Three year retrospective analysis of computer-assisted emergency dental triage in Tasmania, Australia

Tasmania is Australia's smallest state measuring approximately 68,000 km2 and separated (by approximately 240 km of ocean) from the mainland of Australia, at the south-east corner of the continent. The total resident population of Tasmania is approximately 500,000 people with the greatest population density in the capital city, Hobart. Adult dental care is subsidised for socioeconomically disadvantaged people and are provided through the State government dental clinics. Emergency demand for adult dental care is rationed through a triage system (mainly by telephone contact with trained receptionists), applied across the State based on universal clinically agreed criteria. The aim of this study was to analyse the outcomes of this triage system in delivering effective public emergency dental care services in Tasmania.

The study population consisted of all patients who approached the dental services in Tasmania for emergency care over a period of 3 years. The data were collected from all four major fixed public dental clinics for the calendar years 2009, 2010 and 2011.

A total of 56,298 triage events were analysed over the 3 years (2009-2011) of the study. The proportion of each triage outcome category (ie speed to needing to be seen) was stable. Regarding month-to-month variation, December had the lowest overall number of events (n=3921) and August had the greatest (n=5237). There was a tendency mid-year (winter in the southern hemisphere) for triage events to be above the baseline, while in summer (December to February) there were fewer events. Most triage events occurred on the first day of the working week (Monday), and the least occurred on Fridays. Over half the events were driven from two patient symptom sets: (1) pain that woke patients at night; and (2) pain that required analgesics.

In order to deal with the current workforce shortage and funding constraints in the public health sector, the peri-operative workforce such as receptionists can be utilized in innovative ways such as triage, and in particular clinical-based systematic telephone-based assistance.