Departamento de Odontologia Social e Pediátrica, Faculdade de Odontologia, Universidade Federal da Bahia, Salvador, BA, Brasil.
Rev Saude Publica. 2010 Dec;44(6):1005-13. doi: 10.1590/s0034-89102010005000041. Epub 2010 Oct 8.
To analyze the factors associated with comprehensiveness in oral health care in Centers of Dental Specialists, according to the guiding principles of the Brazilian Oral Health Policy.
An exploratory cross-sectional study, based on an interview with 611 users of four specialized dental care centers, was performed in the state of Bahia, Northeastern Brazil, in 2008. The dependent variable was described as "comprehensiveness in oral health care", corresponding to having a primary dental care performed before specialized treatment or concomitantly with it. The main covariables referred to the level of coverage of the family health strategy in the city, users' sociodemographic characteristics, and organizational and geographic accessibility to the service, in addition to the type of specialized care required.
Residents of the cities where the Family Healthcare Program had a coverage >50% were more likely to conclude their dental treatment (PR=2.03, 95% CI: 1.33;3.09), compared to those who lived in places with lower coverage. Individuals who sought endodontic treatment were more likely to receive comprehensive oral health care than users who were seeking other types of specialized care (PR=2.31, 95% CI: 1.67;3.19). Users with better geographic accessibility to specialized services (PR=1.22, 95% CI: 1.03;1.41), with a reference guide from primary care (PR=2.95, 95% CI: 1.82;4.78) and coming from primary health care services (PR=3.13, 95% CI: 1.70;5.77) were more likely to achieve comprehensiveness in oral health care than other users.
Users with better geographic accessibility, lower age and need of endodontic services were more likely to receive comprehensive health care. Implementation of Centers of Dental Specialists in cities where primary healthcare is not adequately structured is not recommended, because secondary health care would meet the free demand and perform basic procedures, thus not fulfilling the expected principle of comprehensiveness.
根据巴西口腔卫生政策的指导原则，分析牙科专家中心口腔保健全面性的相关因素。
本研究是一项在巴西东北部巴伊亚州进行的探索性横断面研究，通过对 4 个专门牙科护理中心的 611 名使用者进行访谈。依赖变量描述为“口腔保健的全面性”，即专门治疗前或同时进行初级牙科护理。主要协变量涉及到城市家庭健康战略的覆盖水平、使用者的社会人口统计学特征以及服务的组织和地理可及性，以及所需的专业护理类型。
与居住在覆盖范围较低地区的人相比，居住在家庭医疗保健计划覆盖超过 50%的城市的人更有可能完成他们的牙科治疗（PR=2.03，95%CI：1.33；3.09）。与寻求其他类型专业护理的使用者相比，接受牙髓治疗的个体更有可能获得全面的口腔保健（PR=2.31，95%CI：1.67；3.19）。地理上更容易获得专门服务的使用者（PR=1.22，95%CI：1.03；1.41）、有初级保健指南（PR=2.95，95%CI：1.82；4.78）和来自初级保健服务（PR=3.13，95%CI：1.70；5.77）的使用者更有可能实现口腔保健的全面性。
地理上更容易获得、年龄较小且需要牙髓治疗的使用者更有可能获得全面的健康护理。不建议在初级卫生保健结构不完善的城市设立牙科专家中心，因为二级卫生保健将满足免费需求并进行基本程序，从而不符合全面性的预期原则。
