Evidence on system-wide benefits for New Zealand’s health sector
Healthline is a free, nationwide, 24/7 health advice service that plays a vital role in Aotearoa New Zealand’s health system. Funded by Health New Zealand – Te Whatu Ora and delivered by Whakarongorau Aotearoa, the service provides confidential clinical advice via phone and online channels, connecting people with registered nurses, paramedics, and trained health advisors. In a health system facing sustained pressure on emergency departments, primary care access, and workforce capacity, understanding the value of services such as Healthline is increasingly important for policy and funding decisions.
Sapere was engaged by Whakarongorau Aotearoa in 2023 to estimate the economic value of Healthline from a system-wide perspective. This is a re-issue of our 2023 report.
Why estimating Healthline’s value matters
Healthline operates at the intersection of primary care, urgent care, and emergency services. Its value does not lie solely in call volumes or operating costs, but in how it influences downstream demand across the wider health system. For policymakers and funders, this raises critical questions:
- Does Healthline reduce avoidable use of higher-cost services?
- Does it support more appropriate and timely care?
- How does it contribute to equity of access, particularly for people facing barriers to in-person care?
- What is the overall return on investment when system effects are considered?
Sapere’s analysis addresses these questions by quantifying Healthline’s impact across multiple parts of the health system rather than assessing it in isolation.
What Sapere analysed
The report estimates the economic value of Healthline by comparing outcomes with and without the service, focusing on how Healthline influences user decisions and health system utilisation. The analysis considers:
- avoided or deferred emergency department presentations
- changes in GP and after-hours service use
- redirection to more clinically appropriate services
- impacts on ambulance use and urgent care
- broader system cost implications arising from these changes
The modelling adopts a conservative approach, drawing on available evidence, stakeholder data, and behavioural assumptions to estimate net system benefits.
“Healthline is a high-performing, indispensable component of Aotearoa’s health infrastructure. It delivers substantial economic returns, alleviates pressure on primary care, improves access and equity for priority populations, and ensures appropriate use of urgent care.”
– Sapere
Key findings from the re-issued analysis
The re-issued report confirms that Healthline delivers substantial net value to the New Zealand health system.
Key findings include:
- Healthline generates benefits that significantly exceed its operating costs when system-wide impacts are considered.
- A large share of value arises from avoided higher-cost care, particularly emergency department presentations that can be safely managed elsewhere.
- Healthline supports better matching of need to service, improving efficiency across the system rather than simply shifting demand.
- The service plays a particularly important role outside standard GP hours and for populations with limited access to timely primary care.
Importantly, the analysis shows that Healthline’s value is highly sensitive to system context: its benefits increase when other parts of the system are under pressure.
Implications for health system decision-makers
As the New Zealand health system continues to face workforce constraints, rising demand, and fiscal pressure, services that improve navigation and triage will become increasingly important.
The findings suggest that:
- Telehealth and clinical advice services should be assessed on system performance, not unit costs alone.
- Investment decisions should account for avoided costs and demand smoothing effects, particularly in emergency and urgent care.
- Healthline represents a form of infrastructure for system efficiency, not just a call centre function.
These insights are relevant for Health New Zealand, Manatū Hauora, and agencies involved in service commissioning, funding prioritisation, and system design.
Read more about our work with Whakarongorau Aotearoa where we conducted a Social Return on Investment (SROI) of the mental health helpline.
Our team included
How can Sapere help your organisation?
Sapere can assess the system-wide value of health services, model demand impacts across care settings, and support evidence-based funding and commissioning decisions.
