Spontaneous Demand Research Articles

Circulation of Trypanosoma cruzi in triatomines and Didelphis sp. in urban areas: Transmission risk assessment in the Metropolitan Region

The presence of Trypanosoma cruzi vectors in urban areas has been frequent, with colonization of homes and associated with reservoir animals that increase risk to humans, with simultaneous circulation of vectors and T. cruzi. The study aimed to describe the circulation of triatomines and T. cruzi in the Metropolitan Region of São Paulo, as well as evaluate risk situations. For analysis purposes, the triatomine notification information from January 2016 to July 2023 was used. While for Didelphis sp. collection with the aid of traps, notification information used was from 2019 to 2023. Information about triatomines came from spontaneous demand by the population and notification services were carried out by state field teams following defined protocols. 202 notifications were received with the capture of 448 triatomines. The positivity for T. cruzi observed was 60.5%. Regarding Didelphis sp., 416 animals were collected, 5.3% of which were positive for T. cruzi. There was overlapping areas of presence of infected triatomines and Didelphis sp., whose Discrete Typing Unit (DTU) was T. cruzi I. This work indicates the presence of infected vectors in urban areas, and the presence of a wild cycle of T. cruzi in didelphiids, reaffirming the need for and importance of vector surveillance work, through actions that can prevent the transmission of Chagas disease.

Tracking People Living with HIV in Loss to Follow Up in Central Brazil: A Call for Attention to Health Services.

Despite the effectiveness of antiretroviral therapy (ART), human immunodeficiency virus (HIV) infection remains a global public health concern. However, weaknesses in its management regarding access to integrated HIV care include treatment gaps and loss to follow-up (LTFU) from antiretroviral treatment (ART). This study aimed to characterize the epidemiological and clinical profiles of people living with HIV/AIDS (PLHA) in LTFU from HIV care in Campo Grande, Central Brazil. This retrospective cross-sectional study was conducted between January 2021 and April 2022 using secondary data from PLHA who had LTFU in Campo Grande. A total of 852 patients with PLHA were included in this study. The majority of participants in LTFU were male (63.1%), had a CD4 cell count > 200 cells/mm3 (68.2%), and had been treated for ≥ 3months (86.4%). Only 287 (33.7%) participants had undetectable HIV viral load. Of the total number of patients who returned to treatment during the study period, 448 (54.3%) were LTFU-positive. The tracking strategy was not applied to 556 (65.26%) patients, and 44.4% of the participants had been in spontaneous demand. These results highlight the relevance of patient-centered interventions and the need to ensure early treatment and promote retention in care systems with consequent viral suppression, impacting the healthcare indicators of the population, with emphasis on health managers and stakeholders in HIV care.

Hanseníase em menores de quinze anos no município mais hiperendêmico do Brasil

ABSTRACT Objective: To describe leprosy involvement and physical disability profiles in children and adolescents under 15 years old. Methods: Ecological time series study, based on data from the Brazilian Notifiable Diseases Information System, including new cases of leprosy residing in Palmas (TO), from 2001 to 2020. Results: A total of 471 notified cases in children and adolescents under 15 years of age were evaluated, resulting in a detection coefficient of 26.5 per 100,000 inhabitants. Of these, 52% (n=243) were women, 5% (n=24) corresponded to grade two disability, and 36% (n=168) were diagnosed through spontaneous demand. The temporal trend analysis showed a 0.5% reduction in the detection coefficient. There was a significant decrease in the diagnosis of the undetermined and tuberculoid clinical forms and a significant increase in the dimorphous form. Diagnosis through contact examination increased significantly by 13.1% and that through spontaneous demand decreased by 4.9%. The detection coefficient of cases with grade two disability reduced significantly by 7.4% while those with grade one increased by 16.8%. Conclusions: Despite the downward trend in the detection coefficient in children and adolescents under 15 years of age and in cases with grade two disability, other factors indicate failure in the adequate management of leprosy in Palmas.

Avaliação da clorexidina 0,12% em pacientes de unidade de terapia intensiva: ensaio clínico randomizado

ABSTRACT Objective: To evaluate the antimicrobial effect of 0.12% aqueous chlorhexidine solution on the oral microbiota of patients on mechanical ventilation in Intensive Care Units (ICUs) at 6, 8 and 12 hours after oral hygiene. Methods: This is a randomized clinical trial in which 30 patients admitted to the ICUs of a philanthropic hospital based in Aracaju-SE, selected by spontaneous demand over a period of 2 months according to inclusion criteria, were randomized and equally distributed into three groups. Oral hygiene followed the disinfection protocol adopted by the hospital, the same recommended by the Brazilian Association of Intensive Medical Care (AMIB). Saliva samples were collected before the application of 0.12% chlorhexidine, shortly after application of the solution, and then after 6 hours (TEST 1 Group), 8 hours (TEST 2 Group) and 12 hours (CONTROL Group), according to each group. Results: The material was sent to a clinical analysis laboratory for microbiological evaluation using the bacterioscopy technique, also called Gram stain. The results were tabulated in spreadsheets and analyzed using the Friedman test between groups and Kruskal Wallis test between groups. Conclusion: The study showed no statistical difference between groups and between groups.

Dental care for persons with disabilities: discretion on the frontline.

To depict the influence of discretionary actions exercised by frontline professionals and organizations on the implementation of diverse modalities of access to specialized dental care within the Care Network for Persons with Disabilities. A case study conducted in two Brazilian health regions characterized by distinct means of access to specialized dental care employing documentary analysis and interviews with key stakeholders across the period spanning from July to December 2019. In the referenced access region, there was a notable centrality of Primary Health Care (PHC) in caregiving, wherein planning and assessment were integral components of institutional routines. Where spontaneous demand scheduling was accepted, sporadic exchanges of information were evident between PHC units and specialized facilities. The coordination role in caregiving was not vested in PHC teams, and activities such as planning and assessment were not assimilated into organizational routines. The implementation of policies for specialized dental care for persons with disabilities relied on the coordination furnished by PHC and the orchestration of planning and assessment endeavors aimed at establishing an integrated care network. This implementation proved subject to the discretionary authority of frontline professionals and organizations, highlighting the significant role of relational and institutional environments in the context of public policy implementation within a decentralized and regionalized healthcare system.

АНАЛІЗ АСОРТИМЕНТНОЇ ПОЛІТИКИ ТОРГОВОГО ПІДПРИЄМСТВА ТА НАПРЯМИ ЇЇ ВДОСКОНАЛЕННЯ

The purpose of the article is to analyze the assortment policy of a trading company and search for directions for its improvement. The conducted analysis proved that the problems of forming an assortment policy are mostly connected with too huge assortment of goods on the market, with changes in customer needs and the growth of non-price competition. The specificity of the problem of the Ukrainian market is further complicated by the active hostilities in the country and related economic instability, inflation, low level of solvent demand, low level of population income growth, problems with the delivery of goods, etc. The essence of the concept of “assortment policy” as a field of activity of the marketing management of the enterprise is defined, which is a set of principles, the observance of which leads to the formation of an optimal assortment of goods from the point of view of increasing the competitiveness of the enterprise, taking into account its own capabilities, the capabilities of suppliers and partners, market needs, seasonality of demand, etc. Based on the ABC analysis for the “EVA” line of stores, it is emphasized that the most significant products are decorative cosmetics, perfumes for women, their share in the total turnover is on average almost 20%, they and other important products for the company belong to the category “A “, that is, they are the most important and significant, their share in the sum is 60%. The “B” group, which assumes medium significance, includes aromas, scented candles, atomizers, etc. Their share in total is 30%, it is the basis of the chain’s range of stores. The smallest share is occupied by goods of the “C” group, which are the least significant in terms of the turnover of the “EVA” line of stores: shaving products for men, cosmetic brushes, jewelry, etc. Their share in total is only 10%. An XYZ analysis was carried out for the “EVA” line of stores, the results of which show that the products marked X are products for which the demand is stable throughout the year (hygiene and care, home care products, home fragrances, etc.); products Y remain relatively stable throughout the year and products Z are volatile products, the coefficient of variation of sales volume by quarter exceeds 20% (sun protection, lip care, etc.). An integrated matrix of ABC-XYZ-analysis was built, which proves that the “EVA” store line carries out a balanced assortment policy, but does not saturate the assortment sufficiently with those items for which a higher level of profitability can be obtained, which leads to a rather low profit in recent years. For the company, the absence of product groups that can be attributed to the CZ classification, which are products of spontaneous demand, in the product range is noticeable, and therefore, increasing the product range in favor of such products can provide an opportunity to obtain a higher level of profit. It is recommended that the company continue to work on the development of new own brands and the creation of new product positions among the old ones, expanding the assortment in the “average” and “average minus” price segments.

Decoding the Profitability of Insurance Products: A Novel Approach to Evaluating Non-Participating and Participating Insurance Policies

This study presents a novel approach to analyzing the present value of total profit for non-participating and participating insurance policies in order to determine the optimal profitability of non-participating and participating insurance policies based on applying the approach used in operations research to the field of finance. As such, a comprehensive insurance product evaluation model was developed using both mathematical models and numerical analysis to evaluate the demand for non-participating and participating life insurance policies in response to changes in interest rates. The findings indicate that non-participating life insurance policies offer greater solvency for insurance companies compared to participating policies. The study also highlights the significance of spontaneous and induced demand in determining the total profit of both types of policies. The study concludes that life insurance companies should focus on generating spontaneous consumer demand, reducing induced demand, and implementing the optimal pricing strategy to achieve maximum profits.

Early diagnosis of autism and other developmental disorders, Brazil, 2013-2019.

To investigate the factors associated with the early diagnosis of autism and other types of pervasive developmental disorder (PDD) in children treated at the Psychosocial Care Center for Children and Adolescents of the Unified Health System, from 2013 to 2019,in Brazil. An exploratory cross-sectional study, based on data from the Record of Outpatient Health Actions (RAAS) of the first appointment of children aged 1 to 12 years. The gross (RRg) and adjusted (RRa) relative risks and respective 95% confidence intervals (95%CI) were estimated using the Poisson regression model with robust variance estimation. Of the 22,483 children included in the study, the majority were male (81.9%), lived in the same municipality where they were diagnosed (96.8%) and in the Southeast region (57.7%). Early diagnosis was higher for childhood autism (RRg = 1.48; 95%CI 1.27-1.71) , PDD without subtype designation (RRg = 1.55; 95%CI 1.34-1.80), other PDD (RRg = 1.48; 95%CI 1.21-1.81) and PDD not otherwise specified (RRg = 1.44; 95%CI 1.22-1.69) than for atypical autism. Children residing in the same municipality where the diagnosis was made had a higher rate of early diagnosis (RRg = 1.31; 95%CI 1.10-1.55) than the others; as well as those referred by primary care (RRg = 1.51; 95%CI 1.37-1.68) and by spontaneous demand (RRg = 1.45; 95%CI 1.31-1.61) than those from other types of referral. Early diagnosis was higher from 2014 and lower in the North region than in the other regions. In the multiple analysis, the magnitude of RRa was similar to that of RRg. Early identification of autism and other PDD has improved in Brazil, but it still represents about 30% of the diagnoses made. The variables included in the model were significant, but still explain little of the early diagnosis of children with autism and other PDD.

ESTUDO SOBRE PACIENTES COM ESCOLIOSE PEDIÁTRICA NO HOSPITAL SANTA CASA DE MISERICÓRDIA DE SÃO PAULO

ABSTRACT Objective: To carry out registration of patients with scoliosis under 18 years old, followed in a quarternary hospital of high complexity, who need surgical treatment, aiming to identify the reasons for the delay in treatment. Methods: Data collection was carried out in person and by spontaneous demand at the spinal orthopedic specialty outpatient clinic in a tertiary hospital of high complexity from January 2021 to December 2022. The results were compiled in the networked database (Red Cap®). Result: 59 patients were evaluated, 45 female (77.9%) and 14 male (22.1%), with a mean age of 13.7 years. Etiology: 30 idiopathic (50.8%), eight syndromic (13.5%), 11 neuromuscular (18.6%), and ten congenital (16.9%). Of the total, 46 (77.9%) were awaiting surgery and 13 (22.1%) were undergoing conservative treatment. The main causes of treatment delay: unavailability of intraoperative neurophysiological monitoring (19 - 41.3%); unavailability of specific surgical material (16 - 34.8%); difficulty of referral to our institution (6 - 13.1%); loss to follow-up (3 - 6.5%) and limitation in casting making (2 - 4.3%). The mean time between diagnosis and the first consultation is 17.25 months (0 - 140). The average surgical wait until December/2022 was 38.4 months (1 - 156). Conclusion: There is a lack of assistance in the steps of monitoring and treatment in the public health system, from directing the patient with scoliosis to the specialized center to performing the surgical procedure, mainly due to limitations in the use of intraoperative neurophysiological monitoring and the unavailability of specific materials to perform highly complex surgeries. Therapeutic Studies - Investigating the Results of Treatment.

HANSEN`S DISEASE IN CHILDREN UNDER 15 YEARS OLD: SOCIODEMOGRAPHIC AND CLINICAL CHARACTERIZATION OF THE CASES IN A HYPERENDEMIC MUNICIPALITY

Objective: to analyze the sociodemographic and clinical profile of reported cases of Hansen´s disease in children under 15 years old in the municipality of São Luís - Maranhão - Brazil. Method: descriptive study conducted with 826 cases reported in the Notifiable Diseases Information System, in São Luís - Maranhão, in the period from 2010 to 2019. Data were analyzed using descriptive statistics and were expressed in absolute and relative frequencies. Results: age group between 10 and 14 years (60.29%), male (51.09%), brown (69.59%), incomplete elementary education (39.58%), multibacillary (62.71%), dimorphic clinical form (54.24%), up to five lesions (74.45%), zero to two nerves affected (83.23%), no bacilloscopic (46.28%), new cases (93.70%), spontaneous demand (46.38%) and zero degree of disability at diagnosis (78.98%). Conclusion: hyper-endemic parameters with high risk for the disease were demonstrated. It is important to create control and prevention strategies to reduce Hansen´s disease transmission in children.

Practical teaching of pathophysiology to LAFFH at the IPD outpatient clinic of FMP/FASE: Historical Report

Background: Undergraduate students of UNIFASE/FMP, through the Academic League of Human Physiology and Pathophysiology (Liga Acadêmica de Fisiologia e Fisiopatologia Humana - LAFFH), participate in a supervised internship to outpatient at the Infectious and Parasitic Diseases Service of FMP/FASE, authorized by Clinical Direction (October 2018). Patients received conventional therapy in addition to complementary therapy with Homeopathy, for external use for cleaning skin lesions and modulating inflammatory responses, whose mechanisms of action are already described in the scientific literature and authorized by ANVISA. Aims: Make approach of undergraduate students to Homeopathic pathophysiology. Methodology: The supervised clinical internship of LAFFH students is in two service rooms with 6 students in each, based on prior appointment due to spontaneous demand, with medical records registered by the IPD outpatient service secretary. Outpatient clinical care addresses the pathophysiology and miasms of the symptoms and signs of neglected chronic parasitic diseases prevalent in our country, identified by anamnesis and physical examination. They are correlated to biological activities in plant chemistry classes, besides official homeopathic pharmacopoeia. So, it was adopted the external use of HUD Ledum palustre 6ch for the cleansing of skin lesions with torpid evolution at IPD. Results and discussion: Two patients with edema and varicose ulcers were treated with the ointment offered. Edema extension which was +++/4+ to both patients diminished to +/4+ in 30 days of interval. Indeed, ulcers remained at the same shape and size, but their bases were cleaned, without purulence. Novel clinical sessions did not occur because of social distancing needed. Conclusion: It has been developed a positive perception among patients and students about the action of homeopathic remedies. The practical teaching activity initiated encourages students in clinical reasoning about complementary therapeutic association with Homeopathy for patients whose evolution is below the expected prognosis with conventional therapy. Project of clinical observation will be elaborated to research ethics committee.

Applicability of the step test for physical fitness assessment of women with chronic venous disease symptoms: a cross-sectional study

Chronic Venous Disease (CVD) can seriously impact physical fitness. Certain measures and aptitude tests can be employed to evaluate this condition in people with CVD that are simple, quick, and less expensive alternatives when compared to laboratory methods. To evaluate the applicability of the 4-minute step test, correlating its results with those of other measures and tests used with people with CVD symptoms. Cross-sectional descriptive study carried out with 47 active women with CVD symptoms who participate in public physical exercise programs and were recruited by spontaneous demand. After clinical evaluation of disease stage, sociodemographic data were collected and calf circumference measurements, ankle goniometry, the tiptoe test, and the 4-minute step test were conducted. The women were already familiar with the apparatus used. The step test showed significant correlations (p<0.05) with calf measurements (r=0.31 and 0.32), flexibility (r=0.48 and 0.47), and the tiptoe test (r=0.33 for number of repetitions and 0.42 for speed of execution), in addition to an inverse correlation with disease severity (r=-0.29). Significant correlations were also found by age group (r=0.60 and 0.54, for calf circumference in the elderly) and by classification in tests and measurements (r=0.19 for the tiptoe test, and r=0 .29, for ankle flexibility). The step test proved applicable and its use in conjunction with other aptitude tests offers a more complete evaluation of active women with CVD symptoms.

Violência sexual contra crianças e adolescentes durante a pandemia de COVID-19: dados do ano de 2020 em um serviço de referência no Estado do Pará

OBJECTIVES: To analyze epidemiological data of children and adolescents who suffered sexual violence in 2020, during the COVID-19 pandemic, to characterize the victims and, thus, to know the magnitude of the injury, to support the planning of care, treatments and monitoring of these and their families, promoting enhancement, improvements and planning for the future and, consequently, enabling benefits for the service itself, for professionals included in it and, mainly, for those who use them. METHODS: This is a cross-sectional, analytical and descriptive epidemiological study, with data collected from the care records of victims referred to the reference service or who attended by spontaneous demand, including children and adolescents aged 0 to 18 years. RESULTS: The study sample consisted of 712 children and adolescents. We found a higher rate of sexual violence against females (86%) aged between 12 and 14 years; the psychology service was the most active; the State capital held the largest number of registrations (54.8%); as for agents of sexual violence, the male aggressor totaled 97.8%, being 91.5% family acquaintances and, 72.8% belonging to the family nucleus, the main aggressors were boyfriends/partners (intra-family) and neighbors (extra-familial); the rape of the vulnerable affected 55.9% of the victims. CONCLUSION: The social isolation established during the epidemic provided a more favorable condition for the occurrence of acts of violence within the home. During the pandemic, there was a reduction in reports of violence against children and adolescents, however, not necessarily a decrease in cases of violence.

Aplicabilidade do teste do degrau na avaliação da aptidão física de mulheres com sintomas de doença venosa crônica: estudo transversal

Abstract Background Chronic Venous Disease (CVD) can seriously impact physical fitness. Certain measures and aptitude tests can be employed to evaluate this condition in people with CVD that are simple, quick, and less expensive alternatives when compared to laboratory methods. Objectives To evaluate the applicability of the 4-minute step test, correlating its results with those of other measures and tests used with people with CVD symptoms. Methods Cross-sectional descriptive study carried out with 47 active women with CVD symptoms who participate in public physical exercise programs and were recruited by spontaneous demand. After clinical evaluation of disease stage, sociodemographic data were collected and calf circumference measurements, ankle goniometry, the tiptoe test, and the 4-minute step test were conducted. The women were already familiar with the apparatus used. Results The step test showed significant correlations (p&lt;0.05) with calf measurements (r=0.31 and 0.32), flexibility (r=0.48 and 0.47), and the tiptoe test (r=0.33 for number of repetitions and 0.42 for speed of execution), in addition to an inverse correlation with disease severity (r=-0.29). Significant correlations were also found by age group (r=0.60 and 0.54, for calf circumference in the elderly) and by classification in tests and measurements (r=0.19 for the tiptoe test, and r=0 .29, for ankle flexibility). Conclusions The step test proved applicable and its use in conjunction with other aptitude tests offers a more complete evaluation of active women with CVD symptoms.

Usuários de substâncias psicoativas: desafios à assistência de enfermagem na Estratégia Saúde da Família

ABSTRACT Objective to analyze the nursing care provided to users of psychoactive substances in the Family Health Strategy. Method a descriptive and qualitative study carried out with seven nurses from the Family Health Strategy of Juiz de Fora, Minas Gerais. Data was obtained through interviews guided by a semi-structured script and the Thematic Content Analysis was used for its treatment. Results the care provided by the interviewees is based on spontaneous demand, without active search strategies, with the valorization of practices guided by the medicalization of the person and the referral to specialized services. The inclusion of the family in the rehabilitation process, immediate care, and therapeutic listening were mentioned as strategies that can be adopted for an integral assistance. The challenges mentioned referred to the lack of training in mental health, the fragmentation of knowledge about the specialty, the absence of training, and the patient's desire to participate in the treatment. Final considerations and implications for the practice the nurses reported insufficient care to ensure comprehensive care permeated by a lack of knowledge and skills to deal with this public, which leads to referral to specialized services as the main intervention, reinforcing the need to train these professionals.

Estratégias de enfrentamento do estresse ocupacional na ótica de enfermeiros emergencistas

A descriptive exploratory study was aimed at, using field research as a source of information, a qualitative approach on the stressors of nurses working in adult emergencies and the capture of different experiences related to the topic. The research scenario will be a general hospital in the Baixada Fluminense that performs urgent and emergency care. The subjects will be nurses and the sample selection will be by spontaneous demand during the workday, individually, where the research objectives will be clarified. The script will be answered at your home, along with the semi-structured questionnaire. After reading the reports, the themes identified for the construction of the results and the elaboration of the analysis categories will be described.

A Rede de Atenção às Urgências e Emergências em cena: contingências e produção de cuidado

ABSTRACT This study aims to analyze the possible transformations in health care management and production processes, in the context of practice, based on the Emergency and Urgent Health Care Network (RUE) policy. The research has a qualitative character and is characterized as a case study. Interviews were conducted with 16 health service managers in four municipalities of different population sizes. The material was analyzed with reference to the context of the Public Policy Cycle Approach practice. It is observed that the RUE is not recognized as a public policy, although some of its elements are identified, such as the implementation of Emergency Care Units, protocols, risk classification, new care technologies, regulatory arrangements, and lines of care. Looking at the ‘RUE on scene’ mainly points to three issues: the relationship between primary care and emergency doors in meeting spontaneous demand; the medical regulation of Mobile Emergency Care Service (SAMU), as a promoter of access and quality; and the (dis)continuity in health care. There is evidence of live movements and productions induced by the policy that qualify health care in urgent and emergency situations. However, inequities are maintained or produced, and the need for articulation between network components, although evoked, translates into fragile and non-regular connections.

How Brazilians access Primary Health Care: evolution and adversities in recent times (2012-2018)

The scope of this study is to analyze access to primary care in Brazil between 2012 and 2018, taking into consideration the availability of services and the physical-structural, temporal and organizational characteristics of the primary care units and teams, highlighting the main advances and obstacles to their enhancement in different contexts. It involved a descriptive cross-sectional and longitudinal study, with a quantitative approach based on secondary data from the National Program for the Improvement of Access and Quality of PC and population coverage data from the Ministry of Health. A total of 15,378 teams were selected and data screened from 59,354 users relating to the teams selected for 2012, and 56,369 users for 2018. Improvements were noted with respect to service availability and in terms of physical and architectural structure; the majority of the teams implemented and/or qualified the reception to spontaneous demand, including emergency care, improved the ways of organizing the agenda to foster a more integrated contact between users and health professionals and qualified the ways of scheduling and reduced the waiting times between scheduling and care. However, the persistence of recurring problems that need to be addressed to improve access to primary care in the country was detected.

Estudo da demanda de uma equipe da Estratégia Saúde da Família que utiliza o acesso avançado como modelo de organização da agenda

O acesso oportuno e a continuidade do cuidado são duas medidas operacionais importantes para a prática dos cuidados na Atenção Primária à Saúde (APS). Objetivo: Realizar um estudo da demanda de uma equipe da Estratégia Saúde da Família (ESF) que utiliza o acesso avançado (AA) como modelo de organização da agenda. Métodos: Trata-se de uma análise documental, quantitativa, descritiva e retrospectiva realizada em uma equipe da ESF no Rio de Janeiro. Os 1410 dados foram coletados em uma planilha do Microsoft® Excel® no Google Drive, utilizada no processo de trabalho da equipe e foram tabulados e analisados em planilhas do Microsoft Excel®. Foram incluídos os registros do período de agosto e setembro de 2017 e excluídos os registros no qual o motivo da consulta (MC) não foi preenchido. Os MC foram codificados a partir de demandas, queixas e necessidades expressas nas narrativas dos usuários, e adaptadas à conformidade da codificação da CIAP (Classificação Internacional de Atenção Primária). Resultados: Dos 1392 registros de MC dos usuários restantes, 149 não foram atendidos por motivo de falta, reagendamento ou evasão, totalizando 1243 registros analisados. Predominou o sexo feminino, faixa etária entre 55 e 59 anos, atendimentos realizados em demanda espontânea, pela manhã, principalmente nas primeiras horas do acolhimento e com queixas gerais e não-específicas. Conclusão: Com o AA parece haver uma acessibilidade maior aos usuários que poderão ter o acesso de primeiro contato mais facilmente para a resolução dos seus problemas. Realizar o estudo da demanda possibilita o levantamento de dados para a elaboração de um planejamento para uma melhor organização da agenda refletindo em um melhor atendimento à população de forma resolutiva, oportuna e integral.

Progress and challenges in potential access to oral health primary care services in Brazil: A population-based panel study with latent transition analysis.

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.