Project objectives

The project arose out of a review of emergency classifications for Australia, which concluded that the classifications that were used for funding emergency care in Australia – Urgency Related Groups (URG) and Urgency Disposition Groups (UDG) – were not suitable for ongoing use due to the reliance on triage (urgency) as a key classification variable. There was also a strong interest in moving to a classification with better markers of complexity and enhanced clinical utility using diagnoses.

Independent Hospital Pricing


Our approach

Our approach involved three major components: the conduct of a detailed costing study to investigate costs associated with emergency care (the ‘costing study’); the development of a new patient-based classification system for emergency care (the AECC); and specifications for modifications and enhancements to emergency care data collections required to support the new classification.

Ten emergency departments across Australia participated in the study, representative of the different sizes and roles of emergency departments. Through the study more detailed patient and emergency stay characteristics than those available through routine national minimum data sets were collected. They include additional factors potentially leading to higher costs of patients (e.g. inability to self-care, homelessness, distress/ confusion/ agitation requiring one-to-one nursing). Also, to help with the costing, additional information was collected by sites on the time clinicians spent in providing care and treatment to individual patients, and in undertaking activities associated with patient care. Barcode scanning was used to collect this information.

HPA compiled the data and developed site-specific relative value units for sites to cost their activity and provide this information for classification development. In some instances, HPA undertook the costing for the sites.

We also undertook a consensus study with clinicians to estimate of the time required to undertake typical procedures and activities undertaken in emergency departments. The study included estimations by medical, nursing and individual allied health disciplines. The result of the consensus study was used to validate the times captured through the empirical study and address gaps.

HPA used the results of the costing study to develop the AECC.

The assignment was a complex, multi-year, multi-stage project, with complexities in project governance, significant stakeholder engagement and complex data collection and analysis.

Overall, 10 hospitals participated in the study, along with almost 1,000 clinicians. It took in over 65,000 patient records and millions of patient interactions for analysis.


The project produced the AECC, which is currently being used for funding emergency departments across Australia.

The AECC moved Australia away from relying on triage and whether the patient is subsequently admitted to hospital or discharged home following treatment for funding emergency care and given more prominence to the patient’s diagnosis.

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