Amaral João Henrique Lara do, Vasconcelos Mara, Gomes Viviane Elisângela, Werneck Marcos Azeredo Furquim, Gaspar Gabriela da Silveira, Lopes Amanda Lívia, Pinheiro Elisa Lopes, Ferreira Raquel Conceição
Department of Community and Preventive Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Department of Collective Health, Universidade Federal de Pernambuco, Recife, Brazil.
Community Dent Oral Epidemiol. 2022 Feb;50(1):27-37. doi: 10.1111/cdoe.12716.
To assess the association between user satisfaction in relation to secondary dental care services and the structure and process of Brazilian Dental Specialty Centers (CEO, in Portuguese).
This study used nationwide secondary data from two CEO evaluation cycles. Ten users from each CEO answered questions on the self-perception of healthcare quality and satisfaction with health services. Latent class analysis (LCA) was performed to identify subgroups of satisfied and dissatisfied users (outcome). The CEO structure included equipment, supplies, instruments, ambience and type of CEO (type I, II or III, according to the number of dental chairs and dental professionals). The work process referred to the planning/monitoring of actions, collaborative care, characteristics of the demand for medical care /the organization of scheduling, and continuing education for employees. Covariables concerned user profiles. A multilevel logistic regression model was used (p-value <.05).
Seven thousand nine hundred and ninety-seven users in 794 CEOs, together with 10056 users in 911 CEOs, participated in the 1st and 2nd evaluation cycles, and satisfied users corresponded to 85.3% and 87.1%, respectively. In both cycles, the CEO's structural characteristics explained most of the variance in satisfaction. CEOs with more favourable structural characteristics showed higher satisfaction. Users from CEOs, type II and III, and those who received dental care where there was an interruption of services due to a lack of equipment or instruments reported a lower level of satisfaction. CEOs that organize their demand through referrals received from primary care dentists who have participated in continuing education actions for dental professionals presented a higher frequency of satisfied users.
Characteristics of the process and structure were associated with user satisfaction, but a quality of care was perceived by users, mainly due to structural characteristics.
评估巴西牙科专科中心（葡萄牙语为CEO）二级牙科护理服务的用户满意度与结构及流程之间的关联。
本研究使用了来自两个CEO评估周期的全国性二级数据。每个CEO的十名用户回答了关于医疗质量自我认知和对健康服务满意度的问题。进行潜在类别分析（LCA）以识别满意和不满意用户的亚组（结果）。CEO结构包括设备、耗材、器械、环境以及CEO类型（根据牙科椅和牙科专业人员数量分为I、II或III型）。工作流程涉及行动的规划/监测、协作护理、医疗护理需求特征/排班安排以及员工继续教育。协变量涉及用户概况。使用了多水平逻辑回归模型（p值<.05）。
794个CEO中的7997名用户以及911个CEO中的10056名用户分别参与了第一和第二个评估周期，满意用户分别占85.3%和87.1%。在两个周期中，CEO的结构特征解释了满意度方面的大部分差异。结构特征更有利的CEO显示出更高的满意度。来自II型和III型CEO的用户，以及那些在因设备或器械短缺导致服务中断的情况下接受牙科护理的用户，报告的满意度较低。通过从参与牙科专业人员继续教育行动的初级保健牙医处获得的转诊来组织需求的CEO，其满意用户的比例更高。
流程和结构特征与用户满意度相关，但用户主要是基于结构特征来感知护理质量。
