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Bomfim RA, Leite HQNC, Zafalon EJ, De-Carli AD, Santos MLDMD. Attributes of primary health care in Mato Grosso do Sul state: PCAT-Brazil paired for users and health professionals, 2018. BMC Health Serv Res 2022; 22:972. [PMID: 35906576 PMCID: PMC9338599 DOI: 10.1186/s12913-022-08363-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 07/18/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE The objective of the present study was to analyse the quality of adults and older adults health care in Primary Health Care (PHC) services in the State of Mato Grosso do Sul, 2018. METHODS A quantitative survey was carried out in which the municipalities participating in the study included the four macro-regions following the Director Regional Plan (DRP). In this study, the quality of care was verified using the validated version of the PCAT-Br for adult and older adults users over 18 years of age and professionals. The professional's and users' views were compared between PHC attributes in the State of Mato Grosso do Sul. We performed the paired student t-test. STATA v.14.2 software (College Station, TX, USA) was used for the analyses. Sensitivity analysis was done to compare socio-demographic characteristics. RESULTS Eight hundred twenty-five users and 424 professionals participated in the study. According to users, the Accessibility attribute had the worst performance in all macro-regions (mean score PCAT = 3.58). There were significant differences between the perception of users and professionals (PCAT = 5.32 for users and PCAT = 7.11 for professionals) in all attributes evaluated. CONCLUSIONS There was a difference in users' and professionals' perceptions between PHC attributes. Therefore, it is necessary to strengthen PHC care networks in the State, mainly considering the users' perspectives.
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Affiliation(s)
- Rafael Aiello Bomfim
- School of Dentistry, Federal University of Mato Grosso do Sul, Campo Grande, Brazil.
| | | | - Edilson José Zafalon
- School of Dentistry, Federal University of Mato Grosso do Sul, Campo Grande, Brazil
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Ribeiro AGA, Martins RFM, Vissoci JRN, da Silva NC, Rocha TAH, Queiroz RCDS, Tonello AS, Staton CA, Facchini LA, Thomaz EBAF. Progress and challenges in potential access to oral health primary care services in Brazil: A population-based panel study with latent transition analysis. PLoS One 2021; 16:e0247101. [PMID: 33725008 PMCID: PMC7963056 DOI: 10.1371/journal.pone.0247101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 02/01/2021] [Indexed: 11/19/2022] Open
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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Affiliation(s)
- Ana Graziela Araujo Ribeiro
- Dentistry Department, Graduate Program in Dentistry, Federal University of Maranhão, São Luís, Maranhão, Brasil
| | | | - João Ricardo Nickenig Vissoci
- Global Emergency Medicine Innovation and Implementation (GEMINI), Division of Emergency Medicine, Department of Surgery, Duke University School of Medicine, Durham, North Carolina, United States of America
- Research Design and Analysis Core (RDAC), Duke Global Health Institute, Durham, North Carolina, United States of America
| | | | - Thiago Augusto Hernandes Rocha
- Global Emergency Medicine Innovation and Implementation (GEMINI), Division of Emergency Medicine, Department of Surgery, Duke University School of Medicine, Durham, North Carolina, United States of America
- MATH Consortium, Belo Horizonte, Minas Gerais, Brasil
| | | | - Aline Sampieri Tonello
- Department of Public Health, Center of Biological Sciences of Health, Federal University of Maranhão, São Luís, Maranhão, Brasil
| | - Catherine A. Staton
- Global Emergency Medicine Innovation and Implementation (GEMINI), Division of Emergency Medicine, Department of Surgery, Duke University School of Medicine, Durham, North Carolina, United States of America
- Duke Global Health Institute, Durham, North Carolina, United States of America
| | - Luiz Augusto Facchini
- Department of Social Medicine, Postgraduate Programs in Epidemiology, Nursing and Family Health, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brasil
| | - Erika Bárbara Abreu Fonseca Thomaz
- Department of Public Health, Graduate Program in Public Health and Dentistry, Federal University of Maranhão, São Luís, Maranhão, Brasil
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Cardozo DD, Stein C, Hauser L, Fontanive LT, Harzheim E, Hugo FN. Validity and reliability of the Brazilian Primary Care Assessment Tool: Oral Health of Adults. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2020; 23:e200076. [PMID: 32638849 DOI: 10.1590/1980-549720200076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 05/20/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To test the factorial validity and reliability of the Primary Care Assessment Tool adapted to Oral Health, adult patient version, an instrument used to verify the presence and extent of attributes in Primary Health Care services. METHODS Population-based cross-sectional study using conglomerate random sample carried out in Primary Health Care Dental services in Porto Alegre between 2011 and 2013. We interviewed 407 adult patients who used Primary Health Care Dental services. Construct validity was tested through factorial validity and reliability of the Primary Care Assessment Tool, that comprises 81 items distributed throughout Primary Health Care attributes. Equamax orthogonal rotation method was used in the factorial analysis; and, in order to assess reliability of each component, we used the item-total correlation and the ratio of success of the scale. RESULTS In the factorial analysis, 10 factors were retained, explaining 53.3% of the total variation. This result demonstrates the multidimensional structure of the instrument. The reliability assessment showed Cronbach's alpha values ranging from 0.39 to 0.89. For the success of the scale most of the results (eight of nine attributes) were greater than 85%. CONCLUSIONS The instrument is valid for the assessment of oral health services in Primary Health Care from the perspective of adult patients, as well as for monitoring and evaluation of oral health services in Primary Health Care attributes and comparative studies.
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Affiliation(s)
- Débora Deus Cardozo
- Program of Postgraduate Studies in Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Caroline Stein
- Program of Postgraduate Studies in Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Lisiane Hauser
- Program of Postgraduate Studies in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Liége Teixeira Fontanive
- Program of Postgraduate Studies in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Erno Harzheim
- Program of Postgraduate Studies in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Fernando Neves Hugo
- Program of Postgraduate Studies in Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Cardozo DD, Hilgert JB, Stein C, Hauser L, Harzheim E, Hugo FN. Presence and extension of the attributes of primary health care in public dental services in Porto Alegre, Rio Grande do Sul State, Brazil. CAD SAUDE PUBLICA 2020; 36:e00004219. [DOI: 10.1590/0102-311x00004219] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 07/08/2019] [Indexed: 11/21/2022] Open
Abstract
The objective was to compare the presence and extension of primary health care (PHC) in oral health services using the PHC attributes according to three different types of PHC organizational arrangements: Family Health Strategy (FHS), Community Health Service (CHS) and Traditional Primary Care (TPC). This is a cross-sectional study carried out between 2011-2013, following a cluster random sampling strategy. Adult users were interviewed from 15 health services of that 6 were managed by the CHS, 4 by the FHS and 5 by the TPC and which had the same oral health team for at least two years. The final sample was 407 users interviewed using the Primary Care Assessment Tool - Oral Health of Adults evaluation instrument and a sociodemographic questionnaire. PHC scores were calculated and transformed on a scale ranging from 0 to 10. For high scores, the cut-off point > 5.5 was used. Most of the interviewees were females, for the three types of services. The performance of CHS and FHS was higher than those of TPC in almost all attributes (p < 0.05). The extent of PHC attributes in services was poor (overall highest score was 5.75 in CHS). The CHS was the only service witch half of the users (83; 49.1%) rated oral health services as having a high overall score for PHC. It is concluded that there were differences among the organizational arrangements of PHC oral health services, however, there is much to be improved in the orientation of dental care services for PHC. More studies are necessary to evaluate the differences in PHC services considering oral health.
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