Department of Dentistry, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.
BMC Public Health. 2021 Mar 19;21(1):541. doi: 10.1186/s12889-021-10586-2.
This study aimed to assess the trend in income-related inequalities in oral health services utilization by the Brazilian population from 1998 to 2013. This period represents a timeline that includes different stages of implementation of the National Oral Health Policy.
The design was based on repeated cross-sectional surveys using secondary data from household-based studies carried out in Brazil in 1998, 2003, 2008, and 2013. The dependent variable was "having access to a dentist appointment at least once in a lifetime (yes/no)." Monthly household per capita income, based on Brazil's minimum wage, was included as the main independent variable. To measure the inequalities in oral health access related to economic position, the following complex indexes based on regression were used: (a) the slope index of inequality (SII) and (b) the relative index of inequality (RII).
There was a reduction in the percentage of individuals who never had a dentist appointment for all age groups and income classifications. In general, there was a reduction trend in absolute inequality for all age groups (p < 0.001). The relative inequality and reduction trend were different between the age groups studied.
The National Oral Health Policy was very important for expanding free of charge, public access to dental appointment. However, despite policy implementation, there continues to be high levels of inequality in access to dental consultation. Assessing which strategies are necessary to overcome this challenge is discussed.
本研究旨在评估巴西人口在 1998 年至 2013 年期间，口腔卫生服务利用方面与收入相关的不平等趋势。这一时期包括国家口腔卫生政策实施的不同阶段。
本设计基于使用来自巴西在 1998 年、2003 年、2008 年和 2013 年进行的基于家庭的研究的二手数据的重复横断面调查。因变量为“一生中至少有一次预约牙医（是/否）”。每月家庭人均收入基于巴西最低工资，被纳入主要的独立变量。为了衡量与经济地位相关的口腔卫生服务利用不平等，使用了以下基于回归的复杂指数：（a）不平等斜率指数（SII）和（b）不平等相对指数（RII）。
所有年龄组和收入分类的从未预约过牙医的个体比例均有所下降。总体而言，所有年龄组的绝对不平等呈下降趋势（p<0.001）。研究的年龄组之间，相对不平等和下降趋势有所不同。
国家口腔卫生政策对于扩大免费、公共牙科预约服务非常重要。然而，尽管政策实施，牙科咨询的获得仍存在高度不平等。讨论了评估需要采取哪些策略来克服这一挑战。
