Centre for Rural and Remote Oral Health, The University of Western Australia, Perth, WA, Australia.
Int Dent J. 2013 Aug;63(4):177-82. doi: 10.1111/idj.12027. Epub 2013 Apr 15.
Australia is the sixth biggest (by area) country in the world, having a total area of about 7.5 million km(2) (3 million square miles). This study located every dental practice in the country (private and public) and mapped these practices against population. The total population of Australia (21.5 million) is distributed across 8,529 suburbs. On average about one-third of the population from each State lives in suburbs without practices and 46% live in suburbs with one to five dentists. Of those living within the study frameset, 86.6% live within 5 km of a private practice and 84.4% live within 10 km of a government practice. Australia's dental practices are distributed in a very uneven fashion across its vast area. Three-quarters of suburbs have no dental practice and over one-third of the population live in these suburbs. This research clearly identified that in a vast and uneven socio-geographically distributed country, service planning, if left to market forces, will end with a practice distribution that is fixed by economic drivers of scale and not that of disease burden. A more population health-driven approach to future design and construction of government safety net services is needed to address these disparities.
澳大利亚是世界上第六大(按面积计算)国家,总面积约为 750 万平方千米(300 万平方英里)。本研究在全国范围内定位了每一家牙科诊所(私人和公共),并根据人口分布对这些诊所进行了映射。澳大利亚的总人口(2150 万)分布在 8529 个郊区。平均而言,每个州约有三分之一的人口居住在没有诊所的郊区,46%的人口居住在有一到五名牙医的郊区。在研究框架内居住的人中,86.6%的人居住在距离私人诊所 5 公里以内的地方,84.4%的人居住在距离政府诊所 10 公里以内的地方。澳大利亚的牙科诊所在其广阔的地域内分布非常不均匀。四分之三的郊区没有牙科诊所,超过三分之一的人口居住在这些郊区。这项研究清楚地表明,在一个幅员辽阔、社会经济分布不均的国家,如果任由市场力量来规划服务,那么服务的分布将由规模的经济驱动因素决定,而不是由疾病负担决定。需要采取更以人口健康为导向的方法来设计和构建政府安全网服务,以解决这些差距。