Dentistry Department, Graduate Program in Dentistry, Federal University of Maranhão, São Luís, Maranhão, Brasil.
Dentistry Department, CEUMA University, São Luís, Maranhão, Brasil.
PLoS One. 2021 Mar 16;16(3):e0247101. doi: 10.1371/journal.pone.0247101. eCollection 2021.
Compared indicators of potential access to oral health services sought in two cycles of the Program for Improvement of Access and Quality of Primary Care (PMAQ-AB), verifying whether the program generated changes in access to oral health services.
Transitional analysis of latent classes was used to analyze two cross-sections of the external evaluation of the PMAQ-AB (Cycle I: 2011-2012 and Cycle II: 2013-2014), identifying completeness classes for a structure and work process related to oral health. Consider three indicators of structure (presence of a dental surgeon, existence of a dental office and operating at minimum hours) and five of the work process (scheduling every day of the week, home visits, basic dental procedures, scheduling for spontaneous demand and continuation of treatment). Choropleth maps and hotspots were made.
The proportion of elements that had one or more dentist (CD), dental office and operated at minimum hours varied from 65.56% to 67.13 between the two cycles of the PMAQ-AB. The number of teams that made appointments every day of the week increased 8.7% and those that made home visits varied from 44.51% to 52.88%. The reduction in the number of teams that reported guaranteeing the agenda for accommodating spontaneous demand, varying from 62.41% to 60.11% and in the continuity of treatment, varying from 63.41% to 61.11%. For the structure of health requirements, the predominant completeness profile was "Best completeness" in both cycles, comprising 71.0% of the sets at time 1 and 67.0% at time 2. The proportion of teams with "Best completeness" increased by 89.1%, the one with "Worst completeness" increased by 20%, while those with "Average completeness" decreased by 66.3%.
We identified positive changes in the indicators of potential access to oral health services, expanding the users' ability to use them. However, some access attributes remain unsatisfactory, with organizational barriers persisting.
比较两个初级保健改善和质量提升计划（PMAQ-AB）周期中寻求口腔卫生服务的潜在可及性指标，以验证该计划是否改变了口腔卫生服务的可及性。
采用潜在类别过渡分析对 PMAQ-AB 的外部评估进行了两次横断面分析（周期 I：2011-2012 年和周期 II：2013-2014 年），确定了与口腔健康相关的结构和工作流程的完整类别。考虑了结构的三个指标（牙医的存在、牙科诊室的存在和最低工作时间）和工作流程的五个指标（每周每天安排预约、上门服务、基本牙科治疗、预约自发需求和治疗延续）。制作了面图和热点图。
两个 PMAQ-AB 周期之间，拥有一名或多名牙医（CD）、牙科诊室和最低工作时间的元素比例从 65.56%变化到 67.13%。每周每天安排预约的团队数量增加了 8.7%，上门服务的团队数量从 44.51%变化到 52.88%。报告保证满足自发需求预约日程的团队数量减少了 62.41%到 60.11%，治疗延续性减少了 63.41%到 61.11%。在卫生要求的结构方面，两个周期都以“最佳完整性”为主导，在时间 1 时占 71.0%，时间 2 时占 67.0%。具有“最佳完整性”的团队比例增加了 89.1%，具有“最差完整性”的团队比例增加了 20%，而具有“平均完整性”的团队比例减少了 66.3%。
我们发现了口腔卫生服务潜在可及性指标的积极变化，扩大了用户使用这些服务的能力。然而，一些可及性属性仍然不尽如人意，组织障碍仍然存在。
