Abstract
The aim of the present study was to investigate the discontinuity of oral health care among children and adolescents who accessed emergency services at primary care units and urgent care units. Records were reviewed of patients aged 0 to 17 years treated in the public healthcare system in city of Curitiba, Brazil. Discontinuity was considered when elective treatment was not registered at the primary care unit within six months after urgent care. The sample was stratified based on the Municipal Human Development Index (MHDI) (≤0.799 or ≥0.800). The association between discontinuity and covariables was assessed using univariate and multivariate Poisson regression models with robust variance (α=0.05). The incidence of discontinuity was 42.2%. In the MHDI≤0.799 stratum, the risk of discontinuity was greater among children younger than five years of age and individuals who had not had a dental appointment in the previous year. In both MHDI strata, the risk of discontinuity was higher in patients who received urgent care at an urgent care unit than those treated at a primary care unit. The incidence of the discontinuity of oral health care was high and was strongly influenced by the characteristics of dental service utilization among individuals living in regions with a lower MHDI.
Highlights
Resumo Este trabalho estudou a descontinuidade do cuidado (DC) em saúde bucal entre crianças e adolescentes que acessaram os serviços de urgência nas unidades básicas de saúde (UBS) e de pronto atendimento (UPA)
A amostra foi estratificada pelo Índice de Desenvolvimento Humano Municipal (IDHM) da Unidade de Desenvolvimento Humano em que o paciente residia em ≤0,799 ou ≥0,800
O risco de DC foi maior para aquelas que utilizaram a Unidades de Pronto Atendimento (UPA) para o atendimento de urgência quando comparadas com as que receberam atendimento na Unidades Básicas de Saúde (UBS)
Summary
Estudo do tipo prospectivo no qual foram selecionados todos os prontuários eletrônicos de indivíduos da faixa etária entre zero e 17 anos que acessaram serviços de urgência nos equipamentos de saúde bucal municipal de Curitiba no mês de abril de 2014. Os atendimentos à urgência em saúde bucal em Curitiba são realizados em 108 Unidades Básicas de Saúde (UBS) e três Unidades de Pronto Atendimento (UPA). Apenas indivíduos com cadastro definitivo no sistema de prontuários eletrônicos (e-saúde) da Secretaria Municipal de Saúde (SMS) de Curitiba foram incluídos no estudo
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