Baumgarten Alexandre, Hugo Fernando Neves, Bulgarelli Alexandre Fávero, Hilgert Juliana Balbinot
Universidade Federal do Rio Grande do Sul. Programa de Pós-Graduação em Epidemiologia. Porto Alegre, RS, Brasil.
Universidade Federal do Rio Grande do Sul. Programa de Pós-Graduação em Saúde Coletiva. Porto Alegre, RS, Brasil.
Rev Saude Publica. 2018 Apr 9;52:35. doi: 10.11606/S1518-8787.2018052016291.
To evaluate if the provision of clinical dental care, by means of the main curative procedures recommended in Primary Health Care, is associated with team structural characteristics, considering the presence of a minimum set of equipment, instrument, and supplies in Brazil's primary health care services.
A cross-sectional exploratory study based on data collected from 18,114 primary healthcare services with dental health teams in Brazil, in 2014. The outcome was created from the confirmation of five clinical procedures performed by the dentist, accounting for the presence of minimum equipment, instrument, and supplies to carry them out. Covariables were related to structural characteristics. Poisson regression with robust variance was used to obtain crude and adjusted prevalence ratios, with 95% confidence intervals.
A total of 1,190 (6.5%) dental health teams did not present the minimum equipment to provide clinical dental care and only 2,498 (14.8%) had all the instrument and supplies needed and provided the five curative procedures assessed. There was a positive association between the outcome and the composition of dental health teams, higher workload, performing analysis of health condition, and monitoring of oral health indicators. Additionally, the dental health teams that planned and programmed oral health actions with the primary care team monthly provided the procedures more frequently. Dentists with better employment status, career plans, graduation in public health or those who underwent permanent education activities provided the procedures more frequently.
A relevant number of Primary Health Care services did not have the infrastructure to provide clinical dental care. However, better results were found in dental health teams with oral health technicians, with higher workload and that plan their activities, as well as in those that employed dentists with better working relationships, who had dentists with degrees in public health and who underwent permanent education activities.
考虑到巴西初级卫生保健服务中是否存在一套最低限度的设备、器械和用品，评估通过初级卫生保健推荐的主要治疗程序提供临床牙科护理是否与团队结构特征相关。
基于2014年从巴西18114个配备牙科保健团队的初级卫生保健服务机构收集的数据进行横断面探索性研究。结果是根据牙医执行的五项临床程序的确认情况得出的，同时考虑了进行这些程序所需的最低设备、器械和用品的存在情况。协变量与结构特征相关。使用具有稳健方差的泊松回归来获得粗患病率比和调整后的患病率比以及95%置信区间。
共有1190个（6.5%）牙科保健团队没有提供临床牙科护理所需的最低设备，只有2498个（14.8%）拥有所需的所有器械和用品并提供了所评估的五项治疗程序。结果与牙科保健团队的组成、更高的工作量、进行健康状况分析以及监测口腔健康指标之间存在正相关。此外，每月与初级保健团队一起规划和安排口腔健康行动的牙科保健团队更频繁地提供这些程序。就业状况更好、有职业规划、毕业于公共卫生专业或参加过继续教育活动的牙医更频繁地提供这些程序。
相当数量的初级卫生保健服务机构没有提供临床牙科护理的基础设施。然而，在配备口腔健康技术人员、工作量较大且对活动进行规划的牙科保健团队中，以及在那些雇佣工作关系较好、拥有公共卫生学位的牙医且参加过继续教育活动的团队中，发现了更好的结果。
