Association between the development stage of the oral health care network and primary health care coverage in a state of southeastern Brazil
DOI:
https://doi.org/10.35699/2178-1990.2021.29734Keywords:
Oral health, Health services, Integrality in health, Systems integrationAbstract
Aim: The present study analyzed the association between the development stage of the oral health care network in a Brazilian state and oral health coverage of Primary Health Care (PHC).
Methods: A cross-sectional descriptive and analytical study was conducted with 205 municipal oral health coordinators of a state in the southeast of Brazil. Data collection was carried out through a validated questionnaire. Descriptive and cluster analysis were performed. Variables oral health coverage (total PHC and in the Family Health Strategy – FHS), allocation factor (AF) of financial resources, and expanded health area of municipalities were compared with the clusters (p < 0.05).
Results: Cluster 1 was classified as containing incipient health care networks (n = 109), and cluster 2 was classified as containing advanced health care networks (n = 96). Descriptive analysis showed that oral health coverage in total PHC was 100% and in FHS was 78.1%. The majority of municipalities were classified in quartiles AF 1 and 2. The expanded health areas with the highest number of municipalities were South and Southeast. Clusters were associated with total PHC coverage (p = 0.038) and FHS (p = 0.009), and no association between clusters with AF (p = 0.754) and expanded health area of municipalities (p = 0.519).
Conclusion: The municipalities’ PHC coverage was related to the effectiveness of oral health network implantation.
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References
Frenk J. Reinventing primary health care: the need for systems integration. Lancet. 2009;374(9684):170-3.
Mendes EV. Health care networks. Ciênc Saúde Colet. 2010;15(5):2297-305.
Fertonani HP, de Pires DE, Biff D, Scherer MD. The health care model: concepts and challenges for primary health care in Brazil. Ciênc Saúde Colet. 2015;20(6):1869-78.
Castro MC, Massuda A, Almeida G, Menezes-Filho NA, Andrade MV, Noronha, KVM, et al. Brazil’s unified health system: the first 30 years and prospects for the future. Lancet. 2019;394(10195):345-56.
Mello AL, Andrade SR, Moysés SJ, Erdman AL. Oral health care in the health network and the regionalization process. Ciênc Saúde Colet. 2014;19(1):205-14.
Rodrigues LB, Silva PC, Peruhype RC, Palha PF, Popolin MP, Crispim JA, et al. Primary Health Care in the coordination of health care networks: an integrative review. Ciênc Saúde Colet. 2014;19(2):343-52.
Palmier AC, Andrade DA, Campos ACV, Abreu MHNG, Ferreira EF. Socioeconomic indicators and availability of oral health services in an underprivileged area of Brazil. Rev Panam Salud Pública. 2012;32(1):22-9.
Reis CM, Matta-Machado AT, Amaral JH, Werneck MA, Abreu MH. Describing the primary care actions of oral health teams in Brazil. Int J Environ Res Public Health. 2015;12(1):667-78.
Almeida PF, Santos AM. Primary Health Care: care coordinator in regionalized networks? Rev Saúde Pública. 2016;50:80.
Macêdo MSR, Chaves SCL, Fernandes ALC. Investments and costs of oral health care for Family Health Care. Rev Saúde Pública. 2016;50:41.
Machado ENM, Fortes FBCTP, Somarriba M. Assessing the effect of the PAB equity initiative on resource allocation and service inequalities among municipalities in Minas Gerais, Brazil. Ciênc Saúde Colet. 2004;9:99-111.
Malachias I, Leles FAG, Pinto MAS. Plano Diretor de Regionalização da Saúde de Minas Gerais. Belo Horizonte: Secretaria de Estado de Saúde de Minas Gerais, 2010. [acesso em: 2019 Maio 29]. Disponível em: https://www.saude.mg.gov.br/parceiro/regionalizacao-pdr2
Macinko J, Starfield B, Shi L. Quantifying the health benefits of primary care physician supply in the United States. Int J Health Serv. 2007;37(1):111-26.
Paim J, Travassos C, Almeida C, Bahia L, Macinko J. The Brazilian health system: history, advances, and challenges. Lancet. 2011;377(9779):1778-97.
Pucca Jr GA, Gabriel M, de Araujo ME, de Almeida FC. Ten years of a National Oral Health Policy in Brazil: Innovation, boldness, and numerous challenges. J Dent Res. 2015;94(10):1333-7.
Leal DL, Martins RC, Carneiro NCR, de Abreu MHNG, Werneck MAF, Borges-Oliveira AC. Analysis of the oral health care network development in Minas Gerais state, Brazil. J Public Health Dent. 2019;79(2):154-9.
Brazil. Brazilian Institute of Geography and Statistics. Census 2010. 2010. [accessed in 2019 May 29]. Available from: https://censo2010.ibge.gov.br/ [Portuguese].
Minas Gerais. Secretaria de Estado de saúde. Diretoria de Saúde Bucal. 2013. Documents available by the Oral Health Board in March/2014. [Portuguese]
Leal DL, Paiva SM, Werneck MA, Oliveira AC. Adaptation of the oral health version of an instrument for diagnosing the healthcare network’s stage of development. Cad Saúde Pública. 2014;30(6):1341-7.
Leal DL, Werneck MA, Oliveira AC. Validation of the oral health version of the Instrument for Diagnosis of the Developmental Stage of the Healthcare Network. Rev Pan-Amaz Saúde. 2017;8(4):65-75.
Johnson RA, Wichem DW. Applied multivariate statistical analysis. 6th ed. Pearson Prentice Hall: Upper Saddle River, NJ; 2007.
Martins RC, Reis CM, Matta Machado AT, Amaral JH, Werneck MA, Abreu MH. Relationship between primary and secondary dental care in public health services in Brazil. PLoS One. 2016;11(10):e0164986.
Lavras C. Primary health care and the organization of regional health care networks in Brazil. Saúde Soc. 2011;20(4):867-74.
Cortelazzi KL, Balbino EC, Guerra LM, et al. Variables associated with the performance of Centers for Dental Specialties in Brazil. Rev Bras Epidemiol. 2014;17(4):978-88.
Wilkinson RG, Pickett KE. Income inequality and population health: a review and explanation of the evidence. Soc Sci Med. 2006; 62(7):1768-84.
Pinto RS, de Abreu MH, Vargas AM. Comparing adult users of public and private dental services in the state of Minas Gerais, Brazil. BMC Oral Health. 2014;14:100.
Godoi H, Mello AL, Caetano JC. An oral health care network organized by large municipalities in Santa Catarina State, Brazil. Cad Saúde Pública. 2014;30(2):318-32.
