Project objectives

With rising demand and costs of ambulance services, there is a need to develop approaches that capture the complexity of patients using ambulance services and reflect this in funding. This project was the first of a series that will lead to an activity based funding (ABF) model for NSW Ambulance. This initial project analysed cost drivers to develop a classification system for ambulance services.

NSW Health

Our approach

Data from NSW Ambulance’s computer-aided dispatch system, electronic medical records, patient health care records and aeromedical service were obtained for 4 years (2017–18 to 2020–21), for a longitudinal view and to smooth fluctuations due to COVID-19.

Process mapping and workshops were undertaken first, to understand the services. Through this, high level groupings of the services delivered by NSW Ambulance (product streams) were defined. Units of count (i.e. the basis on which an ambulance operation would be counted for the purposes of classification and hence funding) were also defined for the different product streams.

In the next stage, the quantitative data were used to develop classes based on resource use but maintaining clinical and business relevance. This involved linking data to create “episodes” for some of the streams (that is, merging all resources relating to an incident, including the initial call and dispatch of one or more ambulances to attend to the case). It also involved investigating the extent to which specific variables impacted resource use (for example, priority, the nature of the problem recorded by the call taker in the operations centre, and the clinical protocol(s) implemented by on-scene clinicians).


The project resulted in a draft classification system for ambulance services, to be tested and refined through a costing study in a subsequent project.

This is the first work of its kind in Australia, and internationally no other country has developed a classification system for ambulance services.

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