Accessibility to dental services

Abstract

Background: Access to dental care has become a key focus for Government officials in Scotland. Newton et al. (2004) note that the White Paper ‘Towards a healthier Scotland’ (The Scottish Office Department of Health, 1999), identifies dental health as a key area for action, with large numbers of the population unable to gain access to dental care. Various methodologies have been developed in an attempt to explore the inequalities in dental health care access; however a number of studies have adopted obsolete methodologies that produced misleading results. This research paper critiques the methodology adopted by Boulos and Phillipps (2004) in their study of the distribution of dentists in England and Wales. We bring to a forefront the importance in measuring both spatial and aspatial factors when measuring access to healthcare by developing a new accessibility index. Furthermore we highlight the importance of studying deprivation and accessibility in order to test for the presence of the Inverse Care Law. Results: We applied the index adopted by Boulos and Phillipps (2004) and highlighted that accessibility is measured one dimensionally based upon the spatial location of dentists. The results from the new index provide a much better representation of the current state of accessibility in the chosen study area of Lothian in Scotland. We highlighted the misleading results produced by Boulos and Phillipps (2004) index by incorporating the dental practices that are currently not accepting patients into the index so that we could display accessibility to dentists for not only the patients that are currently registered but also for those who are looking to register. We have displayed the importance of measuring both accessibility and deprivation by identifying a number of areas in Lothian region that are currently displaying evidence of the Inverse Care Law. Conclusions: New methodologies are urgently needed to explore the inequalities in access to dental care throughout Scotland. Accessibility indexes need to be developed that incorporate a number of characteristics that are currently affecting accessibility to dental services. More research needs to be conducted at a local level to provide better advice to health planners and policy makers. Deprivation and accessibility must be explored together if we are going to improve accessibility to dental care.