Faculty of Dentistry, Federal University of Mato Grosso do Sul, Campo Grande, Brazil.
School of Public Health, University of São Paulo, São Paulo, Brazil.
BMC Health Serv Res. 2023 May 9;23(1):461. doi: 10.1186/s12913-023-09437-0.
Timely diagnosis of oral cancers is critical, and performing biopsies of oral lesions with suspected malignancy is a crucial step in achieving this goal. The waiting time for the diagnosis may be related to the progression and prognosis of malignant neoplasms.
The aim of this observational, cross-sectional, national-level study was to identify the factors associated with the waiting time for scheduling an oral biopsy, based on the identification of its need.
We used secondary data from the Brazilian public health system, obtained from the 2nd cycle of the National Program to Improve Access and Quality of Dental Specialty Centers (PMAQ-CEO). The study outcome was the waiting time for scheduling an oral biopsy, starting from the identification of the need for the exam. We analyzed individual and contextual variables using multilevel statistical analysis.
In 51.8% of DSC the waiting time for scheduling a biopsy was non-immediate; in 58.1% of CEOs, the sum of the weekly workload of dentists working in the Stomatology specialty is up to 20 h per week; in terms of coverage, 67.1% of the CEOs have only municipal coverage and 34.0% are references for up to 12 oral health teams in primary health care; only the coverage variable remained significant in the multivariate model (p < 0.05). Of the contextual variables, none of the variables remained significant (p > 0.05). When these were analyzed together, only the coverage remained significant (p < 0.05); CONCLUSION: Our analysis indicates that the waiting time for scheduling an oral biopsy is longer in CEOs that cover only one municipality and is not related to contextual factors.
及时诊断口腔癌至关重要，对疑似恶性的口腔病变进行活检是实现这一目标的关键步骤。诊断的等待时间可能与恶性肿瘤的进展和预后有关。
本观察性、横断面、国家级研究旨在根据口腔活检需求的识别，确定与口腔活检预约等待时间相关的因素。
我们使用来自巴西公共卫生系统的二级数据，该数据来自改善牙科专业中心准入和质量的国家方案（PMAQ-CEO）的第二周期。研究结果是从确定检查需求开始计算的口腔活检预约等待时间。我们使用多水平统计分析方法分析个体和背景变量。
在 51.8%的 DSC 中，活检预约的等待时间是非即时的；在 58.1%的 CEO 中，从事口腔医学专业的牙医每周的工作量总和高达 20 小时；在覆盖范围方面，67.1%的 CEO 仅覆盖市一级，34.0%的 CEO 是多达 12 个初级保健口腔保健团队的参考；只有覆盖变量在多变量模型中仍然显著（p<0.05）。在背景变量中，没有一个变量仍然显著（p>0.05）。当这些变量一起分析时，只有覆盖变量仍然显著（p<0.05）；结论：我们的分析表明，仅覆盖一个市的 CEO 的口腔活检预约等待时间较长，与背景因素无关。
