The objective of this proposal is to develop improved estimates of health care expenditures for small geographic areas and to document their use in health care planning. Previous expenditure estimates included monies spent for service provided in a area, not necessarily monies spent by or on behalf of the residents of that area. The unique feature of the proposed estimates is that they will represent monies actually spent by or on behalf of area residents regardless of where the service is rendered. Estimates developed in such a manner facilitate population based planning by integrating financial data with other demographic and health service utilization characteristics of the population under study. Unless financial data are linked with various types of population based data, reasons for differences in expenditure patterns between areas or over time cannot be examined. Hence, while analysis of expenditure data alone can be useful for identifying potential problems or opportunities in a local health care system, it is of limited use to the planner who must also understand the underlying determinants of these expenditures. Under this grant we propose to study the development and use of expenditure profiles in a nine-county (Finger Lakes Health Systems Agency (FLHSA) region. The proposed expenditure profiles will have a number of applications to health care planning. They will: 1) provide a baseline upon which to monitor growth and redistribution of services among health care sectors in an area; 2) enable intra- and inter-regional comparisons; and 3) facilitate analysis of the impact of cost containment strategies within a defined area. The approaches used will apply not only to the FLHSA region but to other HSA regions as well. The estimation techniques proposed emphasize data collection from secondary sources wherever possible. These same or similar sources are usually available to all HSAs. The project, therefore, contributes not only to the future of planning in the FLHSA region but to the development of planning methodologies necessary to all HSAs in the U.S.