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解释公共牙科服务利用情况:一个理论模型。

Explaining public dental service utilization: A theoretical model.

机构信息

Postgraduate Program in Public Health, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.

Academic Center of Vitória, Federal University of Pernambuco, Vitória de Santo Antão, Pernambuco, Brazil.

出版信息

PLoS One. 2023 Sep 1;18(9):e0290992. doi: 10.1371/journal.pone.0290992. eCollection 2023.

Abstract

OBJECTIVES

Constructing and validating a theoretical model of relationships between dental services use and socioeconomic characteristics, oral health status, primary care coverage, and public dental services.

METHODS

The first stage of the study consisted of developing a theoretical-conceptual model to demonstrate the expected relationships between variables based on the literature. In the second stage, we tested the proposed theoretical model using the Partial Least Squares Structural Equation Modeling (PLS-SEM) technique, using data from the Brazilian National Health Survey conducted in 2019 with a sample of 41,664 individuals aged 15 or older.

RESULTS

This study successfully defined a theoretical model that explains the systematic relationships involving public dental services utilization. Socioeconomic status was negatively associated with oral health status (β = -0.376), enrollment in primary care facilities (β = -0.254), and the use of public dental consultations (β = -0.251). Being black, indigenous, or living in a rural area was directly associated with lower socioeconomic status and greater use of public dental services.

CONCLUSIONS

The identified relationships, establishing a theoretical basis for further investigations, also provide evidence of a public access policy's effect on oral health services on equity, supporting the construction of more effective and equitable public policies.

摘要

目的

构建和验证一个关于牙科服务利用与社会经济特征、口腔健康状况、初级保健覆盖和公共牙科服务之间关系的理论模型。

方法

研究的第一阶段包括根据文献制定一个理论概念模型,以展示变量之间预期的关系。在第二阶段,我们使用巴西 2019 年全国健康调查的数据,该调查的样本为 41664 名 15 岁或以上的个体,使用偏最小二乘结构方程建模(PLS-SEM)技术检验了所提出的理论模型。

结果

本研究成功定义了一个理论模型,解释了涉及公共牙科服务利用的系统关系。社会经济地位与口腔健康状况(β=-0.376)、初级保健设施的参与(β=-0.254)和公共牙科咨询的使用(β=-0.251)呈负相关。黑人、原住民或居住在农村地区与较低的社会经济地位和更多地使用公共牙科服务直接相关。

结论

所确定的关系为进一步的研究提供了理论基础,也为公共服务政策对口腔健康服务公平性的影响提供了证据,支持构建更有效和公平的公共政策。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bab/10473501/9ed708578d99/pone.0290992.g001.jpg

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