Department of Preventive and Social Dentistry, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
Biomed Res Int. 2022 Mar 20;2022:5365363. doi: 10.1155/2022/5365363. eCollection 2022.
The aim was to evaluate the association between the professional training of dentists and their outpatient production (OP) of clinical and collective/preventive procedures and the total number of procedures registered in a health information system.
It included all 19,947 primary dental care units participating in the Program for Improvement of Access and Quality of Primary Care (PMAQ-AB 2nd cycle) and the number of clinical procedures (CP), collective/preventive procedures (PP), and total procedures (TP) registered in the ambulatory information system between November 2013 and July 2014 for each participant oral health team. The outcome was being above the national median of procedures. The main variables related to training were the dentists specialising in family health, the level of training, and participation in permanent education. Effect estimates were calculated by multiple logistic regression.
In the final model, controlled by contextual factor work process, family health specialists had higher chances (odds ratio (OR) = 1.13, 95% CI: 1.00; 1.27) of producing above the national median of CP than nonspecialists, OR = 1.06 (0.96; 1.18) for PP and OR = 1.17 (1.08; 1.27) for TP. Dentists taking permanent education had higher chances than those not taking it of producing above the national median for CP, PP, and TT, respectively, with OR = 1.40 (1.20; 1.62), OR = 1.24 (1.09; 1.40), and OR = 1.28 (1.18; 1.39).
Training in family health performs more procedures in primary care settings than those without training. However, this OP is influenced by variables related to the municipality and the work process, especially for PP. If the highest production observed is a consequence of training, then public health managers can not only encourage training policies such as permanent education policies to expand the use of services.
本研究旨在评估牙医的专业培训与其在门诊进行临床和集体/预防治疗的产出(OP)以及在健康信息系统中登记的总治疗次数之间的关联。
研究纳入了参加改进初级保健服务可及性和质量计划(PMAQ-AB 第二周期)的所有 19947 个初级牙科护理单位,以及每位参与者口腔保健团队在 2013 年 11 月至 2014 年 7 月间在门诊信息系统中登记的临床治疗(CP)、集体/预防治疗(PP)和总治疗次数(TP)。结果是评估治疗是否高于全国中位数。与培训相关的主要变量是从事家庭健康专业的牙医、培训水平和参加继续教育的情况。通过多因素逻辑回归计算效应估计值。
在最终模型中,控制了工作流程的环境因素后,与非专科牙医相比,从事家庭健康专业的牙医进行 CP 治疗的可能性更高(比值比(OR)=1.13,95%置信区间:1.00;1.27),PP(OR=1.06,95%置信区间:0.96;1.18)和 TT(OR=1.17,95%置信区间:1.08;1.27)。参加继续教育的牙医比未参加的牙医进行 CP、PP 和 TT 治疗的可能性更高,OR 值分别为 1.40(1.20;1.62)、OR 值分别为 1.24(1.09;1.40)和 OR 值分别为 1.28(1.18;1.39)。
在初级保健环境中,接受过家庭健康培训的牙医比未接受过培训的牙医进行的治疗次数更多。然而,这种 OP 受到与市和工作流程相关的变量的影响,特别是对于 PP。如果观察到的最高产量是培训的结果,那么公共卫生管理者不仅可以鼓励培训政策,如继续教育政策,以扩大服务的使用。