Benchmarking Australian Dental Weighted Activity Units against public and private dental fee schedules: a cross-sectional item-code comparator study.

Abstract

Objective: To benchmark Dental Weighted Activity Units (DWAUs) against Australian dental remuneration schedules and derive suggested recalibration factors for endodontics, periodontics and prosthodontics.

Materials and methods: A cross-sectional item-code comparator study linked Australian Dental Association item codes to DWAU values and fees from public and private schedules, standardised to 1 January 2025 Australian dollars. The primary outcome was grouped DWAU per dollar, calculated as the sum of DWAUs divided by the sum of fees and expressed as DWAU per $1000. Lower values indicated fewer DWAUs credited per dollar of remuneration. Merged general and merged specialist fee series were constructed, with bootstrap 95% confidence intervals and suggested stream-specific calibration factors estimated.

Results: Of 343 item codes, 264 had DWAU values greater than zero and 260 were included. Overall DWAU per $1000 was 1.589 for merged general comparators and 1.130 for merged specialist comparators. Under specialist comparators, endodontics had the lowest value at 0.945 DWAU per $1000, 16.40% below the benchmark. The suggested specialist calibration factor for endodontics was 1.196.

Discussion: The findings indicate that current DWAU values are not uniformly aligned with remuneration signals, particularly for specialist endodontics, and supports stream-specific review rather than a single uniform adjustment.

Conclusions: Cross-schedule benchmarking and specialist-adjusted DWAU rates may improve public dental activity measurement, commissioning and specialist service planning.