Abstract
ObjectiveCompared 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.MethodsTransitional 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.ResultsThe 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%.ConclusionWe 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.
Highlights
Since the creation of the Unified Health System ((SUS, in Portuguese), Primary Health Care (PHC) has been strengthening as a priority strategy to guarantee population access to health services [1], being the Strategy Family Health (FHS) the main PHC organization model [2].In the scope of oral health, the Ministry of Health (MS) launched, in 2004, the National Oral Health Policy
We identified positive changes in the indicators of potential access to oral health services, expanding the users’ ability to use them
Oral health policies are fundamental to the guarantee of health rights [4], difficulties in accessing these services are a major challenge in Brazil [5,6,7]
Summary
Since the creation of the Unified Health System ((SUS, in Portuguese), Primary Health Care (PHC) has been strengthening as a priority strategy to guarantee population access to health services [1], being the Strategy Family Health (FHS) the main PHC organization model [2]. In the scope of oral health, the Ministry of Health (MS) launched, in 2004, the National Oral Health Policy. This policy advocates the reorganization of oral health care at all levels, with PHC as a priority, through the implementation of oral health teams (OHT) linked to the FHS [3]. Oral health policies are fundamental to the guarantee of health rights [4], difficulties in accessing these services are a major challenge in Brazil [5,6,7]. We analyze the concept of potential access, characterized by the availability and organization of services and technological resources [14,15,16] and determined by the presence of factors that enable the use of services, incorporating to this concept the factors that can limit or expand the capacity of use by the individual [15], such as the availability of an adequate structure and organizational aspects of the work process [17]
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