Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, Brazil.
Health Technology Assessment Unit, Hospital Alemão Oswaldo Cruz (HAOC), São Paulo, Brazil.
BMC Public Health. 2021 Dec 8;21(1):2234. doi: 10.1186/s12889-021-12319-x.
Integrated dental services within the Health System, particularly at primary health care, are crucial to reverse the current impact of oral diseases, which are among the most prevalent diseases worldwide. However, the use of dental services is determined by complex phenomena related to the individual, the environment and practices in which care is offered. Therefore, factors associated with dental appointments scheduling can affect positively or negatively the use of dental services. The aim of the present study was to evaluate the indicators for dental appointment scheduling in Primary Health Care (PHC).
The present is a cross-sectional analytical study that used data from the external assessment of the third cycle of the National Program for Improving Access and Quality in Primary Care (PMAQ-AB), carried out between 2017 and 2018, in Brazil. The final sample consisted of 85,231 patients and 22,475 Oral Health teams (OHTs). The outcome variable was the fact that the user sought for a dental appointment at the Primary Health Care Unit. A multilevel analysis was carried out to verify the association between individual variables (related to users) and contextual variables (related to the OHTs) in relation to the outcome.
Only 58.1% of the users interviewed at these Primary Health Care Units seek the available dental care. The variables with the greatest effect on the outcome were the patient's age up to 42 years old (OR = 2.03, 95% CI: 1.96-2.10), at individual level, and 'oral health teams that assisted no more than a single family health team (FHT)' (OR = 1.29, 95% CI: 1.23-1.36) at contextual level. Other variables were also associated with the outcome, but with a smaller effect size.
In conclusion, users' age and work process of OHT were indicators for dental appointment scheduling. Our results suggest that when OHT put the National Oral Health Policy guidelines into practice, by assisting only one FHT, the chance for PHC users seeking dental appointments is higher than OHTs that assist more than one FHT. Regarding age, patients aged up to 42 years are more likely to seek an appointment with a dentist.
在卫生系统中整合牙科服务，特别是在初级保健中，对于扭转目前全球最普遍的口腔疾病的影响至关重要。然而，牙科服务的使用受到与个体、环境和所提供护理实践相关的复杂现象的影响。因此，与预约牙科就诊相关的因素可能会对牙科服务的使用产生积极或消极的影响。本研究旨在评估初级保健中牙科预约安排的指标。
本研究是一项横断面分析性研究，使用了 2017 年至 2018 年期间在巴西进行的国家改善初级保健获取和质量计划（PMAQ-AB）第三周期外部评估的数据。最终样本包括 85231 名患者和 22475 个口腔卫生团队（OHT）。因变量是患者在初级保健单位寻求牙科预约的情况。进行了多水平分析，以验证个体变量（与患者相关）和背景变量（与 OHT 相关）与结果之间的关联。
在这些初级保健单位接受访谈的患者中，只有 58.1%的患者寻求可获得的牙科护理。对结果影响最大的变量是患者年龄在 42 岁及以下（OR=2.03，95%CI：1.96-2.10），这是个体层面的变量，以及“仅协助单一家庭健康团队的口腔卫生团队”（OR=1.29，95%CI：1.23-1.36），这是背景层面的变量。其他变量也与结果相关，但影响较小。
总之，患者的年龄和 OHT 的工作流程是牙科预约安排的指标。我们的结果表明，当 OHT 实施国家口腔卫生政策指南时，通过仅协助一个 FHT，与 OHT 协助多个 FHT 相比，初级保健用户寻求牙科预约的机会更高。关于年龄，42 岁及以下的患者更有可能预约看牙医。
