Design of an innovative paediatric capitation payment approach for public sector dentistry: an Australian experience

Abstract

The aim of this study was to trial the methodology and administration processes of a public paediatric capitation programme provided in the period 1 July 2011 to 31 December 2011 through a Bachelor of Oral Health programme in rural New South Wales (NSW), Australia, where access to public dental services is limited. The principal structure of the programme was the development of three diagnostic pathways: active caries and pain (Pathway A); active caries and no pain (Pathway B); and no active caries and no pain (Pathway C). In 2011, de-identified treatment data for NSW public dental services' patients under 18 years of age were analysed to identify the top 10 dental treatment items. These items were clustered according to the mean decayed and/or filled surface of patients under 18 years of age who had decayed, filled or missing teeth. Each treatment item was allocated 60% of the 2011 Australian Government Department of Veteran Affairs Schedule of Fees. The programme was trialled in Charles Sturt University dental facility in Wagga Wagga, NSW. The programme targeted patients in the following age groups: 0-5 years; 6-11 years; and 12-17 years. The 6-month trial provided 361 patients with a capitation pathway, at a total cost of $47,567.90, averaging $131.76 per capitation pathway. The total number of items provided (n=2,070) equated to an average of 5.7 items per capitation diagnostic pathway. This model offered an early entry point for paediatric patients to access dental care that addressed their needs, whilst being flexible enough to be fiscally attractive.