A policy option towards improving skill-mix efficiencies in Victorian
public oral healthcare.
Abstract
Background: International oral health policy directions led by the World
Health Organization call for the inclusion of oral health within
universal health coverage. The aim of this study is to perform a budget
impact analysis of a policy option for a more cost-efficient oral health
workforce skill-mix (dentists and oral health therapists) to provide
public oral healthcare in Victoria, Australia. Methods: Two hypothetical
standard care pathways were developed. A dynamic population Markov model
was generated in TreeAge software, with a time horizon of six years. Two
scenarios were modelled to determine: 1) base-case scenario: the
threshold the dentist workforce could reduce per year, while achieving
the same service delivery outputs, and 2) alternative scenario: the
potential cost-savings for utilising an optimally cost-efficient oral
health workforce skill-mix. Results: The threshold analysis showed a
minimum reduction of 13% of the dentist workforce being replaced with
oral health therapists can occur without having any impact on the same
service delivery outputs. Under the alternative scenario, the potential
cost-savings would be AUD$1,425,037 (SD 58,954). Conclusions:
Governments and policy-decision makers should consider strategies in
training, attracting, and retaining oral health therapists to achieve an
optimally cost-efficient oral health workforce skill-mix when delivering
public oral healthcare.