August 2014 Commonwealth of Australia 2014



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Differences in oral health outcomes and services


The workforce planning projections demonstrate extra capacity exists within the oral health workforce. This section briefly outlines demand for oral health services and barriers that describe inequalities in service access. This is not a comprehensive review or discussion. More detailed analysis and discussion can be found in references cited in this publication, and work published by the Australian Institute of Health and Welfare’s Dental Statistics Unit and the Adelaide University’s ARCPOH.

Demand for oral health services


Demand for dental care reflects people’s want or desire for dental care and willingness to pay at market prices. Demand is expressed through the use of dental services and hence can be measured in dental visits made and services received in a year.14

Figures 5 and 6 demonstrate increasing demand for oral health services. Figure 5 shows the proportion of adults making a dental visit in the previous 12 months increased from 55.4 per cent in 1994 to 60.5 per cent in 2010.

Figure : Adults who made a dental visit in the previous 12 months, 1994-2010

the figure shows the percentage of adults who visited a dentist in the previous 12 months between 1994 and 2010.

Source: AIHW, Harford JE & Islam S 2013. Adult oral health and dental visiting in Australia: results from the National Dental Telephone Interview Survey 2010.

Individuals can purchase dental insurance, either by private patient hospital cover combined with an extras option that includes dental services or the extras option only. Figure 6 shows annual information on the number of dental services for which private health insurance providers paid benefits. This clearly shows an increasing number of dental services provided – more than doubling (up 132 per cent) from 15.0m services in 1996 to 34.8m services in 2013.

The substantial increase in services for which benefits were paid from 2000 (16.2m) to 2001 (19.9m) likely reflects changes to Australia’s private health insurance system. In July 2000, Lifetime Health Cover was introduced to encourage Australians to take out private insurance earlier in life and to maintain their cover. Under this, people aged 30 years or more who joined private health insurance after July 2000 are required to pay a loading on their base rate premium for each year that they were older than 30, up to a maximum 70 per cent loading.

Figure : General Treatment, Dental Services paid by private health insurers, 1996 to 2013

the figure shows the increasing number of dental services paid by private health insurers for general treatment from 1996 to 2013.

Source: Private Health Insurance Administration Council, Benefits Trends Australia, December 2013

Demand for oral healthcare services is expected to continue to grow15, with drivers of demand including:


A number of demand drivers are financially-related – reflecting the nature of oral health service provision, which is primarily provided through the private sector and funded by individuals and families. As noted earlier, this is relatively unique for health service provision in Australia, and gives rise to a number of barriers to accessing oral health services.

Barriers to access


The National Oral Health Plan 2004 – 2013, the NHHRC report A healthier future for all Australians and the Report of the National Advisory Council on Dental Health all highlighted access and equity issues as a major factor for oral health service provision in Australia. Barriers to accessing oral health services can be both financial and non-financial.

Financial burden reflects the cost of oral healthcare services to the individual, the disposable income of a household and the number of people dependent on that income17, and is regularly cited as a reason why people do not seek regular oral healthcare. Financial burden as a barrier can be reflected by people avoiding or delaying dental care due to cost, cost preventing recommended dental care, and dental visits being a large financial burden.18

Table 3 shows the prevalence of financial barriers to dental visiting between 1994 and 2010. The proportion of people who have natural teeth (dentate people) who avoided or delayed dental visiting because of cost has increased between 1994 and 2010. Of those dentate people who made a dental visit in the previous 12 months, approximately two in ten reported that cost prevented recommended treatments in almost each selected survey year.

Table : Prevalence of financial barriers to dental visiting, 1994 to 2010 (per cent)



Financial barrier

1994

1996

1999

2002

2005

2008

2010

Avoided or delayed visiting due to cost

25.8

27.9

27.8

28.3

31.7

34.4

31.4

Cost prevented recommended treatment(a)

19.0

22.0

22.3

14.1

21.6

20.3

21.8

Dental visits in previous 12 months were a large financial burden(a)

10.2

10.7

14.3

10.3

14.1

13.5

11.1

(a) Dentate people who made a dental visit in the previous 12 months.
Notes:
Estimates are age-standardised to the 2010 Australian population.
Data relate to dentate people.
Source: AIHW, Harford JE & Islam S 2013. Adult oral health and dental visiting in Australia: results from the National Dental Telephone Interview Survey 2010.

Non-financial barriers to accessing oral health services also exist, and can include extended waiting lists for services (both public and private); accessibility barriers, in terms of being able to attend a clinic during opening hours, physically being able to get to a clinic, and being able to visit a practitioner or clinic of choice; communication or cultural barriers; awareness of existing services; and dental fear.


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