Association between patient age, geographical location, Indigenous status and hospitalisation for oral and dental conditions in Queensland, Australia
Liam Caffery A C , Natalie Bradford A , Maria Meurer B and Anthony Smith AA Princess Alexandra Hospital, Ground Floor, Building 33, Woolloongabba, Qld 4102, Australia.
B Department of Pathology, Federal University of Santa Catarina, 88040-900 Florianópolis, SC, Brazil.
C Corresponding author. Email: l.caffery@coh.uq.edu.au
Australian Journal of Primary Health 23(1) 46-52 https://doi.org/10.1071/PY15105
Submitted: 2 July 2015 Accepted: 5 March 2016 Published: 15 July 2016
Abstract
A retrospective analysis of hospitalisation due to oral and dental conditions (ODC) was performed for patients in Queensland. The aim was to identify the rate and cost of hospitalisation and to examine the association between hospitalisation and age, geographical location and Indigenous status. There were 81 528 admissions to Queensland’s hospitals due to ODC during the 3-year study period (2011–2013). The annual cost of ODC-related hospitalisation was estimated to be AU$87 million. Indigenous infants (Z = 4.08, P < 0.001) and primary school children (Z = 2.01, P = 0.046) were significantly more likely to be hospitalised than their non-Indigenous counterparts. A non-Indigenous high school child was almost fourfold more likely to be hospitalised. There was no significant difference in the rate of hospitalisation for adults. Infants (Z = 6.70, P < 0.001) and primary school children (Z = 8.73, P < 0.001) from remote areas were significantly more likely to be hospitalised than their age-matched metropolitan counterparts. Whereas high school children (Z = 2.74, P = 0.006) and adults (Z = 6.02, P < 0.001) from remote areas were significantly less likely to be hospitalised. Our findings suggest that there is a need for alternative models of primary dental care to service remote areas of Queensland and Indigenous populations. Strategies that enable Indigenous Health Workers to provide dental care, and the use of teledentistry, are models of care that may reduce potentially preventable hospitalisations and lead to cost savings and better health outcomes.
Additional keywords: dental disease, healthcare disparities.
References
Alsharif AT, Kruger E, Tennant M (2014) Disparities in dental insurance coverage among hospitalised Western Australian children. International Dental Journal 64, 252–259.| Disparities in dental insurance coverage among hospitalised Western Australian children.Crossref | GoogleScholarGoogle Scholar | 24835791PubMed |
Alsharif AT, Kruger E, Tennant M (2015a) Dental hospitalization trends in Western Australian children under the age of 15 years: a decade of population-based study. International Journal of Paediatric Dentistry 25, 35–42.
| Dental hospitalization trends in Western Australian children under the age of 15 years: a decade of population-based study.Crossref | GoogleScholarGoogle Scholar | 24460665PubMed |
Alsharif AT, Kruger E, Tennant M (2015b) A population-based cost description study of oral treatment of hospitalized Western Australian children aged younger than 15 years. Journal of Public Health Dentistry 75, 202–209.
| A population-based cost description study of oral treatment of hospitalized Western Australian children aged younger than 15 years.Crossref | GoogleScholarGoogle Scholar | 25740273PubMed |
Australian Bureau of Statistics (2011) Census 2011. Available at http://www.abs.gov.au/census [Verified February 2016]
Australian Dental Association (2012) Tooth decay – Australia’s most prevalent health condition. Australian Dental Association, Sydney, Australia.
Australian Health Ministers’ Advisory Council (2012) Aboriginal and Torres Strait Islander Health Performance Framework 2012 Report. Australian Health Ministers’ Advisory Council, Canberra, Australia.
Australian Institute of Health and Welfare (2013) Dentist Workforce. Australian Institute of Health and Welfare, Canberra, Australia.
Australian Institute of Health and Welfare (2014) Oral health and dental care in Australia: key facts and figures trends 2014. Australian Institute of Health and Welfare, Canberra, Australia.
Australian Institute of Health and Welfare (2015). Rural, Remote and Metropolitan Areas (RRMA) classification. Available at http://www.aihw.gov.au/rural-health-rrma-classification/ [Verified October 2015]
Bradley M, Black P, Noble S, Thompson R, Lamey PJ (2010) Application of teledentistry in oral medicine in a community dental service, N. Ireland. British Dental Journal 209, 399–404.
| Application of teledentistry in oral medicine in a community dental service, N. Ireland.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC3cbhtlahtw%3D%3D&md5=3ba2b6a13eb87564cdcc81b3ed8bc1f7CAS | 20966999PubMed |
Campbell MA, Hunt J, Walker D, Williams R (2015) The oral health care experiences of NSW Aboriginal Community Controlled Health Services. Australian and New Zealand Journal of Public Health 39, 21–25.
| The oral health care experiences of NSW Aboriginal Community Controlled Health Services.Crossref | GoogleScholarGoogle Scholar | 25560833PubMed |
Christian B, Blinkhorn AS (2012) A review of dental caries in Australian Aboriginal children: the health inequalities perspective. Rural and Remote Health 12, 2032
da Costa MG, Pazzini CA, Pantuzo MCG, Jorge MLR, Marques LS (2013) Is there justification for prophylactic extraction of third molars? A systematic review. Brazilian Oral Research 27, 183–188.
| Is there justification for prophylactic extraction of third molars? A systematic review.Crossref | GoogleScholarGoogle Scholar |
Daniel SJ, Wu L, Kumar S (2013) Teledentistry: a systematic review of clinical outcomes, utilization and costs. Journal of Dental Hygiene 87, 345–352.
Dental Statistics and Research Unit (2007) Australia’s dental generations: the national survey of adult oral health 2004–06. Australian Institute of Health and Welfare, Canberra, Australia.
Estai M, Kruger E, Tennant M (2016) Role of telemedicine and mid-level dental providers in expanding dental-care access: potential application in rural Australia. International Dental Journal
| Role of telemedicine and mid-level dental providers in expanding dental-care access: potential application in rural Australia.Crossref | GoogleScholarGoogle Scholar | 26846683PubMed |
Ha DH, Amarasena N, Crocombe L (2013) The dental health of Australia’s children by remoteness: Child Dental Health Survey Australia 2009. Australian Institute of Health Welfare, Canberra, Australia.
Hallett KB, O’Rourke PK (2006) Caries experience in preschool children referred for specialist dental care in hospital. Australian Dental Journal 51, 124–129.
| Caries experience in preschool children referred for specialist dental care in hospital.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD28vis1aitQ%3D%3D&md5=3e9cc12fa24018e3dc624b2ac9426b44CAS | 16848259PubMed |
Hayman NE, White NE, Spurling GK (2009) Improving Indigenous patients’ access to mainstream health services: the Inala experience. The Medical Journal of Australia 190, 604–606.
Hopcraft M, Chow W (2007) Dental caries experience in Aboriginal and Torres Strait Islanders in the Northern Peninsula Area, Queensland. Australian Dental Journal 52, 300–304.
| Dental caries experience in Aboriginal and Torres Strait Islanders in the Northern Peninsula Area, Queensland.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD1c7gvVaiuw%3D%3D&md5=b4e5980bd5f0eae68cab020a19daceacCAS | 18265686PubMed |
Independent Hospitals Pricing Authority (2013). National efficient price determination 2013–2014. Independent Hospitals Pricing Authority, Sydney, Australia.
Jamieson L, Armfield JM, Roberts-Thomson KF (2007) Oral health of Aboriginal and Torres Strait Islander children. Dental statistics and research series 35. Catalogue number DEN 167. (AIHW: Canberra) Available at http://www.aihw.gov.au/publication-detail/?id=6442468050 [Verified 12 May 2016]
Kruger E, Tennant M (2015) Ten years of hospitalisation for oral health-related conditions in Western Australia: an unjust dichotomy. Australian Journal of Primary Health
| Ten years of hospitalisation for oral health-related conditions in Western Australia: an unjust dichotomy.Crossref | GoogleScholarGoogle Scholar | 26509207PubMed |
Kruger E, Dyson K, Tennant M (2006) Hospitalization of Western Australian children for oral health related conditions: a 5–8 year follow-up. Australian Dental Journal 51, 231–236.
| Hospitalization of Western Australian children for oral health related conditions: a 5–8 year follow-up.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD28ngsFGhuw%3D%3D&md5=851f7cd330bcbc6499d33b0f235c0b86CAS | 17037889PubMed |
Madan C, Kruger E, Perera I, Tennant M (2010) Trends in demand for general anaesthetic care for paediatric caries in Western Australia: geographic and socio-economic modelling of service utilisation. International Dental Journal 60, 190–196.
Marino R, Ghanim A (2013) Teledentistry: a systematic review of the literature. Journal of Telemedicine and Telecare 19, 179–183.
Mettes TG, Ghaeminia H, Nienhuijs MEL, Perry J, van der Sanden WJM, Plasschaert A (2012) Surgical removal versus retention for the management of asymptomatic impacted wisdom teeth. Cochrane Database of Systematic Reviews 13, CD003879
| Surgical removal versus retention for the management of asymptomatic impacted wisdom teeth.Crossref | GoogleScholarGoogle Scholar |
Petersen PE (2003) The World Oral Health Report 2003: continuous improvement of oral health in the 21st century – the approach of the WHO Global Oral Health Programme. Community Dentistry and Oral Epidemiology 31, 3–23.
Petersen PE, Kwan S (2011) Equity, social determinants and public health programmes–the case of oral health. Community Dentistry and Oral Epidemiology 39, 481–487.
| Equity, social determinants and public health programmes–the case of oral health.Crossref | GoogleScholarGoogle Scholar | 21623864PubMed |
Queensland Government Statistician’s Office (2014) Population estimates by Indigenous status. Available at http://www.qgso.qld.gov.au/products/tables/synthetic-pop-est-indigenous-status/index.php [Verified February 2016]
Queensland Health (2014) Queensland hospital and health service maps. Available at http://www.health.qld.gov.au/maps/ [Verified February 2016]
Slack-Smith L, Colvin L, Leonard H, Kilpatrick N, Bower C, Brearley Messer L (2009) Factors associated with dental admissions for children aged under 5 years in Western Australia. Archives of Disease in Childhood 94, 517–523.
| Factors associated with dental admissions for children aged under 5 years in Western Australia.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD1MvivV2huw%3D%3D&md5=193b28123a52d2900d843cf220cc43a8CAS | 19060007PubMed |
Slack-Smith LM, Read AW, Colvin LJ, Leonard H, Kilpatrick N, McAullay D, Messer LB (2011) Total population investigation of dental hospitalizations in indigenous children under five years in Western Australia using linked data. Australian Dental Journal 56, 358–364.
| Total population investigation of dental hospitalizations in indigenous children under five years in Western Australia using linked data.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC387is1Onuw%3D%3D&md5=98d05f5becbc3e2276e7becbca8f8b53CAS | 22126344PubMed |
Slack-Smith L, Colvin L, Leonard H, Kilpatrick N, Read A, Messer LB (2013) Dental admissions in children under two years–a total-population investigation. Child: Care, Health and Development 39, 253–259.
| Dental admissions in children under two years–a total-population investigation.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC38vivVGmsA%3D%3D&md5=14d63ed8159f3a83fbc098eb37fdc3a0CAS |
Tennant M, Namjoshi D, Silva D, Codde J (2000) Oral health and hospitalization in Western Australian children. Australian Dental Journal 45, 204–207.
| Oral health and hospitalization in Western Australian children.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3crhtVCmsg%3D%3D&md5=1d15ca6746da1b9819c0a48095452f0cCAS | 11062939PubMed |
Walker D, Tennant M, Short SD (2013) An exploration of the priority remote health personnel give to the development of the Indigenous Health Worker oral health role and why: unexpected findings. The Australian Journal of Rural Health 21, 274–278.
| An exploration of the priority remote health personnel give to the development of the Indigenous Health Worker oral health role and why: unexpected findings.Crossref | GoogleScholarGoogle Scholar | 24118150PubMed |
Zander A, Sivaneswaran S, Skinner J, Byun R, Jalaludin B (2013) Risk factors for dental caries in small rural and regional Australian communities. Rural and Remote Health 13, 2492