Eighth International Conference on Emergency Medicine, Boston, Massachusetts, USA, 4–7 May 2000

This oral presentation explains the scientific basis of the current HRG version based on disposal codes and work in hand to further refine the HRG in six sites in the UK before June 2000. The refinement sites are studying the impact of the nationally agreed 5 point triage scale, time in the department,and certain procedural cost drivers, for example, thrombolytics and expensive radiographic investigations such as IVU, and computed tomography. The nationally agreed cost model will be displayed, as will a template spread sheet for calculating prospective payments. The HRG profiles for di V erent departments will be displayed and the implications discussed. HRG profiling can be used for work force planning, identifying service requirements by geographical postcodes, monitoring the changing pattern of referrals to the department by family or general practitioners, monitoring the training and work rate of jun-ior doctors and nurse practitioners. The limitations of HRGs will also be considered.