Case-resolving capacity of dental care of the Unified Health System: the perception of users in a city in the state of São Paulo, Brazil

Lima, Arinilson Moreira Chaves; Garbin, Cléa Adas Saliba; Corrente, José Eduardo; Saliba, Nemre Adas; Moimaz, Suzely Adas Saliba

doi:10.1590/1413-81232018235.17902016

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Free Themes • Ciênc. saúde colet. 23 (5) • May 2018 • https://doi.org/10.1590/1413-81232018235.17902016 copy

Case-resolving capacity of dental care of the Unified Health System: the perception of users in a city in the state of São Paulo, Brazil

Resolutividade do serviço odontológico no Sistema Único de Saúde: a percepção de usuários de um município paulista, Brasil

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

The aim of this study was to learn about the users' perceptions concerning the case-resolving capacity of dental care in the Unified Health System and to analyze the associations between solving capacity and both sociodemographic characteristics and access to the service. This was a cross-sectional study with a quantitative approach, in which 461 users responded to individual interviews. The outcome variable was the case-resolving capacity of dental care, obtained through the question: “In your opinion, is the dentist of this health center managing to solve all your oral health problems (Yes/No)”. Independent variables were grouped into the following: sociodemographic and related to the access to the service. Most participants reported that their oral health problems were being solved. By using the Poisson regression, the lack of case-resolving capacity was found to be associated to the patients' not considering the dental surgeon's working hours convenient; to the long time they had to wait to get an appointment in the health center; and to the long time they had to wait in the waiting room. The results showed the positive view that users have about the case-resolving capacity of public dental care, and the relationship between access to the service and the said solving capacity.

Key words
Dental care; Effectiveness; Unified Health System; Health services accessibility

Variable		Case-resolving capacity of the service						p value
		Yes		No		Total
		n	%	n	%	n	%
Sex
	Male	96	73.3	35	26.7	131	100.0	0.529
	Female	242	76.1	76	23.9	318	100.0
Age range
	18 to 29	84	71.8	33	28.2	117	100.0
	30 to 39	74	77.9	21	22.1	95	100.0
	40 to 49	85	79.4	22	20.6	107	100.0	0.291
	50 to 59	48	67.6	23	32.4	71	100.0
	60 or more	47	79.7	12	20.3	59	100.0
Occupation
	Employee	160	80.0	40	20.0	200	100.0
	Self-employed	49	74.2	17	25.8	66	100.0
	Retired	31	75.6	10	24.4	41	100.0	0.321
	Housewife	59	70.2	25	29.8	84	100.0
	Student	25	69.4	11	30.6	36	100.0
	Unemployed	14	63.6	8	36.4	22	100.0
Marital Status
	Married/Consensual Union	98	72.1	38	27.9	136	100.0
	Single	195	75.0	65	25.0	260	100.0	0.303
	Separated/Divorced	16	88.9	2	11.1	18	100.0
	Widow/Widower	29	82.9	6	17.1	35	100.0
Educational level
	Higher education	27	61.4	17	38.6	44	100.0
	High school	170	78.3	47	21.7	217	100.0	0.058
	Elementary school	140	75.3	46	24.7	186	100.0
Family income
	< 2 minimum salaries	220	74.3	76	25.7	296	100.0	0.550
	≥ 2 minimum salaries	107	77.0	32	23.0	139	100.0
Type of health center
	With ESF	268	73.0	99	27.0	367	100.0	0.019
	Without ESF	70	85.4	12	14.6	82	100.0

Variable		Case-resolving capacity of the service						p value
		Yes		No		Total
		n	%	n	%	n	%
Reason why service was sought
	Reexamination/Prevention	61	83.6	12	16.4	73	100.0
	Pain	84	67.2	41	32.8	125	100.0
	Extraction	10	55.6	8	44.4	18	100.0	0.015
	Treatment	180	78.6	49	21.4	229	100.0
	Other	3	75.0	1	25.0	4	100.0
Orientation to seek the service
	No one	205	74.3	71	25.7	276	100.0
	Relative or friend	86	78.2	24	21.8	110	100.0
	Community Health Agent	15	75.0	5	25.0	20	100.0	0.209
	Other professionals of the health center	21	65.6	11	34.4	32	100.0
	Other	11	73.0	0	00.0	11	100.0
Distance between home and health center
	Near	218	77.6	63	22.4	281	100.0
	Reasonable	80	78.4	22	21.6	102	100.0	0.011
	Far	40	60.6	26	39.4	66	100.0
Satisfaction as to the way you are received
	Satisfied	322	79.5	83	20.5	405	100.0
	More or less	15	42.9	20	57.1	35	100.0	<.001
	Dissatisfied	1	11.1	8	88.9	9	100.0
Convenience of the DS's working hours
	Yes	330	79.9	83	20.1	413	100.0	<0.001
	No	8	22.9	27	77.1	35	100.0
Time to set an appointment
	Did not take long	203	82.9	42	17.1	245	100.0
	Took a while	84	73.0	31	27.0	115	100.0	<0.001
	Took a long time	48	55.8	38	44.2	86	100.0
Form of getting an appointment
	Setting a day and time	236	78.4	65	21.6	301	100.0
	By order of arrival	80	70.2	34	29.8	114	100.0	0.153
	Fitting into a time slot	14	63.6	8	36.4	22	100.0
	Other	8	66.7	4	33.3	12	100.0
Time waiting in the waiting room
	Not long	221	83.4	44	16.6	265	100.0
	A little long	104	71.7	41	28.3	145	100.0	<0.001
	Very long	12	31.6	26	68.4	38	100.0
Referral to a specialized treatment
	Yes	85	69.7	37	30.3	122	100.0	0.091
	No	250	77.4	73	22.6	323	100.0
Success in scheduling an appointment with a specialist
	Yes	63	70.8	26	29.2	89	100.0	0.750
	No	21	67.7	10	32.3	31	100.0
Time to schedule an appointment with the specialist
	Up to 1 week	29	76.3	9	23.7	38	100.0
	From 1 week to 1 month	19	67.9	9	32.1	28	100.0	0.599
	More than 1 month	15	65.2	8	34.8	23	100.0

Variable		Non-case-resolving service		Adjusted PR	(CI 95%)	p value
Variable		n	%	Adjusted PR	(CI 95%)	p value
Convenience of the DS's working hour
	Yes	83	20.1	1.00
	No	27	77.1	2.65	1.63-4.31	< 0.001
Time to set an appointment
	Did not take long	42	17.1	1.00
	Took a while	31	27.0	1.19	0.73-1.94	0.473
	Took a long time	38	44.2	1.67	1.03-2.73	0.037
Time waiting in the waiting room
	Not long	44	16.6	1.00
	A little long	41	28.3	0.66	0.42-1.02	0.064
	Very long	26	68.4	2.19	1.23-3.91	0.007

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[1] Collaborations

AMC Lima participated in data collection, and in the elaboration of the paper. SAS Moimaz participated in the conception and design of the study, in data analysis, and in the elaboration of the paper. CAS Garbin and NA Saliba participated in the conception and design of the study, and in the analysis of results. JE Corrente worked on data analysis. In addition, all the authors participated in data interpretation, in the critical review of the intellectual content, and in the approval of the final version to be published.