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Healthcare systems need a fair way of measuring the resources a patient needs for specific services, so that the service provider can obtain fair payment, and the payer can obtain a fair return on the payment. This is challenging for several reasons: need (the ability to benefit) is difficult to determine; the specific inputs required to deliver the benefit are imprecise; and the outcome will be influenced by many factors, both patient-related and contextual. In rehabilitation, the situation is particularly difficult because there are so many variables to take into account. Turner-Stokes et al (see page 146) have developed a measure …