Nearly 300 extra hospital beds will be needed to cater for an estimated 30,000 more hospital admissions annually across the region by 2031.
The Illawarra Shoalhaven Local Health District also expects to see 120 more presentations to its hospital emergency departments per day in the next 10 years.
Meantime the district will be required to cater for an estimated 65,000 more obese adults and 27,000 more adults living with diabetes or high blood sugar.
This week the district released its 10-year plan to help meet the expected increase in demand - and to make changes to ease the pressure on the region's hospitals.
ISLHD Caroline Langston said the plan, It's your health that matters: Health Care Services Plan, represented a shift in perspective.
Rather than focusing just on inpatient hospital care, the health system of the future would reorient services to outpatient, home and community-based settings.
"The aim is to keep people as well and healthy as possible, to provide services where they live and work, to prevent those unplanned presentations and admissions to hospital where possible," she said.
"So we will need to strengthen our links with community and primary health providers to improve services across the board."
Ms Langston said the plan, from 2020 to 2030, was finalised after extensive consultation with community members, partner organisations and other stakeholders.
A clear message was the need to better protect population groups which typically experienced worse health and well-being.
"A major focus of the plan therefore is to better support more vulnerable people," Ms Langston said.
"For instance we want to work even harder to support mothers and babies and fathers in the first 2000 days, which we know is critical to their future health.
"We know Aboriginal people continue to experience disadvantage and poorer health outcomes so we want to work with Aboriginal communities to change that.
"And we also want to help older people, especially those who live by themselves, to ensure they live well in and are connected with their communities."
Investment would continue in hospital infrastructure over the next decade, with redevelopments underway at both Shellharbour and Shoalhaven hospitals.
"A focus here is on how we design and shape hospitals that support better outpatient services and inpatient experiences," she said.
Better use of technology was also a focus of the new plan, Ms Langston said.
"Most people are now walking around with smartphones, so it's about how we can use this enabling technology to help people look after themselves better," she said.
To read the plan visit www.islhd.health.nsw.gov.au