Ulster University

Academic Institute

Economic and Social Research Council

Yes

257

There exists a stark difference in the pattern of publicly funded oral healthcare delivered through general dental practice in Northern Ireland related to social class. Whilst no threshold on need had previously existed, an objective measure of need governing access to publicly funded orthodontic care was introduced in 2014. This study will use a record-linkage methodology to examine the relationship between use of publicly funded oral health care and the introduction of the index of treatment need (IOTN) for orthodontic care in Northern Ireland in 2014. It will utilize data from the 2011 Northern Irish Census returns and link them to reimbursement data for publicly funded oral health care (on all NILS members enumerated in the 2011 Census until the latest date available). By analyzing patterns in service use before and after the introduction of an objective measure of need as a criterion for public funding, we can ascertain the impact of the policy change on levels of and disparities in service use among children/adolescents, and compare that with its effects on adults and those from specific minority groups. This project aims to build on a previously approved NILS projects in order to: • Compare the levels of and socio-economic gradient in publicly funded general dental practitioner services for children/adolescents in the four years preceding the introduction of an objective measure of need for orthodontic care in 2014 with those following this change. • Compare levels of and the socio-economic gradient in publicly funded general dental practitioner services among adults in the four years preceding the introduction of an objective measure of need for orthodontic care in 2014 with the years following this change among adults. • Test whether patterns of service provision in light of the introduction of an objective measure of need are consistent with the target income hypothesis • Examine the impact on service provision of the policy change on difficult to reach groups specifically children and adolescents recently migrated to Northern Ireland

This project will assess the impact of the introduction of the IOTN on the use of publicly funded oral health care in Northern Ireland and how that changed over time. It will build on previously approved NILS projects (033, 179) to compare the socio-economic gradients for publicly funded orthodontics for children/adolescents and adults before and after the introduction of the IOTN. It will allow us to compare changes for those exposed to the new environment at its initiation and those not exposed (those aged 11 and older in 2011) with those exposed at a later stage of its operation (those aged younger than 11 in 2011) and thus enable a greater understanding of the impact of the policy change on care provision. We also seek data on an expanded range of services so as to examine relative changes in the pattern of orthodontic care to provide sharper focus on the policy change as opposed to broader changes publicly funded dental care over time.

15/04/2021

TRE