Monitoring of oral health teams after National Primary Care Policy 2017

Lucena, Edson Hilan Gomes de; Lucena, Carolina Dantas Rocha Xavier de; Alemán, Josiane Aparecida de Souza; Pucca Júnior, Gilberto Alfredo; Pereira, Antônio Carlos; Cavalcanti, Yuri Wanderley

doi:10.11606/s1518-8787.2020054002075

Acessibilidade / Reportar erro

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Original Article • Rev. Saúde Pública 54 • 2020 • https://doi.org/10.11606/s1518-8787.2020054002075 copy

Monitoring of oral health teams after National Primary Care Policy 2017

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVE

To monitor the number of oral health teams implemented in the Family Health Strategy after National Primary Care Policy 2017.

METHODS

This is a study of quantitative, descriptive and analytical nature that used the data from the public reports of the history of oral health coverage available in the e-Manager platform of Primary Care of the Ministry of Health of all Brazilian municipalities (5,570). The survival rate of the municipalities that did not reduce the number of oral health teams was analyzed according to the region of the country, human development index, Gini inequality index and population size. Cox regression was used to analyze the factors associated with the decrease in the number of teams implanted after 1, 3, 6, 9, 12, 15, 18 and 21 months of publication of the 2017 national policy ordinance, considering the hazard ratio (HR) and p < 0.05.

RESULTS

After 21 months of publication of the policy, 6.7% of Brazilian municipalities reduced the number of oral health teams. This reduction was higher in the South (6.7%) and Northeast (4.8%), in municipalities with the highest human development index, i.e., greater than or equal to 0.7 (5.6%), more unequal in terms of income distribution (Gini index > 0.62) and larger population size (more than 100,000 inhabitants). Municipalities in the Northeast (HR = 1.220) and South (HR = 1.771) regions had a higher chance of reducing the number of teams compared with those in the North region. More unequal municipalities (HR = 6.405) and with larger population size (HR = 4.273) were also more likely to reduce the coverage of oral health teams.

CONCLUSION

The municipalities that reduced the number of oral health teams in the Family Health Strategy are from the South and Northeast regions, with greater social inequality and larger population size. This scenario can significantly affect the population’s access to dental health services in the Unified Health System, especially among those in need.

Dental Health Services; Patient Care Team; Family Health Strategy; Health Status Disparities

		Variation in the number of OHT created				p
		Did not reduce		Reduced
		n	%	n	%
Time	1 month	5,457	98.0	113	2.0	< 0.001
	3 months	5,398	96.9	172	3.1
	6 months	5,322	95.5	248	4.5
	9 months	5,333	95.7	237	4.3
	12 months	5,296	95.1	274	4.9
	15 Months	5,187	93.1	383	6.9
	18 Months	5,156	92.6	414	7.4
	21 Months	5,203	93.4	367	6.6
Region	North	430	95.5	20	4.5	< 0.001
	Northeast	1,708	95.2	86	4.8
	Southeast	1,595	95.6	73	4.4
	South	1,111	93.3	80	6.7
	Midwest	450	96.4	17	3.6
HDI	Low	3,502	96.4	130	3.6	< 0.001
HDI	High	1,826	94.4	107	5.6	< 0.001
Gini Index	Less unequal	5,133	95.8	225	4.2	0.010
Gini Index	More unequal	195	94.3	12	5.7	0.010
Population size	≥ 30,000 inhabitants	4,251	96.4	160	3.6	< 0.001
	30,001 to 50,000 inhabitants	458	92.9	35	7.1
	50,001 to 100,000 inhabitants	319	91.4	30	8.6
	More than 100,000 inhabitants	266	83.8	52	16.2

	Regression coefficient	Error - standard	p	Hazard ratio	95% confidence interval
Region
Southeast				1.000
Northeast	0.199	0.078	0.011*	1.220	1.046–1.422
North	-0.073	0.107	0.496	0.930	0.755–1.146
South	0.572	0.058	< 0.001*	1.771	1.580–1.986
Midwest	-0.096	0.096	0.321	0.909	0.752–1.098
HDI	0.818	0.496	0.099	2.266	0.858–5.986
Gini Index	1.857	0.385	< 0.001*	6.405	3.013–13.614
Population size
Up to 30,000 inhabitants				1.000
30,001 to 50,000 inhabitants	0.656	0.068	< 0.001*	1.927	1.687–2.200
50,001 to 100,000 inhabitants	0.818	0.075	< 0.001*	2.265	1.956–2.623
More than 100,000 inhabitants	1.452	0.071	< 0.001*	4.273	3.716–4.914

Faculdade de Saúde Pública da Universidade de São Paulo Avenida Dr. Arnaldo, 715, 01246-904 São Paulo SP Brazil, Tel./Fax: +55 11 3061-7985 - São Paulo - SP - Brazil
E-mail: revsp@usp.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Correspondence: Yuri Wanderley Cavalcanti Universidade Federal da Paraíba Departamento de Clínica e Odontologia Social Cidade Universitária, Campus I 58051-900 João Pessoa, PB, Brasil E-mail: yuri@ccs.ufpb.br