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Teixeira CNG, Pereira SMDS, Hilgert JB, Oliveira NMAD, Ribeiro CCC, Neves M, Thomaz EBAF, Hugo FN, Alves CMC. [The use of dental services in the past year in the brazilian population: a systematic review with meta-analysis]. CIENCIA & SAUDE COLETIVA 2023; 28:1087-1100. [PMID: 37042890 DOI: 10.1590/1413-81232023284.11452022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 09/20/2022] [Indexed: 04/13/2023] Open
Abstract
The scope of this study was to analyze the factors associated with the use of dental services in Brazil. The review strategy included PubMed, SciELO, LILACS, BBO, EMBASE, Scopus, WOS and Google Scholar databases, in addition to repositories and databases of dissertations and theses. Studies were selected using the PEO (Population/Exposure/Outcomes) strategy. The outcome of this study was the use of dental services in the last year by the Brazilian population, treated as dichotomous variables for the following analyses: ≤ 1 year and > 1 year. Mantel-Haenszel random effect meta-analysis was performed, estimating Prevalence Ratios (PR) and 95% confidence intervals (95%CI). A total of 94 studies were selected. The majority (98%) had a cross-sectional design, with 63% derived from primary data. For the meta-analysis, 25 studies were included. The use of oral health services in the last year was associated with higher education (≥ 8 years of schooling) (PR = 0.49, (95%CI: 0.39-0.60)); higher family income (≥ 2 minimum wages) (RP = 0.79, (95%CI: 0.74-0.84)); and living in urban areas (RP = 0.79, (95%CI: 0.64-0.97)). The availability of dental services in the Unified Health System needs to be made readily accessible to people with lower income, less education and those living in rural areas.
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Affiliation(s)
- Cinthia Nara Gadelha Teixeira
- Universidade de Fortaleza. R. São Mateus 1.650, 402, Vila União. 60410-642 Fortaleza CE Brasil.
- Universidade Federal do Maranhão. São Luís MA Brasil
| | | | | | | | | | - Matheus Neves
- Universidade Federal do Rio Grande do Sul. Porto Alegre RS Brasil
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Vahidi J, Takian A, Amini-Rarani M, Moeeni M. "To enroll or not to enroll": a qualitative study on preferences for dental insurance in Iran. BMC Health Serv Res 2022; 22:901. [PMID: 35820919 PMCID: PMC9277837 DOI: 10.1186/s12913-022-08285-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 07/04/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Oral public health services are included in primary healthcare. Although oral diseases are preventable, improving oral health has become a concern in many countries. Evidence shows that functioning insurance coverage can significantly increase the use of dental health services, improve quality of services, and reduce financial barriers to utilization. Little evidence exists on households' preferences for dental insurance in Iran. This study seeks to identify the households' preferences for dental insurance in Tehran-Iran. METHOD This is a qualitative study. We interviewed 84 participants who visited selected public and private dental clinics in Tehran-Iran, from October 2018 until January 2019. All interviews were recorded and transcribed verbatim. We used a mixed inductive/deductive approach for thematic analysis of the interviews. RESULTS We identified two main themes and 12 sub-themes: pecuniary attributes (insurance premium, coinsurance, insurance coverage granted, discounting option, reimbursement of expenses), and non-pecuniary attributes (notification status, ethical issues, benefits package, contract providers with health insurance, quality of service centers, administrative process, and dental insurance scheme). CONCLUSION Our participants considered both pecuniary and non-pecuniary attributes for choosing a dental insurance package. Our findings could help, we envisage, policymakers understand Iranian households' preferences for a dental insurance scheme that they afford to buy.
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Affiliation(s)
- Jamileh Vahidi
- School of Management & Medical Information Sciences, Isfahan University of Medical Sciences, Isfahan, Iran.,Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirhossein Takian
- Department of Health Management, Policy and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Department of Global Health & Public Policy, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Health Equity Research Center (HERC), Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Amini-Rarani
- Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Moeeni
- Social Determinants of Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
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Cericato GO, Agostini BA, Costa FDS, Thomson WM, Demarco FF. Rural-urban differences in oral health among older people in Southern Brazil. Braz Oral Res 2021; 35:e135. [PMID: 34932664 DOI: 10.1590/1807-3107bor-2021.vol35.0135] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 06/20/2020] [Indexed: 11/22/2022] Open
Abstract
This study aimed to assess the association between oral health and rurality in an older Brazilian population. Population-based samples of 1,451 urban and 411 rural elders were obtained from two databases. Several oral health and related measures, including the number of teeth lost, use of dental prostheses, dental visits, self-reported oral health, and perceived need for a dental prosthesis, were compared. Oral health-related information was obtained by a trained research team with interviews conducted in the individuals' homes. Regression models were used to verify the association between living in rural areas and oral health outcomes after adjusting for possible confounding factors. The elderly population mostly comprised of women in rural or urban areas, and the mean age was 70 years in both locations. Less-educated individuals (without or with complete elementary schooling) were more common in rural regions than in urban areas. After adjustment for socioeconomic characteristics, living in rural areas was associated with a lower perceived need for dental prostheses (PR 0.68, 95% CI 0.56-0.84), poor self-reported oral health (OR 1.24; 95% CI 1.05-1.46), and having fewer teeth (β -1.31; 95% CI -2.18 to -0.45). The place of residence had a significant impact on oral health indicators, with rurality negatively influencing oral health. These findings suggest that preventive and curative strategies for dental services may be needed for the Brazilian rural population.
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Affiliation(s)
| | | | - Francine Dos Santos Costa
- Universiade do Vale do Taquari - Univates, Dental School, Department of Biological and Health Sciences, Lajeado, RS, Brazil
| | - William Murray Thomson
- The University of Otago, Faculty of Dentistry, Department of Oral Sciences, Dunedin, New Zealand
| | - Flávio Fernando Demarco
- Universidade Federal de Pelotas - UFPel, Graduate Program in Dentistry, Department of Restorative Dentistry, Pelotas, RS, Brazil
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Debossan SAT, Deps TD, Prado HV, de Abreu MHNG, Borges-Oliveira AC. Access to oral health care services for individuals with rare genetic diseases affecting skeletal development. SPECIAL CARE IN DENTISTRY 2021; 42:32-40. [PMID: 34343360 DOI: 10.1111/scd.12639] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 07/21/2021] [Accepted: 07/22/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To identify factors associated with oral health care services for individuals with and without rare genetic diseases. MATERIALS AND METHOD A cross-sectional study was undertaken, with 140 individuals paired by sex and age (70 with rare genetic diseases and 70 without), aged between 3 and 27 years, and their parents. The sample was selected from two reference hospitals for patients with rare genetic diseases in southeastern Brazil. The parents completed a questionnaire on individual aspects and their child's medical/dental history. Participants who did and did not suffer from rare genetic diseases were examined for dental caries, malocclusion, dental anomalies, and oral hygiene. The theoretical model Directed Acyclic Graphs (DAG) was used to identify possible confounding variables in the association between rare diseases and access to dental care. Descriptive analyses and non-matched and matched logistic regression models (p < 0.05) were carried out. RESULTS The chance of individuals without rare genetic disease having access to oral health care service was 5.32 times higher (95% CI 2.35-12.01) than those with such conditions. Individuals who had not suffered upper respiratory tract infections had a 3.16 times greater chance of being in the group with access to oral health care service (95% CI 1.45-6.90). CONCLUSION Individuals with no rare genetic diseases and no history of upper respiratory tract infections had a greater chance of belonging to the group of individuals with access to a dental service. Individuals with rare genetic diseases have less access to oral health care.
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Affiliation(s)
| | - Tahyná Duda Deps
- Department of Pediatric Dentistry, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Heloisa Vieira Prado
- Department of Dental Public Health, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | | | - Ana Cristina Borges-Oliveira
- Department of Dental Public Health, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
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Utilization of Complementary and Alternative Medicine among Korean Elite Athletes: Current Status and Future Implications. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:5572325. [PMID: 33688359 PMCID: PMC7920696 DOI: 10.1155/2021/5572325] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 02/01/2021] [Accepted: 02/11/2021] [Indexed: 11/17/2022]
Abstract
The objective of the study was to explore the status of usage of complementary and alternative medicine (CAM) among Korean elite athletes. A survey was emailed to all Korean national sports federations recognized by the International Olympic Committee and the Olympic Council of Asia. A total of 705 Korean elite athletes participated in this study. The athletes had to be any of the following to participate in this survey: elite intercollegiate athletes, professional athletes, and national team athletes. 83.3% of the participants stated that they have previously experienced Korean medicine (KM). Compared to the general population in Korea, athletes had more experience (general population = 73.8%). The participants without experience mentioned that they either did not need any KM treatments (39.8%) or lacked information (39.8%) regarding KM treatments. The primary reason for the utilization of KM was the effectiveness of treatments. Therefore, 70.8% of the participants have mentioned recommending KM to others. Generally, athletes are worrisome that the consumption of herbal medicine may not be doping-free; however, it is vital to note that 62% of the participants expressed that prescribed herbal medicine is safe. Overall, this research demonstrates a high prevalence of KM usage by intercollegiate, professional, and national team athletes in Korea. Hence, this study's results may serve as the foundation in future research directions for promoting KM among Korean elite athletes.
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Caúla AL, Pierro VSDS, Santos MPAD, Bundzman ER, Branco Júnior JDS, Tavares LHS. Dental Status of Firefighters of Rio de Janeiro State and Comparison with Brazilian Oral Health Surveys. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2021. [DOI: 10.1590/pboci.2021.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/21/2023] Open
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Uguru N, Onwujekwe O, Uguru CC, Ogu UU. Achieving universal health coverage in Nigeria: the dilemma of accessing dental care in Enugu state, Nigeria, a mixed methods study. Heliyon 2021; 7:e05977. [PMID: 33532639 PMCID: PMC7829146 DOI: 10.1016/j.heliyon.2021.e05977] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 12/11/2020] [Accepted: 01/11/2021] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE Equitable access to oral healthcare is a major focus of the Universal health coverage debate in Nigeria. However, a great majority of the population still do not have full coverage for essential oral healthcare services. This study will determine the extent of inequities in accessing oral healthcare services and the factors influencing access to equitable oral healthcare in Enugu state Nigeria. METHODS A descriptive cross-sectional, urban and rural study conducted over two months in Enugu state Nigeria, using a mixed method approach. The quantitative study design used interviewer administered questionnaires to elicit information from 774 household members (394 urban and 380 rural) in study area who had sought dental care 6 months prior to study, and dental care providers (52) in selected dental health facilities. The qualitative study design involved in-depth interview of heads of selected dental health facilities to investigate factors influencing provision of dental care. Household data was collected house to house from randomly selected households in the LGA, while a face-to-face in-depth interview was conducted for purposively selected oral health professionals from study facilities. RESULTS Majority of respondents sought care when they had toothache (72%). There was inequity in utilization of dental care across socioeconomic status groups (SES). The least poor SES (Q5) sought dental care in the private facilities, and chose to have dental fillings more than the poorest (Q1) and very poor SES (Q2) who visited public facilities and patent medicine dealer shops more and opted more for tooth extractions.(p < 0.05) Cost of services influenced access and treatment choice more among Q1 and Q2 than Q5 (p < 0.05) Qualitative results show that facility location, low awareness, human resource shortage and oral health financing methods influenced access. CONCLUSION Increased awareness and inclusion of oral healthcare in all health insurance schemes with expansion of current oral healthcare benefit package will improve access to care and further improve chances of attaining universal health coverage.
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Affiliation(s)
- Nkolika Uguru
- Department of Preventive Dentistry, Faculty of Dentistry, College of Medicine University of Nigeria Enugu Campus, Nigeria
- Department of Health Administration and Management, Faculty of Health Sciences and Technology, University of Nigeria Enugu Campus, Nigeria
- Health Policy Research Group, Department of Pharmaco-therapeutics, College of Medicine, University of Nigeria, Enugu Campus, Nigeria
| | - Obinna Onwujekwe
- Department of Health Administration and Management, Faculty of Health Sciences and Technology, University of Nigeria Enugu Campus, Nigeria
- Health Policy Research Group, Department of Pharmaco-therapeutics, College of Medicine, University of Nigeria, Enugu Campus, Nigeria
| | - Chibuzo C. Uguru
- Department of Oral and Maxillo-facial Surgery, Faculty of Dentistry, College of Medicine, University of Nigeria Enugu Campus, Nigeria
| | - Udochukwu Ugochukwu Ogu
- Health Policy Research Group, Department of Pharmaco-therapeutics, College of Medicine, University of Nigeria, Enugu Campus, Nigeria
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Ruas BM, Castilho LS, Carneiro NCR, Cardoso NMDM, Reis AB, Silva MESE, Borges-Oliveira AC. Integrality of care for hemodialysis patient in Brazil: an analysis of access to dental care. CIENCIA & SAUDE COLETIVA 2020; 25:533-540. [PMID: 32022193 DOI: 10.1590/1413-81232020252.06362018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2017] [Accepted: 06/18/2018] [Indexed: 11/22/2022] Open
Abstract
The present study aimed to analyze factors associated with access of dental care services by Brazilian hemodialysis patients. A cross-sectional study was carried out with 467 hemodialysis patients aging from 19 to 90 years in two renal therapy centers located in the cities of Contagem and Belo Horizonte, Southeastern Brazil. Data were collected through an oral clinical examination of the patients and the application of a structured questionnaire. The dependent variable was the access to dental care, measured by the question "Have you consulted with a dentist in last six months?". The mean age of participants was 49.9 years. The average number of teeth present in the mouth was 19.3. An average of 1.5 teeth with dental caries cavities lesion was diagnosed among hemodialysis patients. One-third of the sample had gone to the dentist in the last six months (27.8%). The access to dental care was associated with formal education (OR = 1.5 [1.1-2.4]), professional advising to consult with a dentist (OR = 2.1 [1.2-3.8]) and prevalence of dental caries (OR = 2.1 [1.3-3.2]). Hemodialysis patients with eight or more years of formal education, who received professional advising to consult with a dentist and without dental caries cavities had higher chances obtaining access to dental care.
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Affiliation(s)
- Bruna Mara Ruas
- Departamento de Odontologia Social e Preventiva, Faculdade de Odontologia, Universidade Federal de Minas Gerais (UFMG). Av. Presidente Antônio Carlos 6627, Pampulha. 31270-901, Belo Horizonte, MG, Brasil.
| | - Lia Silva Castilho
- DepartamenAto de Odontologia Restauradora, Faculdade de Odontologia, UFMG. Belo Horizonte, MG, Brasil
| | | | | | - Augusto Barbosa Reis
- Departamento de Nefrologia e Urologia, Faculdade de Odontologia, UFMG. Belo Horizonte, MG, Brasil
| | - Maria Elisa Sousa E Silva
- DepartamenAto de Odontologia Restauradora, Faculdade de Odontologia, UFMG. Belo Horizonte, MG, Brasil
| | - Ana Cristina Borges-Oliveira
- Departamento de Odontologia Social e Preventiva, Faculdade de Odontologia, Universidade Federal de Minas Gerais (UFMG). Av. Presidente Antônio Carlos 6627, Pampulha. 31270-901, Belo Horizonte, MG, Brasil.
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Maffioletti F, Vettore MV, Rebelo M, Herkrath F, Queiroz A, Herkrath AP, Pereira J, Rebelo Vieira J. Predisposing, enabling, and need characteristics of dental services utilization among socially deprived schoolchildren. J Public Health Dent 2019; 80:97-106. [PMID: 31788798 DOI: 10.1111/jphd.12349] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 10/11/2019] [Accepted: 10/27/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To test the relationship of predisposing, enabling and need characteristics with dental services utilization and pattern of dental attendance among 12-year-old schoolchildren living in a socially deprived urban area. METHODS A cross-sectional study was carried out involving 358 children enrolled in public schools located in a deprived area of the city of Manaus, Brazil. Predisposing, enabling, and need characteristics were selected according to Andersen's behavioral conceptual model. Self-completed questionnaires were used to collect the predisposing characteristics (child's gender, sense of coherence, self-esteem, oral health beliefs). Parents or guardians provided data on enabling characteristics, including dental health insurance and socioeconomic status. Evaluated need characteristics included oral clinical status assessed through dental examinations conducted by five calibrated examiners. Structural equation modeling was used to test the predictors of dental services utilization and pattern of dental attendance. RESULTS Predisposing characteristics, including male gender and low parents/guardians sense of coherence predicted poor dental services utilization and inadequate pattern of dental attendance, respectively. Low socioeconomic status and poor oral clinical status were linked to poor dental services utilization and worse children's pattern of dental attendance. CONCLUSIONS The present findings suggest that predisposing (child's gender and parental sense of coherence), enabling (socioeconomic conditions) and evaluated need characteristics (oral clinical status) are associated with dental services utilization among children.
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Affiliation(s)
| | | | - Maria Rebelo
- School of Dentistry, Federal University of Amazonas, Manaus, Brazil
| | - Fernando Herkrath
- Superior School of Health Sciences, University of Amazonas State, Manaus, Brazil
| | - Adriana Queiroz
- School of Dentistry, Federal University of Amazonas, Manaus, Brazil
| | - Ana P Herkrath
- School of Dentistry, Federal University of Amazonas, Manaus, Brazil
| | - Juliana Pereira
- School of Dentistry, Federal University of Amazonas, Manaus, Brazil
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Rezaei S, Hajizadeh M, Irandoost SF, Salimi Y. Socioeconomic inequality in dental care utilization in Iran: a decomposition approach. Int J Equity Health 2019; 18:161. [PMID: 31640703 PMCID: PMC6805463 DOI: 10.1186/s12939-019-1072-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 10/04/2019] [Indexed: 11/10/2022] Open
Abstract
PURPOSE Socioeconomic inequalities in dental care utilization in Iran are rarely documented. This study aimed to provide insight into socioeconomic inequalities in dental care utilization and its main contributing factors among Iranian households. DESIGN/METHODOLOGY/APPROACH A total of 37,860 households from the 2017 Household Income and Expenditure Survey (HIES) were included in the study. Data on dental care utilization, age, gender and education attainment of the head of household, socioeconomic status of households, health insurance coverage, living areas and provinces were obtained for the survey. The concentration curve and the normalized concentration index (Cn) was used to illustrate and quantify socioeconomic inequalities in dental care utilization among Iranian households. The Cn was decomposed to identify the main determinants of the observed socioeconomic inequality in dental care utilization in Iran. FINDINGS The study indicated that the prevalence of dental care utilization among Iranian's households was 4.67% (95% confidence interval [CI]: 4.46 to 4.88%). The results suggested a higher concentration of dental care utilization among socioeconomically advantaged households (Cn = 0.2522; 95% CI: 0.2258 to 0.2791) in Iran. Pro-rich inequality in dental care utilization also found in rural (Cn = 0.2659; 95%CI: 0.2221 to 0.3098) and urban (Cn = 0.0.2504; 95% CI: 0.0.2159 to 0.2841) areas. The results revealed socioeconomic status of households, age and education status of head of households and residing provinces as the main contributing factors to the concentration of dental care utilization among the wealthy households. ORIGINALITY/VALUE This study revealed pro-rich inequalities in dental care utilization among households in Iran and its provinces. Thus, health policymakers should focus on designing effective evidence-based interventions to improve healthcare utilization among household with the older head of households, lower education status, and living in relatively poor provinces to reduce socioeconomic inequality in dental care utilization in Iran.
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Affiliation(s)
- Satar Rezaei
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohammad Hajizadeh
- School of Health Administration, Faculty of Health, Dalhousie University, Halifax, Canada
| | - Seyed Fahim Irandoost
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Yahya Salimi
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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Pereira AC, Bahia LR, Cavalcante DDFB, Meneghim MDC, Cavalcanti YW, Ambrosano GMB, Probst LF. Budgetary Impact of Oral Rehabilitation With Complete Dentures: An Economical Evaluation From São Paulo State, Brazil. Value Health Reg Issues 2019; 20:73-78. [PMID: 31048261 DOI: 10.1016/j.vhri.2019.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 01/18/2019] [Accepted: 01/30/2019] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To develop a budgetary impact analysis regarding the possibility of offering complete upper and lower dentures to an eligible population of elderly people (above 65 years) in the São Paulo state, Brazil. METHODS The proportion of eligible population was calculated by assessing the prevalence of edentulous (upper and lower arch) and by defining the eligible group (public health system users). The budgetary impact analysis was designed under the following scenario: 5-year time horizon (2018-2022), prospect of municipal expenses with prostheses, and additional progressive incorporation of technology (upper and lower dentures) at an annual rate of 10%, 15%, 20%, 25%, and 30%. Sensibility analysis was performed in 3 different situations (reference, more pessimistic, and more optimistic) based on the calculation of spending through assessed demand and epidemiological demand. RESULTS The municipal cost for each denture, already discounted the value transferred by the union for this procedure, was R$50.97. The incremental impact on the budget measured by the epidemiological demand relative to assessed demand was approximately R$59 141 510 over 5 years, meaning an impact of 0.08% (0.01% more optimistic; 0.13% more pessimistic) of the "medium and high complexity care" budget and 0.09% (0.03%-0.14%) of the primary care budget. CONCLUSION The budgetary impact of increasing the oral rehabilitation with complete dentures for elderly population in the São Paulo state is low relative to the expenses with primary or specialized care budgets. In addition, incorporation of denture rehabilitation would be feasible, according to the financial availability and priorities of each municipality.
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Carreiro DL, Souza JGS, Coutinho WLM, Haikal DS, Martins AMEDBL. [Access to dental services and related factors: a home-based population study]. CIENCIA & SAUDE COLETIVA 2019; 24:1021-1032. [PMID: 30892522 DOI: 10.1590/1413-81232018243.04272017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 05/15/2017] [Indexed: 11/22/2022] Open
Abstract
The scope of this study was to identify factors associated with lack of access to dental services. It involved a cross-sectional study and a probabilistic complex sample by conglomerates in two stages with 857 participants over 18 years of age in a large city. Multiple analyses by means of logistic and multivariate regression in decision trees were made. The lack of access to dental services was considered a dependent variable. It was identified that 10.3% did not have access. In the multiple and multivariate analyses an association with age was verified and in the logistic regression a greater possibility of lack of access was found for each year of increased age, among those with the lowest per capita income and those who ranked appearance of teeth and gums as "fair/poor/very poor." The lack of access to dental services was greater among the most socially vulnerable. There is a pressing need to increase the allocation of public resources to promote health education and provide knowledge about how to access services when they are needed, focusing on dental care as a human right and ensuring that lack of access does not occur as users get older or among those with low income and also those dissatisfied with their oral appearance.
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Affiliation(s)
- Danilo Lima Carreiro
- Departamento de Odontologia, Universidade Estadual de Montes Claros. Av. Rui Braga s/n, Vila Mauricéia. 39401-089 Montes Claros MG Brasil.
| | | | | | - Desirée Sant'ana Haikal
- Departamento de Odontologia, Universidade Estadual de Montes Claros. Av. Rui Braga s/n, Vila Mauricéia. 39401-089 Montes Claros MG Brasil.
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Barasuol JC, Garcia LP, Freitas RC, Dalpian DM, Menezes JVNB, Santos BZ. Dental care utilization among children in Brazil: an exploratory study based on data from national household surveys. CIENCIA & SAUDE COLETIVA 2019; 24:649-657. [DOI: 10.1590/1413-81232018242.03232017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 03/22/2017] [Indexed: 11/21/2022] Open
Abstract
Abstract Wide availability of access to dental services can be considered a predictor of better oral health outcomes in a population. This article aims to compare data from the Brazilian National Household Sample Surveys (PNAD) on dental services utilization among children aged 4 to 12 years. This cross-sectional study was carried out using data from the 1998, 2003, and 2008 National Household Sample Surveys, involving a total of 61.438, 64.659 and 59.561 children, respectively. Ninety-nine percent confidence intervals were considered for the prevalence of each outcome of interest. In 1998, 60.8% (99%CI: 59.4;62.1) of children had been to a dentist; this prevalence was 65.5% (99%CI: 64.4;66.7) in 2003 and 73.8% (99%CI: 72.1;74.2) in 2008. In 1998, 41.2% (99%CI: 39.1;43.3) of children in the lowest household income quartile had been to a dentist; this value was 61.4% (99%CI: 59.5;63.2) in 2008. Among children from families whose head of household had 4 years of formal education or fewer, 49.5% and 63% had been to a dentist in 1998 and 2008, respectively. The lifetime prevalence of dentist attendance among Brazilian children increased between 1998 and 2008, especially among those from low-income families and those whose head of household had a low educational level.
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Sória GS, Nunes BP, Bavaresco CS, Vieira LS, Facchini LA. Acesso e utilização dos serviços de saúde bucal por idosos de Pelotas, Rio Grande do Sul, Brasil. CAD SAUDE PUBLICA 2019; 35:e00191718. [DOI: 10.1590/0102-311x00191718] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 01/11/2019] [Indexed: 11/21/2022] Open
Abstract
Resumo: O objetivo foi medir a falta de acesso e a utilização dos serviços de saúde bucal por idosos de Pelotas, Rio Grande do Sul, Brasil. Estudo transversal de base populacional foi realizado no ano de 2014, na zona urbana do município, incluindo indivíduos com 60 anos e mais. Variáveis sociodemográficas e de necessidade autorreferidas foram associadas aos desfechos. Utilizou-se regressão de Poisson para as análises bruta e ajustada. Foram entrevistados 1.451 idosos mediante um questionário estruturado. Falta de acesso no último ano alcançou uma prevalência de 1,8% (IC95%: 0,7-3,0). Idosos que nunca consultaram somaram 3,1% (IC95%: 2,2-4,0) e a utilização de serviços de saúde bucal no último ano registrou prevalência de 38,3% (IC95%: 36,0-41,0). A utilização no último ano apresentou associação positiva com as seguintes variáveis: faixa etária mais jovem (RP = 1,16), ter companheiro (RP = 1,28), alta escolaridade (RP = 1,31), problema na boca ou nos dentes (RP = 1,93), necessidade de prótese dentária (RP = 1,36) e ser edêntulo (RP = 3,11). A falta de acesso no último ano foi baixa. A utilização de serviços de saúde bucal foi mais alta do que a observada em outros estudos. Os achados parecem refletir a expansão desses serviços, particularmente na rede pública, sendo úteis para as ações de planejamento das políticas de saúde.
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Chaves SCL, Almeida AMFDL, Reis CSD, Rossi TRA, Barros SGD. Política de Saúde Bucal no Brasil: as transformações no período 2015-2017. SAÚDE EM DEBATE 2018. [DOI: 10.1590/0103-11042018s206] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Este estudo analisou a implementação da Política de Saúde Bucal no Brasil entre 2015 e 2017 em quatro componentes: ações institucionais, implantação, financiamento e resultados. Foram realizados acompanhamento dos sites do Ministério da Saúde (MS) e coleta de dados secundários sobre ações institucionais do MS, implantação dos serviços de Atenção Básica e Atenção Especializada, resultados alcançados (cobertura da primeira consulta odontológica, média de ação coletiva de escovação supervisionada e tratamentos especializados) e financiamento. Entre 2015 e 2017, houve aumento de 5,8% no número de Equipes de Saúde Bucal e de 6,4% no número de Centros de Especialidades Odontológicas. A cobertura de primeira consulta odontológica programática decresceu no período de 14,6% em 2015, para 10,5% em 2016 e 8,3% em 2017. Houve redução discreta do financiamento federal no ano de 2017, quando comparado a 2016. Verificou-se, em 2016, um cenário político restritivo para a saúde bucal na menor implantação de novos serviços, com mudanças sucessivas na coordenação nacional da política. É necessário aprofundar o estudo sobre o financiamento da política, visto que o aporte financeiro de 2016-2017 não está coerente com o pouco avanço na implantação e tendência de manutenção de resultados, com queda de indicadores específicos, como o de primeira consulta odontológica programática.
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Baldani MH, Ribeiro AE, Gonçalves JRDSN, Ditterich RG. Processo de trabalho em saúde bucal na atenção básica: desigualdades intermunicipais evidenciadas pelo PMAQ-AB. SAÚDE EM DEBATE 2018. [DOI: 10.1590/0103-11042018s110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO O objetivo deste estudo exploratório foi identificar desigualdades na organização do processo de trabalho das Equipes de Saúde Bucal (ESB) na Estratégia Saúde da Família, comparando municípios do Estado do Paraná quanto à condição social, econômica e demográfica. Foram utilizados dados secundários obtidos na etapa de avaliação externa do Programa de Nacional do Acesso e da Qualidade da Atenção Básica (PMAQ-AB), referentes aos padrões de certificação de acesso, qualidade e organização do processo de trabalho das equipes. Os municípios foram estratificados segundo o índice proposto pelo programa. Houve ampla participação dos municípios no PMAQ-AB, com predominância de equipes de saúde da família com saúde bucal. Os resultados demonstram desigualdades desfavoráveis aos municípios menores e mais carentes, o que revela a necessidade de compreender o papel da gestão como apoiadora das ESB, favorecendo o resgate de competências e habilidades necessárias para a boa gestão da clínica e do cuidado na Atenção Primária à Saúde. Evidencia-se a necessidade da qualificação da gestão, com apoio federal e estadual, principalmente aos municípios menores e com baixa capacidade de resposta dos sistemas de saúde. É importante que a regionalização seja efetiva, e que a rede de atenção à saúde bucal seja organizada de forma equânime, para incluir esses municípios.
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Fonseca SGOD, Fonseca EPD, Meneghim MDC. Factors associated with public dental service use by adults in the state of São Paulo, Brazil, 2016. CIENCIA & SAUDE COLETIVA 2018; 25:365-374. [PMID: 31859883 DOI: 10.1590/1413-81232020251.04562018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 05/16/2018] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to investigate the factors associated with public dental care use by adults in the State of São Paulo, Brazil. A cross-sectional study was conducted with a representative sample of adults aged 35 to 44 years using data from the 2015 Epidemiological Survey of the Oral Health Status of the Population of the State of São Paulo (SBSP-2015). Multivariate logistic regression was performed using variables based on a model proposed by Andersen for predicting access to public dental services. Results: 3,421 (59.9%) adults visited private services and 2,288 (40.1%) visited public services. Prevalence of the use of public dental services was greatest among women (41.8%) and adults with a lower education level (50.2%). Being non-white (OR = 1.32, 95% CI: 1.16, 1.50), lower household income (OR = 2.37, 95% CI: 2.11, 2.65), having had toothache (OR = 1.60, 95% CI: 1.39, 1.83), and need for endodontic treatment (OR = 1.44, 95% CI: 1.12, 1.85) were associated with public dental service use. Predisposing, enabling, and need factors were associated with public dental care use.
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Affiliation(s)
| | - Emílio Prado da Fonseca
- Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas. Av. Limeira 901, Areião. 13414-900 Piracicaba SP Brasil.
| | - Marcelo de Castro Meneghim
- Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas. Av. Limeira 901, Areião. 13414-900 Piracicaba SP Brasil.
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Mendes SR, Silva MES, Firmo JOA, de Abreu MHNG. What haematopoietic stem cell transplant patients think about health and oral care: A qualitative study in a Brazilian health service. Eur J Cancer Care (Engl) 2018; 27:e12851. [PMID: 29693301 DOI: 10.1111/ecc.12851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2018] [Indexed: 11/29/2022]
Abstract
Differences in the perceptions of treatment between healthcare team and patients should be identified, aiming to provide a more humanised health care. We sought to understand and evaluate the concepts regarding oral health and dental care among haematopoietic stem cell transplant patients. Individual semi-structured interviews were conducted with patients, from both sexes, in the post-haematopoietic stem cell transplant stage, who underwent dental treatment. All interviews were recorded and transcribed, respecting the spelling and syntax used by the interviewees. A thematic content analysis was performed, and three themes were assessed: what is oral health, why was pre-transplant dental treatment performed, and what was the relevance of dental treatment for the haematopoietic stem cell transplant. Oral health was understood as the act of dental care through oral hygiene. The reason for performing prior dental treatment involves strict guidelines for transplants, and when questioned as to the importance of the dental treatment for transplants, the interviewed subjects' statements focused on the prevention of infections during the low-immunity stage. The individuals saw dental treatment as a step towards a successful transplant; their main concerns were not to re-establish their oral health, but rather to end the dental treatment as quickly as possible.
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Affiliation(s)
- S R Mendes
- Department of Community and Preventive Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brasil
| | - M E S Silva
- Department of Operative Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brasil
| | - J O A Firmo
- René Rachou Research Center- FIOCRUZ, Belo Horizonte, Minas Gerais, Brazil
| | - M H N G de Abreu
- Department of Community and Preventive Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brasil
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Chaves SCL, Almeida AMFDL, Rossi TRA, Santana SFD, Barros SGD, Santos CML. Oral health policy in Brazil between 2003 and 2014: scenarios, proposals, actions, and outcomes. CIENCIA & SAUDE COLETIVA 2018; 22:1791-1803. [PMID: 28614500 DOI: 10.1590/1413-81232017226.18782015] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Accepted: 11/26/2015] [Indexed: 11/22/2022] Open
Abstract
This study examined the implementation of Brazil's National Oral Health Policy by the three governments during the period 2003 to 2014. It provides a general overview of oral health care scenarios and examines institutional proposals and actions developed by the executive branch based on the components of the health care system. A documental analysis was conducted using documents produced by key government agencies. The findings show that there was an increase in the provision and coverage of public dental services between 2003 and 2006 and that rates were maintained to a certain degree in subsequent periods (2007 to 2010 and 2011 to 2014). There was an expansion in government funding, human resources and infrastructure. The amount of funds transferred to state and local governments increased from 83.4 million in 2003 to 916 million in 2014, equivalent to a 10.9 fold increase. However, the use of public dental services remained stable, with only a slight increase from 29.7% in 2003 to 30.7% in 2008, while private service utilization increased from 64.4% in 2003 to 74.3% in 2013. The care model component was given lowest priority by the three governments. This shortcoming influences policy effectiveness and requires the adoption of future measures by healthcare managers and officials to correct the situation.
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Affiliation(s)
- Sônia Cristina Lima Chaves
- Instituto de Saúde Coletiva, Universidade Federal da Bahia. R. Araújo Pinho 62, Canela. 40110-912 Salvador BA Brasil.
| | | | | | - Sisse Figueiredo de Santana
- Instituto de Saúde Coletiva, Universidade Federal da Bahia. R. Araújo Pinho 62, Canela. 40110-912 Salvador BA Brasil.
| | - Sandra Garrido de Barros
- Instituto de Saúde Coletiva, Universidade Federal da Bahia. R. Araújo Pinho 62, Canela. 40110-912 Salvador BA Brasil.
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Carreiro DL, Souza JGS, Coutinho WLM, Ferreira RC, Ferreira EFE, Martins AMEDBL. [The use of dental services on a regular basis in the population of Montes Claros in the State of Minas Gerais, Brazil]. CIENCIA & SAUDE COLETIVA 2017; 22:4135-4150. [PMID: 29267730 DOI: 10.1590/1413-812320172212.04492016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Accepted: 05/09/2016] [Indexed: 11/22/2022] Open
Abstract
The use of dental services on a regular basis by residents of Montes Claros (MG) was assessed, as well as related aspects. Cross-sectional study was conducted with a complex probabilistic sample by conglomerates. Logistic regression was used (OR/CI95%) with a significance level of 5. Of the 2582 study participants, 761 required and obtained access to the services for less than a year. Of these, 262 (35.8%) used the services in a regular/routine manner. The use of dental services on a regular basis was greatest among individuals in the age group "≥ 18 ≤ 37"; with schooling "equal to or greater than 9 years"; who classified their oral health, general health and appearance of teeth and gums as "excellent/good"; who reported no pain" on teeth and gums over the last six months; They reported that the "assistance provider had adequate skills"; that they "always/often" received information about oral hygiene and diet/nutrition. In addition, this use was lower among those who rated the time to ask questions about the dental problem or treatment as "regular/bad/terrible." The conclusion drawn is that the use of dental services on a regular basis was relatively low, being associated with personal traits, subjective health conditions and characteristics related to the services.
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Affiliation(s)
- Danilo Lima Carreiro
- Instituto Federal de Educação, Ciência e Tecnologia do Norte de Minas. R. Cel. Luís Píres 202, Centro. 39400-106 Montes Claros MG Brasil.
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Rezaei S, Woldemichael A, Zandian H, Homaie Rad E, Veisi N, Karami Matin B. Dental health-care service utilisation and its determinants in West Iran: a cross-sectional study. Int Dent J 2017; 68:176-182. [PMID: 29171015 DOI: 10.1111/idj.12346] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Dental health care is not only an effective strategy for the prevention, early diagnosis and treatment of oral diseases but also contributes to the general health of communities. This study aimed to investigate the situation of dental health-care service utilisation and its determinants in Kermanshah city, western Iran, in 2015. METHODS AND MATERIALS A cross-sectional study on a total of 894 household heads was conducted. The participants were selected using a multistage sampling technique. A self-administered questionnaire was used to collect the data. Multiple logistic regression was performed to assess factors associated with utilisation of dental-care services and a negative binomial regression was carried out to identify the main factor associated with the frequency of visiting a dentist for dental health care. A statistically significant association was considered at a value of P < 0.05. All the analyses were performed using STATA version 12. FINDING Of the total household heads who participated in the study, 60.3% and 9.9% reported visiting a dentist for dental treatment in the past year and for 6-monthly dental check-ups, respectively. The average ± standard deviation number of visits by a respondent was 2.08 ± 2.97. Of the total number of respondents, 281 (31.4%) reported visiting a dentist once or twice in the last 12 months for dental health-care services, while 28.9% reported visiting a dentist more than twice in the same time period. Ageing, having dental insurance, higher income, being a university graduate, self-rated poor oral health and not regularly brushing own teeth were the main factors associated with utilisation of dental health-care services. CONCLUSION Our study indicates that dental health-care utilisation among households in the study area was influenced by a number of factors, including being socio-economically disadvantaged, self-rated poor oral health and not regularly brushing own teeth. Therefore, in this setting, dental-intervention programmes, including dental health insurance, should focus on mechanisms that can strengthen utilisation of preventive dental health-care services among disadvantaged households.
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Affiliation(s)
- Satar Rezaei
- Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Abraha Woldemichael
- School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia
| | - Hamed Zandian
- School of Health, Ardabil University of Medical Sciences, Ardabil, Iran
| | | | - Navid Veisi
- Students Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Behzad Karami Matin
- Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
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da Fonseca EP, Frias AC, Mialhe FL, Pereira AC, Meneghim MDC. Factors associated with last dental visit or not to visit the dentist by Brazilian adolescents: A population-based study. PLoS One 2017; 12:e0183310. [PMID: 28859102 PMCID: PMC5578480 DOI: 10.1371/journal.pone.0183310] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Accepted: 08/02/2017] [Indexed: 11/27/2022] Open
Abstract
Objectives We investigated the factors associated with no dental visit within the last two years by adolescents in the state of São Paulo, Brazil, by using data from the Oral Health Conditions of São Paulo state population Project (SBSP-2015) conducted in 2015. Methods This was a cross-sectional epidemiological study with a representative sample of adolescents aged 15 to higher years residing in São Paulo State. The examiners were calibrated and dental visits were measured categorically as 1- Less than 1 year, 2- One to two years, 3 - Three years or more, 4- I have never visited the dentist. Based on the literature we dichotomized the outcome in two groups: response 1 plus 2 against response 3 plus 4. Then, Multilevel Poisson Regression (MPR) was used to estimate the prevalence ratios of last dental visit three years or had never been to a dentist by adolescents compared with those who had visited the dentist within the past two years, with contextual variables as the distal level; sociodemographic variables, mesial; and individual variables, proximal level. Results A high percentage of adolescents (84.9%) reported visiting the dentist in the last 2 years. Whereas, 626 (11.6%) had not visited the dentist for over 3 years and 188 (3.4%) had never been. A significantly higher proportion of females than males reported visiting the dentist in the past 2 years (p = 0.003). The oral and dental condition was reported as satisfactory by 4,350 respondents (80.6%), and when they accessed the health service, 2,286 (42.3%) went to the public service. Lower mean family income (1.62PR;95%CI;1.36–1.94); ≥ 1,000 inhabitant/Dental Surgeons (1.25PR;95%IC;1.03–1.56);male (1.26PR;95%CI; 1.11–1.43) non-Caucasian ethnicity (Mulatto:1.30PR;95%CI;1.13–1.50 and Black:1.58PR;95%CI;1.29–1.93); dissatisfaction with the oral health condition (1.20PR;95%CI;1.01–1.45),last visit to the public service versus private service (2.26PR; 95%CI;1.91–2.65) and presenting with periodontal disease in the form of dental calculus as the worst situation (1.38PR; 95%CI; 1.16–1.53) were associated with last visit to the dentist. Conclusions A high proportion of adolescents had visited the dentist in the last two years. No dental visit within the last two years by adolescents were associated with contextual, health care system, sociodemographic, personal and oral health status, demonstrating that this is a complex phenomenon. Actions to promote regular dental visits by adolescents in Brazil should take these factors into consideration.
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Affiliation(s)
- Emílio P. da Fonseca
- Department of Community Dentistry, Piracicaba Dental School, FOP/UNICAMP, Graduate Program, University of Campinas, Piracicaba, São Paulo, Brazil
- * E-mail:
| | - Antonio C. Frias
- Department of Community Dentistry, Dental School of São Paulo University, FO/USP, São Paulo University, São Paulo, Brazil
| | - Fábio L. Mialhe
- Department of Community Dentistry, Health Education and Health Promotion Area of Piracicaba Dental School, FOP/UNICAMP, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Antonio C. Pereira
- Department of Community Dentistry, Preventive Dentistry and Public Health Area of Piracicaba Dental School, FOP/UNICAMP, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Marcelo de C. Meneghim
- Department of Community Dentistry, Preventive Dentistry and Public Health Area of Piracicaba Dental School, FOP/UNICAMP, University of Campinas, Piracicaba, São Paulo, Brazil
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Socioeconomic inequality in the provision of specific preventive dental interventions among children in the UK: Children's Dental Health Survey 2003. Br Dent J 2017; 222:865-869. [DOI: 10.1038/sj.bdj.2017.499] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2017] [Indexed: 11/08/2022]
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Cruz G, Picazzo E. Sustainable human development and oral health. JOURNAL OF ORAL RESEARCH 2017. [DOI: 10.17126/joralres.2017.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Oliveira RFRD, Souza JGS, Haikal DS, Ferreira EFE, Martins AMEDBL. Equidade no uso de serviços odontológicos provenientes do SUS entre idosos: estudo de base populacional. CIENCIA & SAUDE COLETIVA 2016; 21:3509-3523. [DOI: 10.1590/1413-812320152111.22532015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2015] [Accepted: 01/13/2016] [Indexed: 11/22/2022] Open
Abstract
Resumo Propõe-se caracterizar os idosos usuários de serviços odontológicos ofertados pelo Sistema Único de Saúde, considerando o princípio da equidade. Trata-se de um estudo transversal analítico com modelagem hierarquizada, conduzido a partir de uma amostra probabilística, complexa, por conglomerados de idosos (65-74 anos) residentes em um município brasileiro de grande porte populacional. Foram incluídas variáveis independentes referentes a: características sociodemográficas, acesso a informações em saúde, comportamentos/sistema de atenção à saúde e desfechos em saúde. Realizou-se análises descritivas, bivariadas e múltiplas hierarquizadas. Dos 480 idosos incluídos, 138 (31,2%) utilizaram serviços odontológicos provenientes do SUS. O uso desses serviços foi maior à medida que diminuíam a renda per capita e a escolaridade dos idosos, menor entre os que não haviam realizado o autoexame da boca e maior entre os que usavam os serviços odontológicos para procedimentos que não fossem rotina. Além disso, verificou-se que utilizaram mais o SUS pessoas que tiveram o relacionamento afetado pela saúde bucal e uma autopercepção negativa da sua aparência. Conclui-se que o uso dos serviços odontológicos no SUS foi predominante entre os idosos que vivem sob condições de vulnerabilidade.
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Cruz G, Núñez G, Salinas A, Ramos E, Sánchez R. Factors associated with the use of dental health services in primary care in northeastern Mexico. JOURNAL OF ORAL RESEARCH 2016. [DOI: 10.17126/joralres.2016.053] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Ely HC, Abegg C, Celeste RK, Pattussi MP. Impacto das equipes de saúde bucal da Estratégia da Saúde da Família na saúde bucal de adolescentes do sul do Brasil. CIENCIA & SAUDE COLETIVA 2016; 21:1607-16. [DOI: 10.1590/1413-81232015215.07822015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Accepted: 10/24/2015] [Indexed: 11/21/2022] Open
Abstract
Resumo A Estratégia da Saúde da Família (ESF) tem demostrado resultados efetivos em indicadores de saúde. Neste estudo transversal foi avaliado o impacto das equipes de saúde bucal (ESB) da ESF na saúde bucal de 2581 adolescentes escolares, com idade de 12 e 15-19 anos de 36 municípios, 19 com e 17 sem ESB/ESF. Quatro dentistas realizaram exames bucais. Situação socioeconômica, uso e acesso aos serviços de saúde foram coletados em questionário estruturado. Presença das ESB na ESF foi a principal variável independente. Os desfechos foram CPOD e seus componentes, dor de dente, sangramento gengival e cálculo dentário. Os dados foram analisados pelas médias das regressões binomiais negativas e Poisson. O efeito da ESB/ESF e de variáveis individuais foi ajustado em modelo multinível. No modelo bruto não houve associação das ESB na ESF com nenhum dos desfechos analisados. Após o ajuste, jovens de áreas não cobertas pela ESB/ESF tiveram quase a metade da perda de dentes dos adolescentes das áreas cobertas (RM = 0,64 IC95%; 0,43-0,94).
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Soares FF, Chaves SCL, Cangussu MCT. [Local government and public dental health services: an analysis of inequality in use]. CAD SAUDE PUBLICA 2015; 31:586-96. [PMID: 25859725 DOI: 10.1590/0102-311x00077214] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2014] [Accepted: 10/01/2014] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to identify factors associated with the use of primary and specialized public dental health services and private services. A population-based household survey was conducted in two cities of Bahia State, Brazil. Key informants provided data on socioeconomic variables and use of dental health services. Organization of the local public dental health service was ranked as worse versus better. Univariate and multivariate polytomous logistic regression was performed. Of the total of 1,290 individuals, 38.76% used private services, 33.80% used public primary care, and 17.29% used both primary care and the Center for Dental Specialties. Less use of both primary care and specialized public services was associated with lower education (OR = 1.47; 95%CI: 1.03-2.10) and worse organization of services (OR = 1.74; 95%CI: 1.22-2.48), when compared to the exclusive use of primary care. The study showed inequality in the use of dental services, even when comparing more homogeneous groups, namely users of public services.
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Kobayashi HM, Pereira AC, Meneghim MDC, Ferreira RI, Ambrosano GMB. Family risk as adjunct for organizing the demand for oral health service in the Family Health Strategy. REVISTA DE ODONTOLOGIA DA UNESP 2015. [DOI: 10.1590/1807-2577.0003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction One of the main problems of the public health services, in which the family oral health team is included, is access by users to dental treatment in primary care, with particular reference to caries disease. Objective The aim of this study was to evaluate the relationship between family risk, for prioritization of home visits and oral health conditions, with a view to providing evidence about the first indicator for organizing the demand for oral health in the Family Health Strategy (FHS). Method The application of family health is based on Form A of the primary care information database SIAB ("Sistema de Informação de Atenção Básica"), used for registering families with the FHS. Eleven dentists examined the oral health conditions of 1165 persons (608 from 12 to 19 years; and 557 from 35 to 44 years of age), classifying them into six codes from A to F. Multinomial logistic regression was used (α=0.05) to analyze the association between family risk variables and oral health situation. Result There was significant association between family risk and presence of caries disease with treatment needs (OR: 2.08, p<0.0001). Conclusion Persons who have family risk would have twice as much chance of presenting caries disease in comparison with those without risk, corroborating the relevance of this element in organizing the demand for oral health.
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Changes in socioeconomic inequalities in the use of dental care following major healthcare reform in Chile, 2004-2009. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:2823-36. [PMID: 25749319 PMCID: PMC4377935 DOI: 10.3390/ijerph120302823] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Revised: 12/01/2014] [Accepted: 02/05/2015] [Indexed: 11/16/2022]
Abstract
The study examines changes in the distribution and socioeconomic inequalities of dental care utilization among adults after the major healthcare reform in Chile, 2004-2009. We evaluated the proportion of people who visited the dentist at least once in the previous two years, and the mean number of visits. These outcome variables were stratified by sex, age (20-39, 40-59, 60-63; ≥64 years), educational level (primary, secondary, higher), type of health insurance (public, private, uninsured), and socioeconomic status (quintiles of an asset-index). We also used the concentration index (CIndex) to assess the extent of socioeconomic inequalities in the use of dental care, stratified by age and sex as a proxy for dental care needs. The use of dental care significantly increased between 2004 and 2009, especially in those with public health insurance, with lower educational level and lower socioeconomic status. The CIndex for the total population significantly decreased both for the proportion who used dental care, and also the mean number of visits. Findings suggest that the use of dental care increased and socioeconomic-related inequalities in the utilization of dental care declined after a Major Health Reform, which included universal coverage for some dental cares in Chile. However, efforts to ameliorate these inequalities require an approach that moves beyond a sole focus on rectifying health coverage.
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Quinteros ME, Cáceres DD, Soto A, Mariño RJ, Giacaman RA. Caries experience and use of dental services in rural and urban adults and older adults from central Chile. Int Dent J 2014; 64:260-8. [PMID: 25125265 DOI: 10.1111/idj.12118] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To determine whether there is a relationship between the use of dental services and caries experience in adults and older adults from central Chile. MATERIALS AND METHODS A sample of 453 adults, 35-44 years of age, and 438 older adults, 65-74 years of age, was interviewed and examined using World Health Organisation (WHO) methods. Sociodemographic variables were also registered. Caries experience was assessed using the Decayed, Missing and Filled teeth (DMFT) index. Multiple linear regression models were used to determine whether there was an association between the independent variables and caries experience. RESULTS Caries prevalence was 99.6% for adults [DMFT score = 14.89 (±6.16)] and 99.8% for older adults [DMFT score = 25.68 (±6.49)]. Less than half of the population - 41.7% of adults and 31.5% of older adults - received dental care. Regardless of the age group, there were no differences in the DMFT score between those who received and those who did not receive attention (P > 0.05). When the DMFT findings were analysed in greater detail, people who received dental care and urban participants had more fillings (P < 0.05) than did those who were not provided with attention or lived in rural areas, who, in turn, had more missing teeth (P < 0.05). A higher educational level was associated with a decrease of 1.15 DMFT points (P = 0.003) in the group of older adults. CONCLUSIONS Adults and older adults from the Maule Region showed severe dental damage from caries. Although rurality and use of services do not seem to affect caries experience, they are associated with differences in fillings and missing teeth.
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Affiliation(s)
- Maria E Quinteros
- Department of Public Health, Faculty of Health Sciences, University of Talca, Talca, Chile
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da Fonseca DAV, Mialhe FL, Ambrosano GMB, Pereira AC, Meneghim MDC. [Influence of the organization of primary care and the socio-demographic characteristics of the population on the demand for municipal emergency dental care]. CIENCIA & SAUDE COLETIVA 2014; 19:269-77. [PMID: 24473623 DOI: 10.1590/1413-81232014191.2048] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Accepted: 10/25/2012] [Indexed: 11/22/2022] Open
Abstract
The scope of this study was to evaluate the influence of the social determinants and the provision of primary care services in relation to the use of emergency dental care services in a medium-sized municipality. Data recorded for the 57,231 users of emergency care between 2007 and 2009, in accordance with age, gender, date and period of dental care, social exclusion indices of the suburb in which they live and the existence of a benchmark oral health team, were used to perform the analysis. Of the total population, 5.24% on average per year used the service during the period under scrutiny, with the 20-49 year age group (63.84%) showing the highest demand and equality between genders for such care. Surgical procedures (54.90%) were the most prevalent with an increasing trend for restorative procedures (62,8%). Users living in areas of greater social exclusion were 4.15 times more likely to seek dental care (p < 0.05). No statistically significant association was found between gender or the existence of an oral health team of the suburb in which they live and the demand for emergency dental care. In conclusion, there was greater recourse to emergency municipal dental care by individuals living in vulnerable areas, proving the importance of such care in diminishing oral health inequality.
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Miranda CDBC, Peres MA. Determinantes da utilização de serviços odontológicos entre adultos: um estudo de base populacional em Florianópolis, Santa Catarina, Brasil. CAD SAUDE PUBLICA 2013; 29:2319-32. [DOI: 10.1590/0102-311x00139912] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Accepted: 05/27/2013] [Indexed: 11/22/2022] Open
Abstract
Objetivou-se estimar a prevalência da utilização dos serviços odontológicos entre adultos e os fatores associados. Realizou-se um estudo transversal, de base populacional, com 1.720 adultos de Florianópolis, Santa Catarina, Brasil, em 2009. A associação entre a utilização de serviços odontológicos e fatores predisponentes, facilitadores e de necessidade, em nível individual, foi testada. A análise multivariável deu-se por meio de regressão de Poisson e estratificou-se por local da última consulta. A prevalência do uso de serviços odontológicos foi de 66% (IC95%: 62,9-70,7). A prevalência de consulta odontológica foi 20% maior entre as mulheres e 72% entre os mais escolarizados; estes, também foram a maioria nos serviços público e privado. A proporção de pessoas que tinham plano de saúde e utilizaram o serviço foi 13% maior do que as que não tinham. Em Florianópolis, o uso de serviços odontológicos é essencialmente privado e a escolaridade é a variável mais importante. Sugere-se um monitoramento dos fatores associados para que se obtenha uma utilização equitativa dos serviços.
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Bahadori M, Ravangard R, Asghari B. Perceived Barriers Affecting Access to Preventive Dental Services: Application of DEMATEL Method. IRANIAN RED CRESCENT MEDICAL JOURNAL 2013; 15:655-62. [PMID: 24578831 PMCID: PMC3918188 DOI: 10.5812/ircmj.11810] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2013] [Revised: 05/26/2013] [Accepted: 07/17/2013] [Indexed: 11/16/2022]
Abstract
Background Identifying perceived access barriers to preventive dental services is one of the basic steps to improve the public health. Objectives This study aimed to determine the perceived barriers affecting access to preventive dental services in one of Tehran dental clinics in 2012. Patients and Methods This research was a cross-sectional descriptive-analytical study conducted in one of Tehran dental clinics in 2012 using decision–making trial and evaluation laboratory (DEMATEL) method. The study sample included all patients (100 patients) who had referred to the endodontic treatment department from 26 - 31 May, 2012. The required data were collected using a questionnaire. Collected data were analyzed using SPSS 18.0 and MATLAB 7.9.0 SPSSS 18.0, as well as, some descriptive and analytical tests including Mean, Standard Deviation (SD), and Independent T- Test. Results The five determinants of cost, inconvenience, fear, organization, and patient-dentist relationship were determined as barriers to access to dental services among which the cost and patient-dentist relationship were identified as the first and last priorities with the coordinates (1.4 and 1.4) and (1.25 and -0.65), respectively. Conclusions High cost of dental care has led to not referring patients to the clinic. Oral health costs are too high; however insurance organizations have no commitment to support such services. Policymakers, administrators, and insurance organizations have a major role in improving access to dental services. These decision-makers in making their policies can provide the required financial resources, shift the available resources towards preventive care and periodic checkups, and consider providing proper and sufficient places for dental care facilities.
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Affiliation(s)
- Mohammadkarim Bahadori
- Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Ramin Ravangard
- School of Management and Medical Information Sciences, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Baratali Asghari
- Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
- Corresponding Author: Baratali Asghari, Health Management Research Centre, Baqiyatallah University of Medical Sciences, Tehran, IR Iran. Tel: +98-2182482417, Fax: +98-2188057022, E-mail:
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