Project objectives

HPA has conducted several projects for jurisdictions for estimating relative need and/or equitable distribution of resources at a sub-state level. Most recently a project was completed for NSW Health, which aimed to develop ‘expected utilisation indices’ to inform health service planning and purchasing for Local Health Districts and local government areas. These needs-adjusted population funding models have been used in NSW and other jurisdictions over several decades.

Various clients

Our approach

The indices are based on modelling to determine measures that explain variation in relative need expressed as hospital or health service utilisation (adjusted for age/sex). These include: standardised mortality ratios, socio-economic indices, proportion of the population drawn from groups such as Aboriginal and Torres Strait Islander people or those from culturally and linguistically diverse communities. In the modelling, these independent variables are used as predictors of cost weighted activity and can be used to estimate the health needs of local health districts resident populations.



We have developed indices for a range of service streams, including:

  • acute admitted services, including separate indices for:
    • acute (core, excluding separate streams below)
    • maternity
    • renal dialysis
    • chemotherapy
  • emergency department
  • sub- and non- acute care
  • non-admitted care


These needs or expected utilisation indices are important in planning and purchasing decisions, particularly in ensuring that decisions about resource distribution of planned activity and facilities are underpinned by transparent mechanisms that assess the health needs of the populations served.

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