Costly chronic diseases: a retrospective analysis of Chronic Disease Dental Scheme expenditure
Leonard A. Crocombe A B , Jennifer Kraatz A C , Ha Hoang A D , Daiyi Qin A and Diana Godwin AA Centre for Rural Health, School of Health Sciences, The University of Tasmania, Locked Bag 1372, Launceston, Tas. 7250, Australia. Email: Jennifer.Kraatz@utas.edu.au; davidqin2005@hotmail.com; Diana.Godwin@utas.edu.au
B Australian Research Centre for Population Oral Health, School of Dentistry, Level 1, 122 Frome Street, The University of Adelaide, Adelaide, SA 5005, Australia. Email: leonard.crocombe@adelaide.edu.au
C Oral Health Services Tasmania, Tasmanian Department of Health and Human Services, Northern Dental Centre, Kelham Street, Launceston, Tas. 7250, Australia.
D Corresponding author. Email: Thi.Hoang@utas.edu.au
Australian Health Review 39(4) 448-452 https://doi.org/10.1071/AH14191
Submitted: 21 October 2014 Accepted: 19 December 2014 Published: 23 February 2015
Abstract
Objective The aim of the present study was to investigate Medicare rebate claim trends under the Australian Chronic Disease Dental Scheme (CDDS) over time, region and type of service.
Methods CDDS data obtained from the Department of Human Services reflected all Medicare item claims lodged under the CDDS by dental practitioners and processed by Medicare. Retrospective analysis of CDDS rebate claims was conducted.
Results The CDDS rebates for the period 2008–13 totalled A$2.8 billion. Just under 81% of claims were from dental practitioners working in major cities. The most frequent rebates were for crown, bridge and implant (32.4%), removable prostheses (22.4%) and restorative services (21.3%). The rebate claims of restorative services, crown and bridge, and removable prostheses per dentist in all regional areas increased over the time of the CDDS. Per capita, the rebates for every type of dental service were lower in the more remote regions.
Conclusions Rebate claims increased in each of the last 3 full years of the CDDS across all areas. The majority of Medicare rebate claims were from major city areas and for crown and bridge, removable prostheses and restorative services. The service mix varied between regions.
What is known about the topic? The CDDS was described as ‘unsustainable’ from the governmental budgetary perspective, being controversial around the value of the program, ‘poorly targeted’ and having implementation and administrative requirement shortfalls.
What does this paper add? The CDDS rebates for the period 2008–13 totalled A$2.8 billion, with just under 81% of claims from dental practitioners working in major cities. The services with the highest rebate claims were crown and bridge, removable prostheses and restorative services.
What are the implications for practitioners? In future such schemes, the type of services offered could be reviewed regularly by policymakers in order to control item expenses. The take-up of Government dental schemes may be slow to start, but will tend to increase rapidly over the life of the scheme.
Additional keywords: dental health, oral epidemiology, rural health, utilisation of health services.
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