Monitoramento das equipes de saúde bucal após a Política Nacional de Atenção Básica 2017

Lucena, Edson Hilan Gomes de; Lucena, Carolina; Alemán, Josiane Aparecida de Souza; Júnior, Gilberto Alfredo Pucca; Pereira, Antônio Carlos; Cavalcanti, Yuri Wanderley

doi:10.11606/s1518-8787.2020054002075

Cited by 18 publications

(25 citation statements)

References 23 publications

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“…It is already possible to detect loss of implantation amplitude, indicated by the stabilization trend line regarding the number of these teams after January 2018. Between the 1st and the 21st months of the publication of the PNAB 2017 Ordinance, a three-fold increase was observed regarding the number of municipalities that reduced the number of OHTs in the Family Health Strategy [11]. Obviously, the direct negative impact of this fact on citizens' access to oral health services should be more clearly perceived in the coming years.…”

Section: Discussionmentioning

confidence: 99%

“…Regarding the contextual indicators, considering the results found in our study, we could understand that the seeking for dental care is directly related to a better interaction and the articulation of the oral health team with the other members of the Primary Care Health team and with the population of the assisted territory. In 2004, through the Brasil Sorridente program, a series of policies were implemented aiming at the expansion and qualification of oral health in PHC [2,11]. The program highlights the importance of knowing the reality of the covered areas and the building of problem-solving and effective practices regarding the care offered by the OHT.…”

Section: Discussionmentioning

confidence: 99%

“…In the wake of the political-institutional decisions that Brazil made as of 2016, the new National Primary Care Policy (PNAB, Política Nacional de Atenção Básica) published in 2017 sees oral health as non-mandatory in the Family Health Strategy. PNAB has already reflected in an increase in the number of municipalities that reduced the number of oral health teams in the Family Health Strategy [11,33]. It is already possible to detect loss of implantation amplitude, indicated by the stabilization trend line regarding the number of these teams after January 2018.…”

Section: Discussionmentioning

confidence: 99%

“…SUS model of care in Primary Health Care includes multiprofessional teams with Community Health Agents (CHAs) delivering care to a population within a specific territory. By the PNSB, SUS also provides comprehensive oral health care to the Brazilian population [10,11]. PNSB represents a transformative strategy focused on expand a comprehensive oral health care in the public health system [12,13] and it is based on two different strategies.…”

Section: Introductionmentioning

confidence: 99%

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Indicators for dental appointment scheduling in primary health care: a national cross-sectional study

et al. 2021

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Background Integrated dental services within the Health System, particularly at primary health care, are crucial to reverse the current impact of oral diseases, which are among the most prevalent diseases worldwide. However, the use of dental services is determined by complex phenomena related to the individual, the environment and practices in which care is offered. Therefore, factors associated with dental appointments scheduling can affect positively or negatively the use of dental services. The aim of the present study was to evaluate the indicators for dental appointment scheduling in Primary Health Care (PHC). Methods The present is a cross-sectional analytical study that used data from the external assessment of the third cycle of the National Program for Improving Access and Quality in Primary Care (PMAQ-AB), carried out between 2017 and 2018, in Brazil. The final sample consisted of 85,231 patients and 22,475 Oral Health teams (OHTs). The outcome variable was the fact that the user sought for a dental appointment at the Primary Health Care Unit. A multilevel analysis was carried out to verify the association between individual variables (related to users) and contextual variables (related to the OHTs) in relation to the outcome. Results Only 58.1% of the users interviewed at these Primary Health Care Units seek the available dental care. The variables with the greatest effect on the outcome were the patient’s age up to 42 years old (OR = 2.03, 95% CI: 1.96–2.10), at individual level, and ‘oral health teams that assisted no more than a single family health team (FHT)’ (OR = 1.29, 95% CI: 1.23–1.36) at contextual level. Other variables were also associated with the outcome, but with a smaller effect size. Conclusion In conclusion, users’ age and work process of OHT were indicators for dental appointment scheduling. Our results suggest that when OHT put the National Oral Health Policy guidelines into practice, by assisting only one FHT, the chance for PHC users seeking dental appointments is higher than OHTs that assist more than one FHT. Regarding age, patients aged up to 42 years are more likely to seek an appointment with a dentist.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Indicators for dental appointment scheduling in primary health care: a national cross-sectional study

et al. 2021

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“…After the publication of the new Primary Care policy in 2017, a movement was observed indicating a reduction in the number of OHTs in Brazil, particularly in the most unequal municipalities in terms of income distribution and larger populations. [25] In this sense, it is worth mentioning the politicaleconomic moment presently experienced by Brazil, of which current government, with the justi cation of the need for austere measures, has promoted the dismantling and precariousness of SUS, also regarding oral health care, deactivating health units that make up the health network attention (particularly the Dental Specialty Centers). This may imply a weakening of the opportunity for early diagnosis of the neoplasms assessed in this study, which would be a perverse re ection of irresponsible political attitudes, given that the most affected population will be precisely the one who lives in the most disadvantaged places.…”

Section: Discussionmentioning

confidence: 99%

Oral Health Team in Primary Health Care Favors the Early Diagnosis of Oral and Oropharyngeal Cancers: A Nationwide Study

Vargas¹,

Probst²,

Cunha³

et al. 2021

Preprint

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Background Oral and oropharyngeal cancers are considered an important public health problem around all world. The most effective way to improve survival and reduce disease-related morbidity and mortality is the prevention of its major risk factors combined with early detection. This study aims to analyze the association between late diagnosis of oral and oropharyngeal cancers in Brazil and the contextual socioeconomic and coverage indicators of Primary Health Care (PHC), as well as to assess the temporal trend of the late diagnosis. Methods This observational study evaluated secondary data with a time series analysis. All Brazilian cities that reported at least one case of oral and oropharyngeal cancers each year, between 2000 and 2013 were included. These data were obtained from the National Cancer Institute José Alencar Gomes da Silva (INCA); the staging was analyzed by calculating the ratio risk for late diagnosis by municipality. The association between staging and socioeconomic variables and PHC provision was calculated using multiple linear regression. The time trend of the risk ratio for late-stage diagnosis was calculated using the Prais-Winsten method. Results One hundred and sixty Brazilian municipalities had at least one annual case of oral and oropharyngeal cancers notified to the INCA hospital system between 2000 and 2013. The adjusted model identified that the higher the Gini value (greater social inequality) and the lower the HDI value (less human development), the greater the number of tumors diagnosed at a late stage, considering the size of the tumor. A greater risk for late diagnosis was identified, already in the stage of lymph node involvement, when there is greater social inequality and less coverage of Oral Health Team (OHT) in PHC. The greater the social inequality, the greater the risk of late diagnosis, already in the metastasis stage. Conclusions Better socioeconomic indicators and greater coverage by the OHT were associated with the diagnosis of oral and oropharyngeal cancers still in the early stages. During the evaluated period, there was an increase in the number of cases diagnosed at the most advanced stage.

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Inclusion of oral health teams in primary health care promotes early diagnosis of oral and oropharyngeal cancers: a nationwide study

et al. 2021

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Background Oral and oropharyngeal cancers are considered important public health problems worldwide. This study aims to analyze the association between late diagnosis of oral and oropharyngeal cancers in Brazil and the contextual indicators of socioeconomic variables and coverage of Primary Health Care (PHC), and to assess the temporal trend of late diagnosis. Methods In this cross-sectional observational study, secondary data were evaluated with a time series analysis. All Brazilian cities that reported at least one case of oral and oropharyngeal cancers each year in the period between 2000 and 2013 were included; and the staging was analyzed by calculating the ratio risk for late diagnosis for each municipality. The association between staging and socioeconomic variables and offer of PHC was calculated using multiple linear regression. The time trend of the risk ratio for late-stage diagnosis was calculated using the Prais–Winsten method. Results One hundred and sixty Brazilian municipalities had at least one annual case of oral and oropharyngeal cancers notified to the INCA hospital system between 2000 and 2013. The adjusted model showed that the higher the Gini value (greater social inequality) and the lower the HDI value (less human development) was, the higher was the number of tumors diagnosed at a late stage, considering the size of the tumor. A greater risk for late diagnosis was identified, as early as at the stage of lymph node involvement, when there was a higher level of social inequality and lower level of coverage by Oral Health Teams (OHT) in PHC. The greater the social inequality, the greater was the risk of late diagnosis, as early as in the stage of metastasis. Conclusions We concluded that, during the evaluated period, there was an increase in the number of cases diagnosed at the most advanced stage. Furthermore, there was association between higher levels of social inequality and an increase in the proportion of late diagnosis of oral and oropharyngeal cancers. In addition, the inclusion of Oral Health Teams in Primary Health Care promoted the early diagnosis of these types of cancers.

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Monitoramento das equipes de saúde bucal após a Política Nacional de Atenção Básica 2017

Cited by 18 publications

References 23 publications

Indicators for dental appointment scheduling in primary health care: a national cross-sectional study

Indicators for dental appointment scheduling in primary health care: a national cross-sectional study

Oral Health Team in Primary Health Care Favors the Early Diagnosis of Oral and Oropharyngeal Cancers: A Nationwide Study

Inclusion of oral health teams in primary health care promotes early diagnosis of oral and oropharyngeal cancers: a nationwide study

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