Abstract

This study aimed to assess time trends in production and performance indicators in secondary dental care services in the Brazilian Unified National Health System (SUS) from 2008 to 2018. A time series study was conducted, based on production data from the Specialized Dental Clinics (CEOs in Portuguese) obtained from the Ambulatory Information System of the SUS. The monitoring indicator was assessed as the proportion of clinics that met the monthly target set for each specialty (primary care, endodontics, surgery, periodontics). Dental services' performance was defined as poor for those that met only one or no targets in the four dental specialties. The time series were analyzed by the decomposition method, considering the components trend, seasonal variation, and random variation. All the analyses were performed for Brazil as a whole and for each of the country's five major geographic regions. A decline was seen in Brazil as a whole in the proportion of clinics that met the primary care targets. There were upward trends in the proportion of compliance with the targets for surgery and periodontics in Brazil as a whole. Important differences were seen between the regions of Brazil in the proportion of compliance with the targets, with the worst performance for the clinics in the North and Northeast regions. Time trends showed an improvement in the services for Brazil as a whole, while emphasizing the importance of assessing the country's regions and the need for constant monitoring of these indicators.

Highlights

  • The monitoring indicator was assessed as the proportion of clinics that met the monthly target set for each specialty

  • The time series were analyzed by the decomposition method

  • All the analyses were performed for Brazil as a whole

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Summary

ARTIGO ARTICLE

Este trabalho teve o objetivo de avaliar a tendência temporal dos indicadores de monitoramento de produção e desempenho dos serviços de atenção secundária em saúde bucal do Sistema Único de Saúde (SUS), no período de 2008 a 2018. O indicador de monitoramento foi avaliado segundo a proporção de CEOs que cumpriram a meta mensal estabelecida para cada especialidade (atenção básica, endodontia, cirurgia, periodontia). A Região Centro-oeste também registrou crescimento no cumprimento de todas as metas, mas apresentou declínio na atenção básica e mostrou crescimento significante na proporção de CEOs com desempenho ruim [VPA = 1,60% (IC95%: 0,14; 3,06)]. Observaram-se, ainda, importantes desigualdades entre as macrorregiões, com o pior desempenho dos CEOs nas regiões Norte e Nordeste (declínio na atenção básica e endodontia, tendência estacionária no desempenho ruim e no atendimento de todas as metas), melhor desempenho nas regiões Sul e Sudeste (crescimento em todas as metas, declínio em desempenho ruim) e perfil intermediário para a Região Centro-oeste. Séries temporais (2008-2018) da proporção de Centros de Especialidades Odontológicas (CEOs) que cumpriram as metas para cada especialidade odontológica e que apresentaram desempenho ruim, no Brasil e macrorregiões

Atenção básica Cirurgia Periodontia Endodontia Todas as metas Desempenho ruim
Atenção básica Cirurgia Endodontia Periodontia
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