Bomfim Rafael Aiello, da Cunha Inara Pereira, Lacerda Valéria Rodrigues de
School of Dentistry, Federal University of Mato Grosso do Sul, Campo Grande, Brazil.
Public Health School, Campo Grande, Brazil.
Community Dent Oral Epidemiol. 2022 Feb;50(1):11-18. doi: 10.1111/cdoe.12713. Epub 2021 Dec 6.
This study aimed to verify racial differences in the performance of Dental Specialities Centers in Brazil, according to the presence of active health ombudsman on four primary outcomes: (1) access and dental appointment, (2) reception services, (3) bond and responsibility, and (4) social participation.
Data came from the PMAQ-CEO national evaluation of public healthcare services, 2018-2019. The two main explanatory variables were the self-classified race at the individual level and the presence of the health ombudsman at the second level (level of services provision). Individual covariates included age, sex and schooling. Multilevel logistic regression was used to calculate the OR (Odds Ratios) in racial gaps according to the primary outcomes with individuals at the first level and public health services at the second level.
The analytical sample comprised of 8993 respondents. Brown people were less likely to report better Access (27%), good reception services (31%), bond and responsibility (30%) and social participation (22%) than Whites. Black people showed similar patterns. Dental Specialities Centers that use health ombudsman for planning have attenuated racial inequities in all analysed dimensions.
Dental Specialities Centers that use active health ombudsman for planning showed lower racial inequities in access, reception, bond and responsibility and social participation than those who did not use. Therefore, the health ombudsman should be implemented and used for planning better specialized dental services in Brazil.
本研究旨在根据四个主要结果中是否设有活跃的健康监察员，验证巴西牙科专科中心在服务表现方面的种族差异，这四个主要结果分别为：（1）就诊机会与牙科预约；（2）接待服务；（3）联系与责任；（4）社会参与。
数据来自2018 - 2019年公共医疗服务的PMAQ - CEO全国评估。两个主要解释变量分别是个体层面的自我分类种族以及二级（服务提供层面）是否设有健康监察员。个体协变量包括年龄、性别和受教育程度。采用多水平逻辑回归，根据一级个体和二级公共卫生服务的主要结果计算种族差距中的比值比（OR）。
分析样本包括8993名受访者。与白人相比，棕色人种在报告有更好的就诊机会（27%）、良好的接待服务（31%）、联系与责任（30%）以及社会参与（22%）方面的可能性更低。黑人呈现出类似模式。使用健康监察员进行规划的牙科专科中心在所有分析维度上都减少了种族不平等。
与未使用健康监察员进行规划的牙科专科中心相比，使用活跃的健康监察员进行规划的牙科专科中心在就诊机会、接待、联系与责任以及社会参与方面的种族不平等程度更低。因此，巴西应设立并利用健康监察员来规划更好的专科牙科服务。
