Networked remote area dental services: a viable, sustainable approach to oral health care in challenging environments

Aust J Rural Health. 2012 Dec;20(6):334-8. doi: 10.1111/j.1440-1584.2012.01318.x.


Objective: This study examines the cost effectiveness of a model of remote area oral health service.

Design: Retrospective financial analysis.

Setting: Rural and remote primary health services.

Participants: Clinical activity data and associated cost data relating to the provision of a networked visiting oral health service by the Centre for Rural and Remote Oral Health formed the basis of the study data frameset. The cost-effectiveness of the Centre's model of service provision at five rural and remote sites in Western Australia during the calendar years 2006, 2008 and 2010 was examined in the study.

Main outcome measured: Calculations of the service provision costs and value of care provided were made using data records and the Fee Schedule of Dental Services for Dentists. The ratio of service provision costs to the value of care provided was determined for each site and was benchmarked against the equivalent ratios applicable to large scale government sector models of service provision.

Results and conclusion: The use of networked models have been effective in other disciplines but this study is the first to show a networked hub and spoke approach of five spokes to one hub is cost efficient in remote oral health care. By excluding special cost-saving initiatives introduced by the Centre, the study examines easily translatable direct service provision costs against direct clinical care outcomes in some of Australia's most challenging locations. This study finds that networked hub and spoke models of care can be financially efficient arrangements in remote oral health care.

MeSH terms

  • Community Networks
  • Cost-Benefit Analysis
  • Dental Health Services / economics*
  • Dental Health Services / organization & administration
  • Health Services Accessibility / economics*
  • Health Services Accessibility / organization & administration
  • Health Services, Indigenous / economics*
  • Health Services, Indigenous / organization & administration
  • Health Status Disparities
  • Humans
  • Models, Organizational
  • Mouth Diseases / economics*
  • Mouth Diseases / ethnology
  • Native Hawaiian or Other Pacific Islander / statistics & numerical data
  • Poverty
  • Retrospective Studies
  • Rural Health Services / economics*
  • Rural Health Services / organization & administration
  • Western Australia / epidemiology
  • Workforce