Family Health Unit of Alto das Pombas, Municipal Health Department of Salvador, Salvador 40226-500, Brazil.
Department of Social and Pediatric Dentistry, Faculty of Dentistry, Federal University of Bahia, Salvador 40110-912, Brazil.
Int J Environ Res Public Health. 2024 Apr 27;21(5):555. doi: 10.3390/ijerph21050555.
This study sought to carry out a systematic and preliminary evaluation of the policies on access to public dental services for people with ASD in a Brazilian city. The study, conducted between November/2019 and February/2020, was developed through document analysis, the design of the theoretical logical model of the policies, and seven semi-structured interviews with key informants. The sample was intentionally selected. We also considered the answers to 108 questionnaires from a pilot study on the access of people with ASD to dental services applied to caregivers, dentists, and non-dental professionals. No refusals were recorded. The availability study showed that the policies' objectives were not being achieved in terms of care network organization: there were no institutional flows, personal contacts were used between professionals to guarantee access to secondary attention, there was no specific training for the dentists about ASD, and the oral health care network was unknown to non-dentist professionals and caregivers. Most people with ASD have visited the dentist at least once in their lives, but a large percentage of those within this study did not do so in the last year. This study identified difficulties in implementing policies and suggested possible strategies for overcoming them as dimensions and subdimensions for evaluation.
本研究旨在对巴西某城市为 ASD 患者提供公共牙科服务的政策进行系统和初步评估。该研究于 2019 年 11 月至 2020 年 2 月期间通过文件分析、政策理论逻辑模型设计和对 7 名关键信息提供者的半结构化访谈进行。样本是经过有意选择的。我们还考虑了对 108 份 ASD 患者牙科服务获取情况调查问卷的答复,这些问卷是针对照顾者、牙医和非牙科专业人员进行的试点研究。没有记录到拒绝答复。可用性研究表明,在护理网络组织方面,政策目标没有实现:没有机构间的流动,专业人员之间通过个人联系来保证获得二级关注,牙医对 ASD 没有专门的培训,非牙医专业人员和照顾者也不了解口腔保健网络。大多数 ASD 患者一生中至少看过一次牙医,但本研究中很大一部分人在过去一年中没有看过牙医。本研究发现了实施政策方面的困难,并提出了可能的策略,作为评估的维度和子维度。