Trends in Work Effort among Australian Dentists
The 1990 WHO report Educational imperatives for oral health personnel predicted dramatic changes in dental service provision in industrialised countries in the immediate decade. These would be characterised by a shift away from medium level interventions that dominated at that time and an increase in high level interventions. Objectives: (1) to describe the baseline and trends in work effort for service provision in Australia, and (2) to test the validity of the WHO predictions. Methods: The study used data from cross-sectional studies of private dentists surveyed by mailed questionnaire in 1983, 1988, 1993 and 1998 (response rates 71-75%). Data were weighted to provide representative estimates at each time. A log of patients seen and services provided at each visit was collected. Services were divided into low, medium and high level interventions (or levels of care) and converted to a work effort metric, relative value units. Results: The work effort of medium level interventions provided per visit was highest, closely followed by low level interventions, with high level interventions having the lowest work effort per visit. Over time the work efforts for low and medium level interventions have increased, while work effort for high level interventions initially increased, then decreased (Poisson regression; p<0.01).
Conclusion: In contrast to the WHO predictions, these data illustrate a strong and growing work effort in low level interventions in the presence of an increase in work effort among medium interventions, without any substantial overall increase in high level interventions. Supported by NHMRC (981195) and AIHW.
AJ Spencer*, DS Brennan
Presented at the 81st General Session and Exhibition of the IADR, 25-28 June 2003, Goteborg, Sweden
| Level of Intervention | 1983 | 1988 | 1993 | 1998 |
| Low | 0.922 | 1.020 | 1.060 | 1.200 |
| Medium | 1.123 | 1.236 | 1.242 | 1.327 |
| High | 0.136 | 0.215 | 0.160 | 0.152 |
Conclusion: In contrast to the WHO predictions, these data illustrate a strong and growing work effort in low level interventions in the presence of an increase in work effort among medium interventions, without any substantial overall increase in high level interventions. Supported by NHMRC (981195) and AIHW.
AJ Spencer*, DS Brennan
Presented at the 81st General Session and Exhibition of the IADR, 25-28 June 2003, Goteborg, Sweden