Harford Jane, Spencer A John
Australian Research Centre for Population Oral Health, University of Adelaide, South Australia.
Aust N Z J Public Health. 2004 Aug;28(4):363-8. doi: 10.1111/j.1467-842x.2004.tb00445.x.
To evaluate the impact of recent changes in public subsidies for oral health care in Australia, and to propose more effective and equitable uses of Commonwealth Government subsidies.
Review of literature and Australian Research Centre for Population Oral Health information.
Commonwealth subsidies for oral health care services in Australia have been moved from public dental services to private dental health insurance. This has resulted in a redistribution of funds from people on low incomes with poor oral health, to people on middle to high incomes with relatively better oral health.
Public funding for dental care in Australia favours the financially and orally better off at the expense of disadvantaged and orally unhealthy Australians. Current approaches to public funding for oral health services in Australia are unlikely to result in a substantial improvement in oral health.
Maximum gains in oral health are likely to be achieved by a reorientation of Commonwealth subsidies towards preventive and basic treatment services. This reorientation needs to occur within a primary health care framework. Whereas the Commonwealth plays a national leadership role in the provision of general health services, this is not apparent in relation to oral health. This lack of leadership leaves many vulnerable Australians without basic preventive services and at high risk of losing teeth that might otherwise have been preserved. Channelling the funding now used to subsidise private dental services for the well off and dentally healthy to community-wide and targeted preventive services for vulnerable and low-income Australians would have a larger impact on oral health and represent a more equitable use of these funds.
评估澳大利亚近期口腔卫生保健公共补贴变化的影响,并提出更有效和公平地使用联邦政府补贴的建议。
文献综述及澳大利亚人口口腔健康研究中心的信息。
澳大利亚口腔卫生保健服务的联邦补贴已从公共牙科服务转向私人牙科健康保险。这导致资金从口腔健康状况较差的低收入人群重新分配到口腔健康状况相对较好的中高收入人群。
澳大利亚牙科护理的公共资金有利于经济状况和口腔健康状况较好的人群,却以处境不利和口腔不健康的澳大利亚人为代价。澳大利亚目前的口腔卫生服务公共资金投入方式不太可能大幅改善口腔健康状况。
通过将联邦补贴重新导向预防和基本治疗服务,可能实现口腔健康的最大改善。这种重新导向需要在初级卫生保健框架内进行。虽然联邦政府在提供一般卫生服务方面发挥着国家领导作用,但在口腔健康方面却不明显。这种缺乏领导力的情况使许多弱势澳大利亚人无法获得基本的预防服务,面临牙齿脱落的高风险,而这些牙齿原本可能得以保留。将目前用于补贴富裕且口腔健康人群私人牙科服务的资金用于为弱势和低收入澳大利亚人提供社区范围的针对性预防服务,将对口腔健康产生更大影响,并代表着对这些资金更公平的使用。