Abstract
BackgroundIntegrated dental services within the Health System, particularly at primary health care, are crucial to reverse the current impact of oral diseases, which are among the most prevalent diseases worldwide. However, the use of dental services is determined by complex phenomena related to the individual, the environment and practices in which care is offered. Therefore, factors associated with dental appointments scheduling can affect positively or negatively the use of dental services. The aim of the present study was to evaluate the indicators for dental appointment scheduling in Primary Health Care (PHC).MethodsThe present is a cross-sectional analytical study that used data from the external assessment of the third cycle of the National Program for Improving Access and Quality in Primary Care (PMAQ-AB), carried out between 2017 and 2018, in Brazil. The final sample consisted of 85,231 patients and 22,475 Oral Health teams (OHTs). The outcome variable was the fact that the user sought for a dental appointment at the Primary Health Care Unit. A multilevel analysis was carried out to verify the association between individual variables (related to users) and contextual variables (related to the OHTs) in relation to the outcome.ResultsOnly 58.1% of the users interviewed at these Primary Health Care Units seek the available dental care. The variables with the greatest effect on the outcome were the patient’s age up to 42 years old (OR = 2.03, 95% CI: 1.96–2.10), at individual level, and ‘oral health teams that assisted no more than a single family health team (FHT)’ (OR = 1.29, 95% CI: 1.23–1.36) at contextual level. Other variables were also associated with the outcome, but with a smaller effect size.ConclusionIn conclusion, users’ age and work process of OHT were indicators for dental appointment scheduling. Our results suggest that when OHT put the National Oral Health Policy guidelines into practice, by assisting only one FHT, the chance for PHC users seeking dental appointments is higher than OHTs that assist more than one FHT. Regarding age, patients aged up to 42 years are more likely to seek an appointment with a dentist.
Highlights
Integrated dental services within the Health System, at primary health care, are crucial to reverse the current impact of oral diseases, which are among the most prevalent diseases worldwide
58.1% of the patients registered in the Primary Health Care Units with an oral health team had already sought dental appointments
This study showed that the seeking for dental appointments in Primary Health Care is related to variables of individuals and of the organization of oral health teams; it showed that only 58.1% of the users interviewed at these Primary Health Care Units seek the available dental care
Summary
Integrated dental services within the Health System, at primary health care, are crucial to reverse the current impact of oral diseases, which are among the most prevalent diseases worldwide. The use of dental services is determined by complex phenomena related to the individual, the environment and practices in which care is offered. Even in scenarios with guaranteed and subsidized care, the use of dental services can be influenced by issues related to the individual, such as overall awareness of oral health or a previous negative experience [4]. In addition to individual issues, the use of available health services is determined by complex interactions with the environment and with the practices in which care is offered [5]. By implementing a new model of care and establishing specific regulations for planning, financing, governance, and provision of healthcare services, SUS has brought nearly universal access to health care and has kept track of the population’s health needs [8, 9]
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