Galvão Maria Helena Rodrigues, Roncalli Angelo Giuseppe
Universidade Federal do Rio Grande do Norte, Natal, Brasil.
Cad Saude Publica. 2021 Jan 11;37(1):e00184119. doi: 10.1590/0102-311X00184119. eCollection 2021.
The study aimed to analyze factors associated with the availability of specialized dental services in Brazilian municipalities. This was an ecological study with a sample of 776 municipalities that participated in the first cycle of the Program to Improve Access and Quality of Dental Specialization Centers (PMAQ-CEO, in Portuguese) survey held in 2014. The study's dependent variables consisted of a coefficient created with variables on the number of professionals and the workweek of dentists in the minimum set of specialties, per 10,000 inhabitants. Exploratory factor analysis was performed to create a score for the municipalities' performance with the availability of specialized dental services. Factors associated with the municipalities' performance were assessed with Pearson's chi-square test, with the following municipal indicators as independent variables, categorized in tertiles: per capita income, Municipal Human Development Index (HDI-M), resident population, total health spending per inhabitant, and Oral Health Teams per 10,000 inhabitants. Higher performance with the availability of specialized oral health services was associated with municipalities having smaller populations (67.3%; CI: 61.6-73.0; p < 0.001), lower HDI-M (41.9%; CI: 35.8-48.0; p < 0.001), lower per capita income (41.2%; CI: 35.2-47.3; p < 0.001), and higher mean number of oral health teams per 10,000 inhabitants (50.6%; CI: 46.0-58.4; p < 0.001). The results show positive impacts from the implementation of the National Oral Health Policy in Brazil, meeting the goal of expanding the supply of secondary care services according to the principle of equity in care.
该研究旨在分析巴西各市与专业牙科服务可及性相关的因素。这是一项生态研究，样本为776个市，这些市参与了2014年举行的提高牙科专科中心服务可及性和质量计划（葡萄牙语为PMAQ-CEO）首轮调查。该研究的因变量由一个系数构成，该系数由每10000名居民中最低限度的专科领域牙医数量和工作周数的变量得出。进行探索性因素分析以得出各市在专业牙科服务可及性方面的表现得分。采用Pearson卡方检验评估与各市表现相关的因素，以下市指标作为自变量，分为三个三分位数：人均收入、市人类发展指数（HDI-M）、常住人口、人均卫生总支出以及每10000名居民中的口腔卫生团队数量。专业口腔卫生服务可及性方面表现较高与人口较少的市相关（67.3%；置信区间：61.6 - 73.0；p < 0.001）、HDI-M较低（41.9%；置信区间：35.8 - 48.0；p < 0.001）、人均收入较低（41.2%；置信区间：35.2 - 47.3；p < 0.001）以及每10000名居民中口腔卫生团队的平均数量较多（50.6%；置信区间：46.0 - 58.4；p < 0.001）。结果显示巴西国家口腔卫生政策的实施产生了积极影响，符合根据医疗公平原则扩大二级护理服务供应的目标。
