title: Geographic modelling of jaw fracture rates in Australia: a methodological model for healthcare planning.
abstract: OBJECTIVE
  While Australians are one of the healthiest populations in the world, inequalities in access to health care and health outcomes exist for Indigenous Australians and Australians living in rural or urban areas of the country. Hence, the purpose of this study was to develop an innovative methodological approach for predicting the incidence rates of jaw fractures and estimating the demand for oral health services within Australia.
  
  
  METHODS
  Population data were obtained from the Australian Bureau of Statistics and was divided across Australia by statistical local area and related to a validated remoteness index. Every episode of discharge from all hospitals in Western Australia for the financial years 1999/2000 to 2004/2005 indicating a jaw fracture as the principle oral condition, as classified by the International Classification of Disease (ICD-10AM), was the inclusion criterion for the study. Hospitalization data were obtained from the Western Australian Hospital Morbidity Data System.
  
  
  RESULTS
  The model estimated almost 10 times higher jaw fracture rates for Indigenous populations than their non-Indigenous counterparts. Moreover, incidence of jaw fractures was higher among Indigenous people living in rural and remote areas compared with their urban and semi-urban counterparts. In contrast, in the non-Indigenous population, higher rates of jaw fractures were estimated for urban and semi-urban inhabitants compared with their rural and remote counterparts.
  
  
  CONCLUSIONS
  This geographic modelling technique could be improved by methodological refinements and further research. It will be useful in developing strategies for health management and reducing the burden of jaw fractures and the cost of treatment within Australia. This model will also have direct implications for strategic planning for prevention and management policies in Australia aimed at reducing the inequalities gap both in terms of geography as well as Aboriginality.
authors.affiliation: The Centre for Rural and Remote Oral Health, The University of Western Australia, Crawley, WA, Australia. ekruger@crroh.uwa.edu.au
authors.forename: Estie
authors.initials: E
authors.lastname: Kruger
authors.forename: Lisa J A
authors.initials: LJ
authors.lastname: Heitz-Mayfield
authors.forename: Irosha
authors.initials: I
authors.lastname: Perera
authors.forename: Marc
authors.initials: M
authors.lastname: Tennant
mesh_terms: D000293:Adolescent; D000328:Adult; D001315:Australia / Q000453:epidemiology; D002648:Child; D003752:Dental Health Services / Q000706:statistics & numerical data; D005260:Female; D005544:Forecasting; D006285:Health Planning / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D054625:Healthcare Disparities / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007572:Jaw Fractures / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D044382:Population Groups / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012423:Rural Health / Q000706:statistics & numerical data; D018881:Suburban Health / Q000706:statistics & numerical data; D014504:Urban Health / Q000706:statistics & numerical data; D055815:Young Adult