Who and what decides you get public dental care?

Until recently it has been when you contact a public clinic for oral and/or dental care that mostly determined when you get an appointment, not how urgent your need for care, according to a report released by the Australian Institute of Health and Welfare.

A study using information from nearly 1,600 individual experiences of people reporting to public clinics in New South Wales and South Australia between 1999 and 2001 was aimed at developing an accurate method that could be used by reception staff to give priority to prospective dental patients based on need.

The report, Relative Needs Index Study South Australia and New South Wales, examines how to efficiently and fairly allocate those limited resources in the face of need for urgent dental services.

“The study used people’s self-reported symptoms and consequences of oral problems to predict the urgency with which they should be seen as judged by a dentist,” said report co-author, Professor John Spencer of The University of Adelaide.

Patients seeking ’emergency’ dental care were divided into those needing to be seen in less than 48 hours, 2-7 days, 8-13 days, and able to wait 14 days or more.

Only 36% needed to be seen in less than 48 hours. About 35% needed to be seen within 2-7 days, 10% needed to be seen in 8-13 days and 19% could wait 14 days or longer.

“We looked for reported experience of pain or other oral symptoms and how these affected people’s day-to-day living, which then helped to predict the urgency of dental care as judged by a public dentist,” said Professor Spencer.

“People’s experiences can be readily collected by receptionist staff and appropriate advice given about the urgency of their need for dental care.

“This leads to a fairer system than a ‘first come, first served’ approach. It also assists with more consistency in how requests for dental services are handled across public clinics and allows better management of appointments and clinic staff,” he said.

The report also documents ways of prioritising general dental services, where waiting times for an appointment are much longer, usually many months.

“The study has influenced some state public dental service procedures and these appear to be working very well. It is important that ways of improving dental service provision are explored as well as anticipating additional resources,” said Professor Spencer.