This article has been peer reviewed and accepted for publication. It is in production and has not been edited, so may differ from the final published form.
Hospital admissions and ED presentations for dental conditions indicate access to hospital, rather than poor access to dental healthcare in the community.
Objectives High rates of dental-related potentially preventable hospitalisations are thought to be associated with poor access to non-hospital dental services. The association between accessibility (geographic and financial) to non-hospital dentists and potentially preventable hospitalisations was examined to test the validity of this belief. Methods Areas with persistently high rates of dental-related potentially preventable hospitalisations were mapped. Areas with persistently high rates of dental-related emergency department (ED) presentations were also mapped. Statistical models examined factors associated with these events. All hospital admissions and ED presentations meeting diagnostic criteria in residents of metropolitan Perth 2002-2014 were used in the analysis. Results Persistently high rates of dental-related potentially preventable hospitalisations were clustered in areas of metropolitan Perth that were socio-economically advantaged and had more dentists per capita (RR 1.06, 1.04-1.08) after adjusting for age, sex, socio-economics, and Aboriginality. However more dentists per capita correlated with fewer ED presentations (adjusted RR 0.91, 0.88-0.94). Persistently high rates of ED presentations were clustered in socio-economically disadvantaged areas near metropolitan EDs. Conclusions A positive association between dental-related potentially preventable hospitalisations and poor financial or geographic access to dentists was not found. Dental-related potentially preventable hospitalisations are positively associated with greater access to hospitals, socio-economic advantage, and greater access to non-hospital dental services. ED presentations for dental conditions are also inappropriate indicators of poor access to non-hospital dental services because of their relationship with hospital proximity. Health service planners and policy makers are encouraged to pursue alternative indicators of dental service accessibility.
PY17044 Accepted 29 August 2017
© La Trobe University 2017