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[巴西贫困地区的社会经济指标与口腔健康服务]

[Socioeconomic indicators and oral health services in an underprivileged area of Brazil].

作者信息

Palmier Andréa Clemente, Andrade Danielle Alves, Campos Ana Cristina Viana, Abreu Mauro Henrique Nogueira Guimarães, Ferreira Efigênia Ferreira

机构信息

Departamento de Odontologia Social e Preventiva, Faculdade de Odontologia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.

出版信息

Rev Panam Salud Publica. 2012 Jul;32(1):22-9. doi: 10.1590/s1020-49892012000700004.

Abstract

OBJECTIVE

To evaluate the association between the proportion of tooth extractions, socioeconomic indicators, and the availability of oral health services in an underprivileged area of Brazil.

METHODS

An ecological study was carried out in 52 municipalities in the state of Minas Gerais, Brazil. The socioeconomic indicators employed were criteria for health care resources allocation, municipal human development index, Theil index, Gini coefficient, and sanitation conditions. Concerning the availability of oral health services, the following were considered: number of inhabitants, number of dental surgeons living in the city, number of dentists working in the public services, and number of municipal oral health care teams. The utilization of oral health services was evaluated using the indicators recommended by the Health Ministry's Basic Care Package (Pacto da Atencão Básica in Portuguese) and the number of procedures carried out in the primary care setting. The 17 variables assessed were grouped into factorial components, which were then analyzed in terms of their relationship with the dependent variable, tooth extractions.

RESULTS

The following six components explained 73.5% of the overall variance: socioeconomic conditions, social inequality, Basic Care Package indicators, number of procedures carried out, ratio of dentists to inhabitants, and coverage of the Family Health Strategy. Inequalities in income distribution (P = 0.031) and coverage by the Family Health Strategy (P = 0.015) contributed significantly to explain the difference in the proportion of tooth extractions in the different municipalities under study.

CONCLUSIONS

The dental loss observed in the region is largely explained by socioeconomic factors and aspects related to the organization of oral health services.

摘要

目的

评估巴西贫困地区拔牙比例、社会经济指标与口腔卫生服务可及性之间的关联。

方法

在巴西米纳斯吉拉斯州的52个市开展了一项生态学研究。所采用的社会经济指标为医疗保健资源分配标准、市人类发展指数、泰尔指数、基尼系数和卫生条件。关于口腔卫生服务的可及性,考虑了以下因素:居民人数、居住在该市的牙科外科医生人数、在公共服务部门工作的牙医人数以及市口腔卫生保健团队的数量。利用卫生部基本保健套餐(葡萄牙语为Pacto da Atencão Básica)推荐的指标以及在初级保健机构开展的诊疗程序数量来评估口腔卫生服务的利用情况。所评估的17个变量被分组为因子成分,然后分析它们与因变量拔牙之间的关系。

结果

以下六个成分解释了总体方差的73.5%:社会经济状况、社会不平等、基本保健套餐指标、开展的诊疗程序数量、牙医与居民的比例以及家庭健康战略的覆盖范围。收入分配不平等(P = 0.031)和家庭健康战略的覆盖范围(P = 0.015)对解释所研究的不同市拔牙比例的差异有显著贡献。

结论

该地区观察到的牙齿缺失在很大程度上可由社会经济因素以及与口腔卫生服务组织相关的方面来解释。

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