A Comparison of Three Payment Systems for Public Paediatric Dental Services

Abstract

Objective: This study investigated the delivery of paediatric (0-17 years) government dental services in New South Wales (NSW), Australia through public dental clinics and the commissioned payments models of Fee-for-Service and Capped-Fee. 

Method: De-identified patient data from government provided dental care and the commissioned services was sourced from NSW Oral Health Data Warehouse for evaluation and interpretation using descriptive analysis during the period 1 January 2012 to 31 December 2013. 

Result: The breakdown of dental care provided the associated cost analysis for the study’s cohort that resulted in both years, more than 50 percent dental services offered to paediatric patients were preventive care in all payment systems.  The most common preventive items offered were fluoride treatment, dietary advice, oral health education and fissure sealants.

Conclusion: There was little difference in the mix of dental care provided between study years and age groups through the three payment systems in NSW.  The difference between the government services and those provided via the Fee-for-Service and Capitation payment systems was negligible.

This has important implications for the delivery of dental care to public dental care, particularly when patients may not live close to a public dental clinic and also with the interest nationally in giving patients greater choice.