Equitable access to dental care for an at-risk group: a review of services for Australian refugees.
OBJECTIVE
Despite the poor dental health of refugees, few specific services are available. This review maps public dental services for refugees across Australian jurisdictions, identifies gaps in provision, identifies barriers to accessing dental care, and provides recommendations for improving access and oral health promotion for this group.


METHODS
Data were sought from the State and Territory services for: a) the survivors of torture; b) oral health care units; and c) auditors-general reports of dental services. Eligibility criteria and estimated waiting times for general dental services, criteria for access to emergency care and availability of interpreter services were reviewed.


RESULTS
Marked variation exists across Australian jurisdictions in available dental services and criteria for access to public dental care for refugees. There is limited priority access to general dental services for refugees. Waiting times for public dental treatment in most, if not all, jurisdictions are unacceptably long (range 13-58 months). Few interpreter services exist for refugees seeking to access dental services.


CONCLUSIONS
Access to dental services for refugees across Australia remains fragmented and limited, particularly in rural and regional areas. Refugees are not using services because of several barriers, including long waiting times, variation in assessment criteria, different eligibility criteria and limited interpreter services. Consequently, their pattern of service use does not accurately reflect their needs.


CONCLUSIONS
Australia needs better co-ordinated, more extensive dental services that are easily accessible for this very high risk group. Identification of refugees as a special needs group and provision of targeted interventions addressing barriers to care are needed to establish adequate dental care.
Davidson
Natasha
N
Victorian Immigrant Health Program, Victoria.
Skull
Sue
S
Calache
Hanny
H
Chesters
Donna
D
Chalmers
Jane
J
D000293:Adolescent; D000328:Adult; D001315:Australia; D002648:Child; D002675:Child, Preschool; D003144:Communication Barriers; D003752:Dental Health Services / Q000706:statistics & numerical data / Q000600:supply & distribution*; D006293:Health Promotion / Q000379:methods; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008875:Middle Aged; D009909:Oral Health; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D012036:Refugees / Q000523:psychology / Q000706:statistics & numerical data*; D013997:Time Factors; D035862:Vulnerable Populations / Q000523:psychology / Q000706:statistics & numerical data*; D014850:Waiting Lists