Universidade Federal da Paraíba . Centro de Ciências da Saúde . Departamento de Clínica e Odontologia Social . João Pessoa , PB , Brasil.
Fundação Oswaldo Cruz . Instituto Aggeu Magalhães . Programa de Pós-Graduação em Saúde Pública . Pernambuco , PE , Brasil.
Rev Saude Publica. 2020 Nov 11;54:99. doi: 10.11606/s1518-8787.2020054002075. eCollection 2020.
To monitor the number of oral health teams implemented in the Family Health Strategy after National Primary Care Policy 2017.
This is a study of quantitative, descriptive and analytical nature that used the data from the public reports of the history of oral health coverage available in the e-Manager platform of Primary Care of the Ministry of Health of all Brazilian municipalities (5,570). The survival rate of the municipalities that did not reduce the number of oral health teams was analyzed according to the region of the country, human development index, Gini inequality index and population size. Cox regression was used to analyze the factors associated with the decrease in the number of teams implanted after 1, 3, 6, 9, 12, 15, 18 and 21 months of publication of the 2017 national policy ordinance, considering the hazard ratio (HR) and p < 0.05.
After 21 months of publication of the policy, 6.7% of Brazilian municipalities reduced the number of oral health teams. This reduction was higher in the South (6.7%) and Northeast (4.8%), in municipalities with the highest human development index, i.e., greater than or equal to 0.7 (5.6%), more unequal in terms of income distribution (Gini index > 0.62) and larger population size (more than 100,000 inhabitants). Municipalities in the Northeast (HR = 1.220) and South (HR = 1.771) regions had a higher chance of reducing the number of teams compared with those in the North region. More unequal municipalities (HR = 6.405) and with larger population size (HR = 4.273) were also more likely to reduce the coverage of oral health teams.
The municipalities that reduced the number of oral health teams in the Family Health Strategy are from the South and Northeast regions, with greater social inequality and larger population size. This scenario can significantly affect the population's access to dental health services in the Unified Health System, especially among those in need.
监测 2017 年国家初级保健政策后实施的家庭健康战略中的口腔卫生团队数量。
这是一项定量、描述性和分析性研究,使用了卫生部初级保健电子经理平台上提供的所有巴西城市(5570 个)的口腔卫生覆盖公共报告中的数据。根据国家区域、人类发展指数、基尼不平等指数和人口规模,分析了未减少口腔卫生团队数量的城市的生存率。使用 Cox 回归分析了在 2017 年国家政策条例发布后 1、3、6、9、12、15、18 和 21 个月,与团队数量减少相关的因素,考虑了风险比(HR)和 p < 0.05。
在政策发布 21 个月后,巴西有 6.7%的城市减少了口腔卫生团队的数量。南部(6.7%)和东北部(4.8%)的降幅更高,人类发展指数较高(即大于或等于 0.7)、收入分配更不平等(基尼指数>0.62)和人口规模较大(超过 10 万居民)的城市降幅更高。与北部地区相比,东北部(HR = 1.220)和南部(HR = 1.771)地区的城市减少团队数量的可能性更高。更不平等的城市(HR = 6.405)和人口规模较大的城市(HR = 4.273)也更有可能减少口腔卫生团队的覆盖率。
在家庭健康战略中减少口腔卫生团队数量的城市来自南部和东北部地区,社会不平等程度更高,人口规模更大。这种情况可能会严重影响人口在统一卫生系统中获得牙科保健服务的机会,尤其是那些有需要的人。