Reis Clarice Magalhães Rodrigues Dos, Mendes Suellen da Rocha, Matta-Machado Antônio Thomaz Gonzaga da, Mambrini Juliana Vaz de Melo, Werneck Marcos Azeredo Furquim, Abreu Mauro Henrique Nogueira Guimarães de
Department of Community and Preventive Dentistry.
Department of Preventive and Social Medicine, School of Medicine, Universidade Federal de Minas Gerais.
Medicine (Baltimore). 2020 Apr;99(17):e19872. doi: 10.1097/MD.0000000000019872.
This study evaluated the factors associated with the performance of Brazilian Oral Health Teams (OHTs).This is multilevel research that used data from 12,386 Brazilian OHTs in 2012. The OHTs performance was estimated in previous research by using Item Response Theory model, which employed 20 questions about dental procedures in Primary Care. The first level covariates were based on OHTs procedures such as: the record of pregnant woman dental appointment, provision of dentistry home care, dental appointments scheduled choices, and OHTs in charge for more than 5000 individuals. Moreover, the use of guidelines was accessed concerning delivering prostheses in primary care, referring to secondary care, referring to suspected oral cancer, and providing care towards patients with special needs. Variables included in level 2 were GINI and Human Development Index. Multilevel linear regression models were constructed, estimating linear regression coefficients, 95% confidence intervals, and P values.OHTs performance was different among the 3,613 municipalities analyzed (P < .001), with 36.7% of the variation in the performance of the OHTs being attributed to the variability between municipalities. The adjusted model showed that higher performance OHTs reported attention to pregnant women, dentistry home care and use of dental care guidelines (P < .001). There were lower performance scores for those OHTs with more restricted scheduling (P < .05), compared to those that reported scheduling appointments at any day and time. The best OHTs and population ratio led to a better performance score (P = .010). At the municipal level, better socioeconomic status was associated with better performance of the OHTs (P < .001).OHTs with higher performance are associated with oral health services organizations and municipalities' socioeconomic status.
本研究评估了与巴西口腔健康团队（OHTs）绩效相关的因素。这是一项多层次研究，使用了2012年来自12386个巴西口腔健康团队的数据。在先前的研究中，通过项目反应理论模型评估口腔健康团队的绩效，该模型采用了20个关于初级保健中牙科程序的问题。第一层次协变量基于口腔健康团队的程序，如：孕妇牙科预约记录、提供牙科家庭护理、牙科预约安排选择，以及负责超过5000人的口腔健康团队。此外，还评估了在初级保健中提供假体、转诊至二级保健、转诊疑似口腔癌以及为特殊需求患者提供护理方面指南的使用情况。第二层次纳入的变量是基尼系数和人类发展指数。构建了多层次线性回归模型，估计线性回归系数、95%置信区间和P值。在分析的3613个市中，口腔健康团队的绩效存在差异（P<0.001），口腔健康团队绩效的36.7%的变异归因于市与市之间的差异。调整后的模型显示，绩效较高的口腔健康团队报告关注孕妇、牙科家庭护理和牙科护理指南的使用（P<0.001）。与那些报告可在任何日期和时间安排预约的团队相比，预约安排更受限的口腔健康团队绩效得分较低（P<0.05）。最佳的口腔健康团队与人口比例导致更好的绩效得分（P=0.010）。在市一级，更好的社会经济地位与口腔健康团队的更好绩效相关（P<0.001）。绩效较高的口腔健康团队与口腔健康服务组织和市的社会经济地位相关。
