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Keywords:

  • dental;
  • medicare;
  • chronic disease;
  • over-servicing;
  • treatment planning

Abstract

Objective: Australia's Medicare universal insurance system has supported comprehensive dental service through the Chronic Disease Dental Scheme (CDDS) since November 2007. Public debate opposing CDDS includes claims of over-servicing, calls for expansion to universal eligibility, and government threat of closure. Here we examine CDDS services over the first 23 months of operation.

Methods: CDDS statistics on patient age, gender and item numbers claimed from November 2007 to December 2009 from Medicare were subjected to analysis.

Results: The distribution of 404,768 total CDDS patients varied across Australia from 3.6% of the population in NSW to 0.07% in NT, while uptake increased over time. The average patient had 7.58 dental treatments, and the most common were: direct restorations (2.27), preventive and periodontal services (1.46), diagnostic services (1.43), extractions (0.77), and new dentures (0.53). Crown and bridgework appeared over-represented (0.48).

Conclusion: Although data do suggest over-servicing in crown and bridgework, there also appears to be significant community need for the CDDS.

Implication: Clear guidelines for dental clinical diagnosis and treatment planning, as well as a pre-approval process for crown and bridgework is suggested to improve the CDDS, and this could form the basis for expansion to universal eligibility for dental Medicare.