Objectives: To assess whether the degree of socio-economic disadvantage in access to dental care altered under either of the subsidy programs
Methods: Data were obtained from four nationally-representative telephone interview surveys of the Australian adult population conducted in 1994, 1996, 1999 and 2002. In each survey, respondents were asked about the period since their last dental visit and the reason for their visit. Optimal access was defined as attendance within the previous year for a checkup. Three groups were investigated: Health Card Cardholders (HCC), Pensioner Concession Cardholders (PCC) and Non-cardholders with household income less than $40,000 (NC<$0K). Disadvantage in access to dental care was indexed by computing their odds of optimal access relative to odds for the high socio-economic group of non-cardholders with household income °Ý$40,000. Weighted bivariate and multivariate logistic regression analyses were performed using SUDAAN9.0 to estimate odds ratios (OR). Results: The percentage of Australians with optimal access fell from 26.2% in 1994 to 23.9% in 1996 then increased to 25.2% in 1999 and 27.5% in 2002. Socio-economic disadvantage in access did not change significantly between 1994 and 1996: for HCC, ORs were 0.71 and 0.76 respectively, for PCC ORs were 0.71 and 0.73 (P>0.05) and for NC<$0K, ORs were 0.86 and 1.02 (P>0.05). By 1999, socioeonomic disadvantage had worsened significantly and it persisted through 2002 for HCC (OR=0.52 in 1999 and 0.63 in 2002), PCC (OR=0.52 and 0.57) and NC<$0K (OR=0.79 and 1.00).
Conclusion: Population levels of optimal access to dental care first declined then improved over the period 1994 to 2002. However, between 1996 and 1999, socio-economic disadvantage in optimal access increased.