title: Disparities in dental health of rural Australians: hospitalisation rates and utilisation of public dental services in three communities in North Queensland.
abstract: The oral health of rural Australians continues to lag behind that of those living in metropolitan areas. Research has shown that people living in rural areas are more likely to suffer from dental caries (decay), visit the dentist less often and have poorer access to oral health services. The purpose of the study was to examine hospitalisations for dental conditions and utilisation of public dental services in three rural communities in Queensland compared with the whole of Queensland.
  
  
  
  Aggregated hospitalisation data for dental conditions and counts of public outpatient service data were requested for residents of three rural communities in Queensland and for the whole of Queensland for the calendar year 2013. Hospitalisation rates per 1000 and risk ratios were calculated to examine the risk of hospitalisation for dental procedures for those living in the selected rural communities and the rest of Queensland. Data were grouped by gender, age and Indigenous status and comparisons made between Queensland and the rural communities. Outpatient service data were converted to percentage of all services delivered to allow comparisons between groups of different sizes. Population data were grouped into age cohorts and compared with the proportion of public oral health services delivered to each age cohort.
  
  
  
  Residents of the rural communities were twice as likely to be hospitalised and children aged 0-14 years living in the communities were three times more likely to be hospitalised for dental conditions compared to residents of the rest of Queensland. Outpatient oral service data showed that the proportion of services delivered to children aged up to 14 years living in the rural communities was less than the whole of Queensland. Interestingly, in one rural community where the public dental service was open to all, the distribution of public oral health services aligned with the age distribution of the population.
  
  
  
  The study showed that residents of these rural communities experience poorer oral health and are a greater risk of hospitalisation for dental conditions compared with the whole of Queensland. Whilst public dental services account for a small proportion of all dental care across the state, service utilisation data provide a unique insight into the population groups who may not be accessing public dental services. In the rural context, more effective use of the local workforce and a flexible approach to funding models could have a positive impact on access to dental care.
authors.affiliation: Northern Australia Primary Health Limited, James Cook Drive, Douglas, Queensland, Australia. karen.carlisle@jcu.edu.au.
authors.forename: Karen
authors.initials: K
authors.lastname: Carlisle
authors.affiliation: James Cook University, James Cook Drive, Douglas, Queensland, Australia. sarah.larkins@jcu.edu.au.
authors.forename: Sarah
authors.initials: S
authors.lastname: Larkins
authors.affiliation: James Cook University, Smithfield, Queensland, Australia. felicity.croker@jcu.edu.au.
authors.forename: Felicity
authors.initials: F
authors.lastname: Croker
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003729:Dental Care / Q000706:statistics & numerical data*; D003752:Dental Health Services / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility; D006303:Health Services, Indigenous / Q000706:statistics & numerical data; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009909:Oral Health / Q000706:statistics & numerical data*; D011793:Queensland; D019035:Rural Health Services / Q000706:statistics & numerical data*; D012424:Rural Population / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Australia/Pacific; Oral health; Public Health; Workforce