A study of strategies to address needs and service expenditures in the non-insured health benefits program

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Cooney, Peter
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The recent fiscal restraint policies adopted by different levels of government have impacted on Canadian publicly-funded programs, including the Non-Insured Health Benefits (NIHB) program that provides dental services to the First Nations Treaty and Inuit communities. Considering the previous disparity between increased resource allocations to the above groups, these policies of fiscal restraint are particularly relevant to the dental health of First Nations Treaty and Inuit communities, who have yet to witness the remarkable declines in dental disease prevalence exhibited by most other Canadians. In this trial study, service data were compared between quivalent nine month periods in 1995 and 1996 (i.e. before and after the implementation of the 'needs-based' (Manitoba) and 'frequency-based' strategies (other regions)). Preliminary analyses of these results indicated that: (1) the 'needs-based' strategy was more effective in the constraint of service expenditures than that based on service frequencies; (2)no significant reductions in service discrepancies were achieved by either strategy. More appropriate (long-term) preventive strategies are therefore required to reduce the dental disease burdens of these communities (and their associated service expenditures). Also epidemiological data on their dental needs and service outcomes are crucial to assay the effectiveness of the NIHB dental program. (Abstract shortened by UMI.)