Acesso aos serviços de saúde bucal no Brasil: desigualdades na utilização e fatores associados à oferta de atenção secundária
The aim of this study was to evaluate the influence of socioeconomic determinants on access to dental services in Brazil, from a perspective of use and availability, considering two analytical strategies: (a) inequality in the use of dental services related to income in the Brazilian population b...
Na minha lista:
| Autor principal: | |
|---|---|
| Outros Autores: | |
| Formato: | Dissertação |
| Idioma: | pt_BR |
| Publicado em: |
Brasil
|
| Assuntos: | |
| Endereço do item: | https://repositorio.ufrn.br/jspui/handle/123456789/27686 |
| Tags: |
Adicionar Tag
Sem tags, seja o primeiro a adicionar uma tag!
|
| Resumo: | The aim of this study was to evaluate the influence of socioeconomic determinants on
access to dental services in Brazil, from a perspective of use and availability, considering two
analytical strategies: (a) inequality in the use of dental services related to income in the
Brazilian population based on data from the National Household Sample Survey (PNAD from
the Portuguese acronym) for the years 1998, 2003 and 2008 and the National Health Survey
(PNS from the Portuguese acronym) in the year 2013 (b) the association between the social
indicators and the organization of the health services of the municipalities and the availability
of services in the Specialized Dental Facilities (CEO from the Portuguese acronym), based on
data from the Nacional Program for Access and Quality Improvement (PMAQ-CEO from the
Portuguese acronym). The first approach consists of a study of repeated panels, with analysis
of secondary data from home-based sectional studies. Data from the 1998, 2003 and 2008
PNADs and the data from the PNS 2013 were selected. The dependent variables were: "Already
had access to dental consultation ever in life" and "Last dental consultation performed 3 years
or more". The independent variable selected was "Household per capita income in minimum
wages". In order to evaluate the health inequality for the evaluated outcomes, were used
complex indices of evaluation of health inequality based on regression, the Slope Index of
Inequality and the Relative Index of Inequality. The second approach is an ecological study,
with a sample of 776 Brazilian municipalities that participated in the first cycle of the PMAQCEO in 2014. The dependent variables of the study consisted of the number of professionals
and the weekly workload of surgeons- dentists working in the minimum specialties per 10,000
inhabitants. An analysis of the main components was carried out to create a score to measure
the performance of municipalities regarding the availability of specialized dental services. In
order to evaluate the factors associated to the performance of the municipalities, the Pearson
Chi-square test was used, with the following municipal variables categorized as tertiles: per
capita income, Human Development Index, Gini index, population resident, total health
expenditure per inhabitant, Oral Health Teams per 10,000 inhabitants, and number of CEO
chairs per 10,000 inhabitants. As main results, there was a reduction in the absolute difference
in the percentage of the absence of access among individuals with higher and lower income.
The absolute difference for the absence of access from the groups spend from 10.92% in 1998
to 7.61% in 2013. For the absence of access in the last 3 years, the values decreased from
48.19% in 1998 to 26, 98% in 2013. There was also a reduction in relative inequality in terms
of income for both outcomes. Regarding the second approach, the better performance regarding
the availability of specialized oral health services was observed in municipalities with a lower
population size (67.3%), with lower HDI (41.9%) and lower per capita income (41,2%), the
highest average of oral health teams per 10,000 inhabitants (50.6%), the highest average of
CEO chairs per 10,000 inhabitants (66.3%). It was concluded that there was a reduction in the
inequalities in access to dental consultation over the years, although it remains at levels of
concern. The municipalities with the worst socioeconomic indicators and better organization of
the oral health services obtained better performance regarding the availability of specialized
dental services. The results demonstrate the progress obtained from the National Policy on Oral
Health, however, there are challenges to be overcome of the effectiveness of the assumptions
of this policy, particularly with regard to inequality. |
|---|