Hospital admissions and emergency department presentations for dental conditions indicate access to hospital, rather than poor access to dental health care in the community
Matthew Yap A , Mei-Ruu Kok A , Soniya Nanda B , Alistair Vickery A and David Whyatt A CA School of Medicine, Faculty of Health and Medical Sciences, University of Western Australia, M706, 35 Stirling Highway, Crawley, WA 6009, Australia.
B Department of Health, Western Australia, 189 Royal Street, East Perth, WA 6004, Australia.
C Corresponding author. Email: david.whyatt@uwa.edu.au
Australian Journal of Primary Health 24(1) 74-81 https://doi.org/10.1071/PY17044
Submitted: 11 April 2017 Accepted: 29 August 2017 Published: 21 November 2017
Abstract
High rates of dental-related potentially preventable hospitalisations are thought to reflect poor access to non-hospital dental services. The association between accessibility (geographic and financial) to non-hospital dentists and potentially preventable hospitalisations was examined in Western Australia. Areas with persistently high rates of dental-related potentially preventable hospitalisations and emergency department (ED) presentations were mapped. Statistical models examined factors associated with these events. Persistently high rates of dental-related potentially preventable hospitalisations were clustered in metropolitan areas that were socioeconomically advantaged and had more dentists per capita (RR 1.06, 95% CI 1.04–1.08) after adjusting for age, sex, socioeconomics, and Aboriginality. Persistently high rates of ED presentations were clustered in socioeconomically disadvantaged areas near metropolitan EDs and with fewer dentists per capita (RR 0.91, 0.88–0.94). A positive association between dental-related potentially preventable hospitalisations and poor (financial or geographic) access to dentists was not found. Rather, rates of such events were positively associated with socioeconomic advantage, plus greater access to hospitals and non-hospital dental services. Furthermore, ED presentations for dental conditions are inappropriate indicators of poor access to non-hospital dental services because of their relationship with hospital proximity. Health service planners and policymakers should pursue alternative indicators of dental service accessibility.
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