Brief finds integrated primary health care key to improving oral health in rural and remote Australia

oral health in remote and regional Australia
Scenery at the Mundi Mundi lookout near Silverton, NSW, Australia

An Issues Brief recently released by the Australian Healthcare and Hospitals Association’s Deeble Institute for Health Policy Research synthesises evidence about the extent of access challenges in rural and remote Australia. The title of the brief is ‘Integrating oral health into primary healthcare for improved access to oral health care for rural and remote populations’.

Access to oral health care for rural and remote Australians is limited, particularly for underserved populations that rely on public dental services. This includes First Nations Peoples. This is largely due to poor distribution of oral health services and a limited dental workforce supply in these areas.

“Primary care providers are often the first point of contact for health services in rural and remote communities, and are well positioned to provide basic oral health care,” brief co-author AHHA’s A/Professor Rebecca Haddock said.

“This could include screening for risk factors, oral health education, provision of non-invasive preventative interventions, and referral.

“However, limited oral health knowledge and skills and boundaries to professional scopes of practice curb the possibility of leveraging existing primary healthcare resources for oral health care provision.

“Accessing oral health care anywhere in Australia is also likely to incur out-of-pocket costs, as these services are not generally covered by Medicare,” A/Prof Haddock added.

“This is also the case when accessing the limited non-government oral health services in these areas.”

The brief recommends subsidy schemes based on the fee-for-service payment model, directed at specific population groups in rural and remote areas, to ensure timely access to this much-needed care.

It also highlights the missed opportunities for interprofessional collaboration and interoperability of oral and primary healthcare professionals, as there are no mandated data reporting, management, and sharing mechanisms between dental and broader healthcare systems.

Other key recommendations include improving health training for rural and remote primary healthcare professionals, allowing primary healthcare professionals to include oral health care in their scope of practice, identifying oral health as a ‘core’ primary healthcare service, increasing interoperability and data sharing, and improving access to oral health care under Medicare for rural and remote populations.

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