HSE Funded Primary Care Treatments and Claims, 2017-2021

Introduction

The Primary Care Reimbursement Service (PCRS) within the HSE is responsible for reimbursing dentists under the Dental Treatment Services Scheme (DTSS). Under this scheme, GMS eligible persons have access to a range of treatments and clinical procedures comprised of routine treatments and full upper and lower dentures. Routine treatments are available for all eligible persons. Dentists may also prescribe a range of medicines, as part of their treatment, to eligible persons.

Please see Background Notes for a further description of the GMS and DTSS. The figures in this release are based off fully complete and processed claims under the DTSS. For this reason, figures may vary from those published by the HSE. Please note, care should be taken when examining trends over time in the form of expenditure and average amounts as eligibility criteria can change over time.

Total number of HSE funded dental treatments falls from 1.2 million to 0.7 million treatments between 2017 and 2021

The number of HSE funded treatments under the GMS fell from 1.2 million treatments in 2013 to 748,000 treatments in 2021, a 36% decrease. The largest year on year decrease was seen between 2019 and 2020 with a 25% decrease from 1.03 million to 778,000 treatments. There was a similar decrease in the total cost of HSE funded treatments from €63.3 million in 2017 to €39.3m in 2021, a 38% decrease. The average cost per HSE funded dental treatment remained relatively stable between 2017 and 2021, decreasing by 3% over this period from €53.92 to €52.46. See Figure 5.1 and Table 5.1.

Almost three in five HSE funded dental treatments were for females in 2021

More females than males had publicly funded dental treatments for all years between 2017 and 2021. In 2021, approximately 426,000 HSE funded dental treatments were carried out on females compared to approximately 322,000 treatments on males. In 2021, the fewest HSE funded dental treatments were carried out on those aged 24 and under, at approximately 66,000. Regionally, the highest number of dental treatments were carried out in the South LHO region at approximately 227,000. The lowest number of treatments were carried out in the Dublin North East region, at approximately 143,000. See Figure 5.2 and Table 5.2.

The total costs of HSE funded dental treatments fell by almost half for those aged 34 and under between 2017 and 2021

Between 2017 and 2021, there was a 38% decrease in the total costs for HSE funded dental treatments, from €63.3 million to €39.3 million. For those aged 34 and under, there was a 49% decrease in HSE dental costs, from €12.1 million to €6.2 million. The smallest proportional decrease in total costs for HSE funded dental treatments was seen for those aged 75 years and over between 2017 and 2021. This cohort saw a 28% decrease in total costs, from 9.6 million to 6.9 million. See Figure 5.3 and Table 5.3.

Oral examinations are the most common HSE funded dental treatment at almost a third of all treatments in 2021

In 2021, oral examinations are the most commonly carried out dental procedure, accounting for over 32% of all publicly funded treatments each year. The second most commonly performed treatment that year was restoration using amalgam filling, which made up approximately 19% of the total number of treatments each year. Apicectomy/amputation of roots is the least carried out treatment. Exodontics, which is the removal of a tooth or teeth, comprised approximately 13% of total treatments in 2021. See Table 5.4.

In 2021 curative treatments comprised of over half of all HSE funded dental treatments

Dental treatments were divided into three treatment categories: preventative, curative and miscellaneous. In 2021, 55% of all HSE funded dental treatments were curative. The total number of HSE funded curative treatments in 2021, at 413,000, is higher than the combined total of 336,000 for HSE funded preventative and miscellaneous treatments. Those aged 65-74 years have the highest number of HSE funded curative and preventative treatments in 2021 at 78,000 and 42,000 respectively. The region with the most curative treatments in 2021 was the South where approximately 127,000 treatments were carried out. Dublin North East had with the lowest number of curative treatments that year, with a total of approximately 79,000. See Table 5.5.

The average payment per HSE funded dental treatment decreased by 3% between 2017 and 2021

There was a 3% decrease in the average payment per HSE funded dental treatment between 2017 and 2021, from €53.92 to €52.46.

The average payment per treatment in 2021 was higher for males at €53.85 than for females at €51.42. Both of these figures have fallen since 2017, when the average payment per treatment for a male was €54.88 and €53.15 for a female. The average payment per HSE funded dental treatment those aged 75 years and over was on average 60% higher than a treatment for those aged 24 years and under in 2021, at €64.68 and €40.53 respectively. In 2021, the average payment per HSE funded dental treatment was highest in the Dublin North East LHO region at €54.71. The lowest was in the West LHO region at €51.10. See Table 5.6.