Progress and Challenges in Potential Access to Oral Health Primary Care Services in Brazil: A Population-based Panel Study with Latent Transition Analysis

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2021 Mar 16

PMID 33725008

Citations 3

Authors

Ana Graziela Araujo Ribeiro

Rafiza Felix Marao Martins

Joao Ricardo Nickenig Vissoci

Nubia Cristina da Silva

Thiago Augusto Hernandes Rocha

Rejane Christine de Sousa Queiroz

Aline Sampieri Tonello

Catherine A Staton

Luiz Augusto Facchini

Erika Barbara Abreu Fonseca Thomaz

Affiliations

Soon will be listed here.

Abstract

Objective: Compared indicators of potential access to oral health services sought in two cycles of the Program for Improvement of Access and Quality of Primary Care (PMAQ-AB), verifying whether the program generated changes in access to oral health services.

Methods: Transitional analysis of latent classes was used to analyze two cross-sections of the external evaluation of the PMAQ-AB (Cycle I: 2011-2012 and Cycle II: 2013-2014), identifying completeness classes for a structure and work process related to oral health. Consider three indicators of structure (presence of a dental surgeon, existence of a dental office and operating at minimum hours) and five of the work process (scheduling every day of the week, home visits, basic dental procedures, scheduling for spontaneous demand and continuation of treatment). Choropleth maps and hotspots were made.

Results: The proportion of elements that had one or more dentist (CD), dental office and operated at minimum hours varied from 65.56% to 67.13 between the two cycles of the PMAQ-AB. The number of teams that made appointments every day of the week increased 8.7% and those that made home visits varied from 44.51% to 52.88%. The reduction in the number of teams that reported guaranteeing the agenda for accommodating spontaneous demand, varying from 62.41% to 60.11% and in the continuity of treatment, varying from 63.41% to 61.11%. For the structure of health requirements, the predominant completeness profile was "Best completeness" in both cycles, comprising 71.0% of the sets at time 1 and 67.0% at time 2. The proportion of teams with "Best completeness" increased by 89.1%, the one with "Worst completeness" increased by 20%, while those with "Average completeness" decreased by 66.3%.

Conclusion: We identified positive changes in the indicators of potential access to oral health services, expanding the users' ability to use them. However, some access attributes remain unsatisfactory, with organizational barriers persisting.

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References

Macinko J, Harris M, Rocha M . Brazil's National Program for Improving Primary Care Access and Quality (PMAQ): Fulfilling the Potential of the World's Largest Payment for Performance System in Primary Care. J Ambul Care Manage. 2017; :S4-S11. PMC: 5338882. DOI: 10.1097/JAC.0000000000000189. View

Hwang W, Brookmeyer R . Design of panel studies for disease progression with multiple stages. Lifetime Data Anal. 2003; 9(3):261-74. DOI: 10.1023/a:1025884719728. View

Macinko J, Harris M, Rocha M . Introduction to the Special Edition on the Brazilian National Program to Improve Primary Care Access and Quality (PMAQ). J Ambul Care Manage. 2017; 40 Suppl 2:S1-S3. PMC: 5338885. DOI: 10.1097/JAC.0000000000000191. View

Andrade M, Coelho A, Xavier Neto M, de Carvalho L, Atun R, Castro M . Brazil's Family Health Strategy: factors associated with programme uptake and coverage expansion over 15 years (1998-2012). Health Policy Plan. 2018; 33(3):368-380. DOI: 10.1093/heapol/czx189. View

Neves M, Giordani J, Hugo F . [Primary dental healthcare in Brazil: the work process of oral health teams]. Cien Saude Colet. 2019; 24(5):1809-1820. DOI: 10.1590/1413-81232018245.08892017. View

Bastos L, Hugo F, Hilgert J, Cardozo D, Bulgarelli A, Mello Dos Santos C . Access to dental services and oral health-related quality of life in the context of primary health care. Braz Oral Res. 2019; 33:e018. DOI: 10.1590/1807-3107bor-2019.vol33.0018. View

Amorim L, Senna M, Alencar G, Rodrigues L, Paula J, Ferreira R . Public oral health services performance in Brazil: Influence of the work process and service structure. PLoS One. 2020; 15(5):e0233604. PMC: 7259635. DOI: 10.1371/journal.pone.0233604. View

Ryu J, Lee T . The Waiting Game - Why Providers May Fail to Reduce Wait Times. N Engl J Med. 2017; 376(24):2309-2311. DOI: 10.1056/NEJMp1704478. View

Pucca Jr G, Gabriel M, de Araujo M, de Almeida F . Ten Years of a National Oral Health Policy in Brazil: Innovation, Boldness, and Numerous Challenges. J Dent Res. 2015; 94(10):1333-7. DOI: 10.1177/0022034515599979. View

10.

Nascimento A, Moyses S, Werneck R, Gabardo M, Moyses S . Assessment of public oral healthcare services in Curitiba, Brazil: a cross-sectional study using the Primary Care Assessment Tool (PCATool). BMJ Open. 2019; 9(1):e023283. PMC: 6340483. DOI: 10.1136/bmjopen-2018-023283. View

11.

Hill Z . Reducing attrition in panel studies in developing countries. Int J Epidemiol. 2004; 33(3):493-8. DOI: 10.1093/ije/dyh060. View

12.

Freeman R, Doughty J, Macdonald M, Muirhead V . Inclusion oral health: Advancing a theoretical framework for policy, research and practice. Community Dent Oral Epidemiol. 2019; 48(1):1-6. DOI: 10.1111/cdoe.12500. View

13.

ODonnell O . Access to health care in developing countries: breaking down demand side barriers. Cad Saude Publica. 2007; 23(12):2820-34. DOI: 10.1590/s0102-311x2007001200003. View

14.

Vidal T, Rocha S, Harzheim E, Hauser L, Tesser C . Scheduling models and primary health care quality: a multilevel and cross-sectional study. Rev Saude Publica. 2019; 53:38. PMC: 6536099. DOI: 10.11606/S1518-8787.2019053000940. View

15.

Goncalves K, Giordani J, Bidinotto A, Ferla A, Martins A, Hilgert J . [Oral healthcare utilization during prenatal care in primary healthcare: data from PMAQ-AB]. Cien Saude Colet. 2020; 25(2):519-532. DOI: 10.1590/1413-81232020252.05342018. View

16.

Baumgarten A, Hugo F, Bulgarelli A, Hilgert J . Curative procedures of oral health and structural characteristics of primary dental care. Rev Saude Publica. 2018; 52:35. PMC: 5893271. DOI: 10.11606/S1518-8787.2018052016291. View

17.

Santos T, Matta Machado A, Abreu M, Martins R . What we know about management and organisation of primary dental care in Brazil. PLoS One. 2019; 14(4):e0215429. PMC: 6472765. DOI: 10.1371/journal.pone.0215429. View

18.

Pinto L, Giovanella L . The Family Health Strategy: expanding access and reducinghospitalizations due to ambulatory care sensitive conditions (ACSC). Cien Saude Colet. 2018; 23(6):1903-1914. DOI: 10.1590/1413-81232018236.05592018. View

19.

Cookson R, Mondor L, Asaria M, Kringos D, Klazinga N, Wodchis W . Primary care and health inequality: Difference-in-difference study comparing England and Ontario. PLoS One. 2017; 12(11):e0188560. PMC: 5705159. DOI: 10.1371/journal.pone.0188560. View

20.

Aday L, Andersen R . A framework for the study of access to medical care. Health Serv Res. 1974; 9(3):208-20. PMC: 1071804. View