Patterns and predictors of public dental service utilisation among refugees in Victoria, Australia : a latent profile and multilevel analysis

Background: The purpose of the study was to explore, analyse, and describe the patterns of public dental service utilisation among the refugee populations in Victoria, Australia, and determine their predictors at the individual and contextual levels. Methods: Data on the refugees who attended Victorian public dental services between July 2016 to June 2020 was gathered from the Dental Health Program dataset. Latent profile analysis was used to identify discrete groups among the refugee clientele with similar mean utilisation patterns across six indicator variables describing the attributes of dental services received and the site of care provision, over the study period. Multilevel multinomial logistic regression analysis was performed to examine the individual and contextual level correlates of the identified utilisation patterns. Results: Six distinct profiles of public dental service utilisation were identified among the study population (n = 25,542). The largest group comprised refugees predominantly using restorative services under general course of care (38.10%), followed by extraction services under emergency course of care (23.50%). Only a small proportion were estimated as having a higher mean utilisation of preventive services under general course of care (9.10%). Multilevel analysis revealed that the following variables had a significant association with refugee utilisation pattern: at the individual-level – demographic and ethnic attributes including age, gender, region of birth, preferred language for communication, use of language interpreter services, and type of eligibility card; at the contextual-level – characteristics of refugees’ neighbourhood of residence including urbanicity, socioeconomic disadvantage, delivery of Refugee Health Program at the community health centres, and spatial accessibility to public dental services via driving and public transit modes of travel. Conclusions: The study represents a significant step towards the development of an evidence-based knowledge around public dental service utilisation among Victorian refugees. Overall, the study findings reiterate the critical need for targeted strategies to promote the importance of routine dental visits, oral disease prevention, and timely intervention among refugee groups.