National dental waitlists: what would it take to reset to zero?
Yevgeni Dudko A , Estie Kruger A B and Marc Tennant AA International Research Collaborative – Oral Health and Equity, School of Anatomy, Physiology and Human Biology, The University of Western Australia, 35 Stirling Highway, Nedlands, WA 6009, Australia. Email: impact@wn.com.au; marc.tennant@uwa.edu.au
B Corresponding author. Email: estie.kruger@uwa.edu.au
Australian Health Review 40(3) 277-281 https://doi.org/10.1071/AH15025
Submitted: 10 February 2015 Accepted: 17 July 2015 Published: 14 September 2015
Journal Compilation © AHHA 2016
Abstract
Objective Over the years, long public dental waitlists across Australia have received much attention from the media. The issue for eligible patients, namely a further deterioration of dental health because of not being able to address dental concerns relatively quickly, has been the subject of several state and Federal initiatives. The present study provides a cost model for eliminating public dental waitlists across Australia and compares these results with the cost of contracting out public dental care to private clinics.
Methods Waitlist data from across Australia were collected from publicly available sources and confirmed through direct communication with each individual State or Territory Dental Health body. Average costs associated with employing key dental personnel and performance figures were used from previously published data to estimate the potential financial commitment and probable public benefits.
Results The cost model suggests that, on average, it would be more than twice as expensive to contract the work out to private dental clinics as to treat eligible patients within public dental clinics. It is estimated that the cost of eliminating the legacy dental waiting lists (over 12 months) would be between A$50 and A$100 million depending on the method adopted. The effort would require some 360 dental teams.
Conclusion The design of the Australian public dental care system that is targeted at meeting the needs of eligible patients into the future, in addition to being effective and sustainable, must also offer a level of protection to the taxpayer. The ability to address waitlist backlog identified in the present study clearly would require a mix of service models depending on service availability at different locations. Further research is needed to optimise the mix of service providers to address community needs.
What is known about the topic? Long public dental waitlists across Australia have received much attention from the media. The topic has been the subject of debate at the government level and, over the years, has seen an increase in allocation of public funds in an effort to address the policy needs.
What does this paper add? This study calculates the actual number of people on the public dental waitlist, provides a detailed analysis of the distribution of the demand for the services and offers a cost model for resetting public dental waitlists across Australia.
What are the implications for practitioners? This study carries no implications for individual practitioners at the clinical level. However, at the state and national levels, this model offers direction to a more cost-effective allocation of public funds and human resources.
References
[1] Biggs A. Overview of Commonwealth involvement in funding dental care. Canberra: Parliament of Australia; 2008. Available at: http://www.aph.gov.au/About_Parliament/Parliamentary_Departments/Parliamentary_Library/pubs/rp/rp0809/09rp01[2] Lam R, Kruger E, Tennant M. Experiences in the implementation of a national policy: a retrospective analysis of the Australian Chronic Dental Disease Scheme. Australas Med J 2012; 5 551–9.
| Experiences in the implementation of a national policy: a retrospective analysis of the Australian Chronic Dental Disease Scheme.Crossref | GoogleScholarGoogle Scholar | 23173020PubMed |
[3] Kruger E, Tennant M, George R. Application of geographic information systems to the analysis of private dental practices distributed in Western Australia. Rural Remote Health 2011; 11 1736
| 21843026PubMed |
[4] Tennant M, Kruger E. A national audit of Australian dental practice distribution: do all Australians get a fair deal? Int Dent J 2013; 63 177–82.
| A national audit of Australian dental practice distribution: do all Australians get a fair deal?Crossref | GoogleScholarGoogle Scholar | 23879252PubMed |
[5] Dental Health Services. Eligibility information for adults. 2008. Available at: http://www.dental.wa.gov.au/adult/eligibility.php [verified 10 July 2014].
[6] Lalloo R, Kroon J. Analysis of public dental service waiting lists in Queensland. Aust J Prim Health 2015; 21 27–31.
| Analysis of public dental service waiting lists in Queensland.Crossref | GoogleScholarGoogle Scholar | 23927861PubMed |
[7] Chu CH, Lo ECM. Patients’ satisfaction with dental services provided by a university in Hong Kong. Int Dent J 1999; 49 53–9.
| Patients’ satisfaction with dental services provided by a university in Hong Kong.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3czksFKrtA%3D%3D&md5=6ead4a42aef24b6d0b65bb4d87fb81edCAS | 10887474PubMed |
[8] Queensland implementation plan. National Partnership Agreement on treating more public dental patients. Parkes: Council of Federal Financial Relations; 2013. Available at: http://www.federalfinancialrelations.gov.au/content/npa/health_service/public_dental/QLD_dental_patients.pdf [verified 30 April 2015].
[9] Dudko Y, Kruger E, Tennant M. Is mix of care influenced by the provider environment? A comparison of four care pathways in oral health. Aust Health Rev 2015; 39 51–55.
| Is mix of care influenced by the provider environment? A comparison of four care pathways in oral health.Crossref | GoogleScholarGoogle Scholar |
[10] Gutacker N, Harris A, Brennan D, Hollingsworth B. The determinants of dentists’ productivity and the measurement of output. Soc Sci Med 2015; 124 76–84.
| The determinants of dentists’ productivity and the measurement of output.Crossref | GoogleScholarGoogle Scholar | 25461864PubMed |
[11] Australian Dental Association. The Australian Schedule of Dental Services and Glossary. 2013. Available at: http://www.ada.org.au/app_cmslib/media/lib/1303/m538110_v1_10th%20editon%20schedule%20and%20glossary_web.pdf [verified 16 February 2014].
[12] Open Universities Australia. Career advice: dental practitioners. Melbourne: Open Universities Australia; 2014. Available at: http://www.open.edu.au/careers/healthcare-medical-pharmaceuticals/dental-practitioners [verified 15 November 2014].
[13] Open Universities Australia. Career advice: dental assistants. Melbourne: Open Universities Australia; 2014. Available at: http://www.open.edu.au/careers/healthcare-medical-pharmaceuticals/dental-assistants [verified 15 November 2014].
[14] Australian Dental Association. ‘Dental access’ proposal. Proposal to the Australian Government for a scheme to assist disadvantaged Australians obtain improved access to dental care. St Leonards: Australian Dental Association; 2009. Available at: http://www.ada.org.au/app_cmslib/media/lib/1108/m329081_v1_dental%20access%20proposal.pdf [verified 26 April 2015].
[15] Armfield J, Brennan D, Carter K, Chalmers J, Kriven S, Stewart J, Szuster F, Mathew R, Narayanan A, Slade G, Roberts-Thomson K, Spencer AJ , editors. Patterns of dental service provision in general practice. DSRU Newsl 1998; IX. Available at: https://www.adelaide.edu.au/arcpoh/downloads/publications/newsletters/newsletter-IX-no-1.pdf [verified 10 February 2014].
[16] Australian Dental Association. Inquiry into adult dental services in Australia. St Leonards: Australian Dental Association; 2013. Available at: http://www.ada.org.au/App_CmsLib/Media/Lib/1304/M578038_v1_635018044353624420.pdf [verified 26 April 2015].
[17] Cotti E, Dessi C, Piras A, Mercuro G. Can a chronic dental infection be considered a cause of cardiovascular disease? A review of the literature. Int J Cardiol 2011; 148 4–10.
| 20851474PubMed |
[18] Biggs A. The proposed Denticare scheme: an overview. Canberra: Parliament of Australia; 2009. Available at: http://www.aph.gov.au/About_Parliament/Parliamentary_Departments/Parliamentary_Library/pubs/BN/0910/Denticare#_Toc246729292 [verified 29 January 2015].
[19] Ponnusamy A, Monty R, Alam N, Kruger E, Tennant M. Three year retrospective analysis of computer-assisted emergency dental triage in Tasmania, Australia. Rural Remote Health 2013; 13 2353
| 1:STN:280:DC%2BC3svos1yjtg%3D%3D&md5=57c35e8793935e3a065281ac2e598ba4CAS | 23517439PubMed |