PhD Students: Greg Hall; Sue Moore

11. A Decision Model to Target
Intensive Support

13. A Multi Criteria Decision Model
Weights w1 w2 w3 wm
Option 1
Option 2
Option 3
Option n
Criterion 1
Criterion 3
Criterion 2
Criterion m
x1,1
x1,2
x1,3
x1,n
x2,1
x2,2
x2,3
x2,n
x3,1
x3,2
x3,3
x3,n
xm,1
xm,2
xm,3
xm,n
Utility Function
Performance
scores
v1
v2
v3
v4
Policy Objectives

14. Ratio of total population to Centrelink social worker staff
Population growth rate (% per year)
Accommodation
security
Households (per 1000) receiving rent assistance
Households (per 1000) rented under public housing schemes
Households (per 1000) with mortgage repayment stress
Households (per 1000) with rental payment stress
Service
gap
Average distance (kilometres) to service point from households
Employment
Unemployment rate (persons per 1000 of population)
Persons (per 1000) receiving an unemployment benefit
Number of persons (per 1000) receiving long term,
>180 days, unemployment benefit
Income stress
Age pensioners (per 1000 of population)
Disability support pensioners (per 1000 of population)
Female sole parent pensioners (per 1000 of population)
Children in low income families (per 1000 of population)
Investment
priority
Ratio of total population to Centrelink customer service staff
Average personal income ($/year)
Carers providing support to another person (per 1000 of population)

15. Children in low income families (per 1000 of population)
Health
Attendance at secondary school by age 16 (per 1000 of population)
Mental
Physical
Persons (per 1000) with high or very high
psychological distress
Persons (per 1000) with mental and
behavioural problems
Number of suicides (per 1000 of population)
Number of avoidable mortalities (per 1000 of population)
Involvement
in society
Households (per 1000) with internet connection
Persons (per 1000) not proficient in English
Persons (per 1000) working in voluntary community groups
Education
Participation in vocational & educational training (per 1000 of population)
Social
need
Carers providing support to another person (per 1000 of population)
Persons (per 1000) obese or overweight
Persons (per 1000) subject to physical inactivity
Persons (per 1000) with alcohol abuse
Persons (per 1000) smoking

16. The Decision Model

17. Benefit Cost Analysis of
Intensive Support

18. Outcome Estimates – Expert Judgments

19. Benefit Cost Ratios - Histogram

20. Sensitivity to Outcome Optimism

21. The Next Things We’re Working to Solve
1. Evidence base for Treatment-Response
2. Design a WSBI (with social preferences)
3. Identify and characterize trigger points

23. Thank You