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Potentially Preventable Hospitalisations (PPH) is a widely used indicator of the effectiveness of non-hospital care. Specified using the International Classification of Diseases (ICD) coding, PPH comprises a suite of health conditions that could have potentially been prevented with appropriate care. The most recent edition of the National Guide to a Preventative Health Assessment for First Nations People documents the health conditions of interest to providers of primary care, many of which are not represented in PPH. Given the National Guide has been developed specifically with First Nations in mind, the aim of this research is twofold. The first aim is to formally posit the question of whether a summative measure of hospitalisations aligned diagnostically to the National Guide has value either as an alternative or complement to PPH in the context of First Nations primary health information. The second aim is to develop and present a prototype ICD-10 data specification for such a measure, referred to as the First Nations primary healthcare (FNPHC) data specification, and examine the age-standardised hospitalisation rates for FNPHC and PPH for correlations and/or differences. Age-standardised hospitalisation rates from 2016-17 to 2019-20 using both classifications were examined to assess the usefulness and relevance of summative measures of hospitalisations for informing primary care. Rates of FNPHC for principal diagnoses were between 1.5 and 2.5 times higher than those of PPH and approximately between 6 and 12 times higher for additional diagnoses. There was a strong correlation with PPH when rates were compared across all observations: jurisdictions with higher rates of PPH tended to have higher rates of hospitalisations according to the custom specification. Findings support its application as a summary measure for First Nations primary care providers. Given the policy landscape in Australia that aims to close the gap, it is imperative that measures of primary health take advantage of the concepts and application of First Nations data sovereignty and governance. The validity and cultural appropriateness of the First Nations primary health data specification needs to be further researched.

Since 2006, the Australian Aboriginal and Torres Strait Islander Health Performance Framework (HPF) reports have provided information about Indigenous Australians' health outcomes. The HPF was designed, in consultation with Indigenous stakeholder groups, to promote accountability and inform policy and research. This paper explores bridging the HPF as a theoretical construct and the publicly available data provided against its measures. A whole-of-framework, whole-of-system monitoring perspective was taken to summarise 289 eligible indicators at the state/territory level, organised by the HPF's tier and group hierarchy. Data accompanying the 2017 and 2020 reports were used to compute improvement over time. Unit change and confidence indicators were developed to create an abstract but interpretable improvement score suitable for aggregation and visualisation at scale. The result is an exploratory methodology that summarises changes over time. An example dashboard visualisation is presented. The use of secondary data inevitably invites acknowledgments of what analysis cannot say, owing to methods of collection, sampling bias, or unobserved variables and the standard mantra regarding correlation not being causation (though no attempt has been made here to infer relationships between indicators, groups, or tiers). The analysis presented questions the utility of the HPF to inform healthcare reform.