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Abstract
Objective: To analyze the correlations between the production of specialized dental procedures from 2008 to 2012 and factors related to the services and context of the Brazilian states. Material and Methods: A quantitative ecological-type study was developed, in which secondary data from Brazilian national databases were used. Procedures for outpatient production of specialized procedures throughout Brazil, from 2008 to 2012, were consolidated from the offering state, the state of the federation being the analysis unit. In order to collect data on coverage by oral health family teams in the Family Health Strategy, as well as the number of CEOs per state, the Strategic Support Management Room (SAGE) was accessed. The corresponding indicator mean proportion of specialized procedures in Brazil (Pmb) was used as dependent variable. Correlations were tested using Spearman's test. The software was Statistical Package for Social Sciences, v. 17.0, with a level of significance of 5%. Results: Pmb was 4.9% for the evaluated period. There was a negative correlation between indicator and the coverage of oral health teams in the family health strategy. Conclusion: The correlations analyzed were influenced by the organization and distribution of the professionals' workforce; revealing that the non-organization of the health care network may increase the performance of specialized procedures resulting from spontaneous demand due to the poor basic care coverage.
Highlights
The Federal Constitution of 1988, born from the struggle for the country’s redemocratization, brings in its Article 196 "health as a right of all and duty of the State", and in its Article 198 expresses the principles and guidelines of the new health system, the Unified Health System (SUS), among which are Universality, Equity and Integrality of health care [1].The principle of Integrality understood within its polysemy as the guarantee of the continuity of care in the various levels of technological density of services underlies the need for a continuous construction of the health care network, including Oral Health [2,3,4,5]
Data from this study showed that the average of specialized procedures (Pmb) in Brazil in relation to the total number of dental procedures remained around 4.9% in the study period
The implantation of Centers of Dental Specialties was constituted as the main strategy of the PNSB in the SUS to guarantee this level of attention; currently the number of these health units exceeds the number of 1000 CEOs in Brazil
Summary
The Federal Constitution of 1988, born from the struggle for the country’s redemocratization, brings in its Article 196 "health as a right of all and duty of the State", and in its Article 198 expresses the principles and guidelines of the new health system, the Unified Health System (SUS), among which are Universality, Equity and Integrality of health care [1].The principle of Integrality understood within its polysemy as the guarantee of the continuity of care in the various levels of technological density of services underlies the need for a continuous construction of the health care network, including Oral Health [2,3,4,5]. In the scope of oral health, the insertion of the Dental Surgeon and of oral health in the Family Health Strategy (ESF), which took place through Ordinance No 1444 of 2000, marked the beginning of the restructuring of the oral health care model. This ordinance was the result of a long process of discussions between dental entities, health councils and professionals, which dates from the end of 1994 [6,7]. In 2003, after 12 years of governments that adopted policies of neoliberal tendencies in the country, a new presidential administration emerged, which at that moment represented a break in the political-economic process developed in the previous period and a "hope" of advancement in the Sanitary Reform and, by the institution of a national oral health policy
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