Abstract
To evaluate the association between dentists' profile and health work management with the performance of primary care dental teams in the Brazilian National Health System, both nationally and regionally. Secondary data analysis from a Brazilian National Programme that evaluated 18,114 Brazilian dental teams, working in the public sector, between 2013 and 2014. Twenty-four independent variables taken from dentists' profile and dental team management characteristics were analysed to assess their influence on reported “dental team performance.” An estimated score was generated from their performance on 20 dental procedures by an item response theory model. Multiple linear regression models were performed for each Brazilian geographical region, separately and for the whole of Brazil. p values ≤ 0.05 were considered significant. Two variables related to dentists' profile, “having graduate studies” (β = 0.151) and “undertaking continuing professional development training” (β = 0.101), were associated with enhanced dental team performance in all five Brazilian geographical regions and nationally. The dental team management variables of “having a flexible dental appointment list” (β = 0.218) and “monitoring oral health indicators” (β = 0.132) also contributed to improve team performance in each of the regions and nationally. Dentists' profile influenced the performance of dental teams from south region more than the other regions. The findings suggest that continuing professional development, including postgraduate education, and strategic management characteristics are important for primary dental care performance and should be reflected in health policy initiatives in support of quality care. Regional factors could be considered for health care management.
Highlights
Primary health care (PHC) is the most important level of care of the Brazilian National Health System, where all the citizens can have access to health promotion, prevention, and treatment, through integrated services and free of charge at the point of delivery
The National Oral Health Policy (NOHP), published in 2004, defines the inclusion and organisation of the dental teams at the SUS, comprising strategies to expand and improve the health care provided to the population [1,2,3]
The psychometric analyses of the questions related to the execution of the dental procedures attributed a score to the dental teams that we called “dental team performance,” varying between -3.66 and +1.87 and showed that these items were better in discriminating the dental teams with negative scores, especially those between -2 and -3 [11]
Summary
Primary health care (PHC) is the most important level of care of the Brazilian National Health System (known as Sistema Único de Saúde—“SUS”), where all the citizens can have access to health promotion, prevention, and treatment, through integrated services and free of charge at the point of delivery. The psychometric analyses of the questions related to the execution of the dental procedures attributed a score to the dental teams that we called “dental team performance,” varying between -3.66 and +1.87 (mean of -0.06; median of +0.01) and showed that these items were better in discriminating the dental teams with negative scores, especially those between -2 and -3 [11] These preliminary analyses were necessary to achieve the aim of the present study, that is, to evaluate the influence of dentists’ profile and health work management in the performance of primary care dental teams of the Brazilian National Health System. New public policies that guarantee greater employment stability can be considered
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