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Distribution of NHS resources for children's dental care in general dental practice in England
D P Landes1, G C Adams, S Whiston
1Durham Dales Primary Care Trust , Bishop Auckland, County Durham, UK.
Objective:
To determine the relationship between the distribution of NHS resources in general dental practice and dental need and access to services for the population in England under the age of 18 in different socio-economic areas.
Basic Research Design:
A proxy for the oral health of under 18 year olds was made from prevalence surveys undertaken on five year old children in each health authority area in 1999/2000. The level of spending per head of the population was ascertained from Dental Practice Board data. Health authorities were grouped according to the eleven United Kingdom Office of National Statistics socio-economic groups. Access was measured by using registration levels of children.
Setting:
General dental practices providing National Health Service treatment for children aged 0-18 in England.
Results:
There was no correlation (r = -0.03) between increasing need for dental care using mean dmft as a proxy and increasing spending per head of the population for each health authority. There was a correlation (r = 0.38) between increasing registration rates and increased spending per head. The populations under 18 had more spent on their oral health care living in areas classified as Mixed Economies, Services and Education and Most Prosperous. Those in Inner London, Manufacturing, Ports and Industry had proportionately the least. The difference between the highest and lowest group was 33%. The groups of Authorities were not homogenous in their level of resources with variations between Authorities in the same groups.
Conclusions:
The distribution of NHS resources to general dental practice for people under 18 does not reflect population need. The higher the registration rate for children the greater the amount resources deployed in an area.
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