Accessibility to Specialized Public Oral Health Services from the Perspective of Brazilian Users
Abstract
:1. Introduction
2. Materials and Methods
2.1. Type of Study
2.2. Sample
2.3. Data Collection
2.4. Calibration and Pilot Study
2.5. Variables
2.6. Statistical Analysis
2.7. Ethical Aspects
3. Results
3.1. Descriptive Statistics
3.2. Classification of Oral Health Services Offered by the SDC
3.3. Resolutive Nature of Oral Health Services Offered by the SDC
4. Discussion
5. Conclusions
Acknowledgments
Author Contributions
Conflicts of Interest
References
- Labra, M.E. Política e saúde no Chile e no Brasil: Contribuições para uma comparação. Ciência Saúde Coletiva 2001, 6, 361–376. [Google Scholar] [CrossRef]
- Antunes, J.L.F.; Narvai, P.C. Políticas de saúde bucal no Brasil e seu impacto sobre as desigualdades em saúde. Revista de Saúde Pública 2010, 44, 360–365. [Google Scholar] [CrossRef] [PubMed]
- Roncalli, A.G. Epidemiologia e saúde bucal coletiva: Um caminhar compartilhado. Ciência Saúde Coletiva 2006, 11, 105–114. [Google Scholar] [CrossRef]
- Nascimento, A.C.; Moyses, S.T.; Werneck, R.I.; Moyses, S.J. Oral health in the context of primary care in Brazil. Int. Dent. J. 2013, 63, 237–243. [Google Scholar] [CrossRef] [PubMed]
- Soares, C.L. Constructing public oral health policies in Brazil: Issues for reflection. Braz. Oral Res. 2012, 26 (Suppl. 1), 94–102. [Google Scholar] [CrossRef] [PubMed]
- Cameron, A.; Lart, R.; Bostock, L.; Coomber, C. Factors that promote and hinder joint and integrated working between health and social care services: A review of research literature. Health Soc. Care Community 2014, 22, 225–233. [Google Scholar] [CrossRef] [PubMed]
- Widstrom, E.; Komu, M.; Mikkola, H. Longitudinal register study of attendance frequencies in public and private dental services in Finland. Community Dent. Health 2013, 30, 143–148. [Google Scholar] [PubMed]
- Jones, E.; Shi, L.; Hayashi, A.S.; Sharma, R.; Daly, C.; Ngo-Metzger, Q. Access to oral health care: The role of federally qualified health centers in addressing disparities and expanding access. Am. J. Public Health 2013, 103, 488–493. [Google Scholar] [CrossRef] [PubMed]
- McKernan, S.C.; Kuthy, R.A.; Momany, E.T.; McQuistan, M.R.; Hanley, P.F.; Jones, M.P.; Damiano, P.C. Geographic accessibility and utilization of orthodontic services among medicaid children and adolescents. J. Public Health Dent. 2013, 73, 56–64. [Google Scholar] [CrossRef] [PubMed]
- Kahabuka, C.; Moland, K.M.; Kvåle, G.; Hinderaker, S.G. Unfulfilled expectations to services offered at primary health care facilities: Experiences of caretakers of underfive children in rural Tanzania. BMC Health Serv. Res. 2012, 12, 2–10. [Google Scholar] [CrossRef] [PubMed]
- De Goes, P.S.A.; Figueiredo, N.; das Neves, J.C.; da Motta Silveira, F.M.; Costa, J.F.R.; Pucca Júnior, G.A.; Rosales, M.S. Avaliação da atenção secundária em saúde bucal: Uma investigação nos centros de especialidades do Brasil. Cadernos de Saúde Pública 2012, 28, s81–s89. [Google Scholar] [CrossRef]
- Crocombe, L.A.; Broadbent, J.M.; Thomson, W.M.; Brennan, D.S.; Slade, G.D.; Poulton, R. Dental visiting trajectory patterns and their antecedents. J. Public Health Dent. 2011, 71, 23–31. [Google Scholar] [CrossRef] [PubMed]
- Kengne Talla, P.; Gagnon, M.P.; Dramaix, M.; Leveque, A. Barriers to dental visits in Belgium: A secondary analysis of the 2004 national health interview survey. J. Public Health Dent. 2013, 73, 32–40. [Google Scholar] [CrossRef] [PubMed]
- Wagner, J.; Diehl, K.; Mutsch, L.; Löffler, W.; Burkert, N.; Freidl, W. Health status and utilisation of the healthcare system by homeless and non-homeless people in Vienna. Health Soc. Care Community 2014, 22, 300–307. [Google Scholar] [CrossRef] [PubMed]
- Kuthy, R.A.; Kavand, G.; Momany, E.T.; Jones, M.P.; Askelson, N.M.; Chi, D.L.; Wehby, G.L.; Damiano, P.C. Periodicity of dental recall visits for young children first seen in community health centers. J. Public Health Dent. 2013, 73, 271–279. [Google Scholar] [CrossRef] [PubMed]
- Noro, L.R.; Roncalli, A.G.; Mendes Júnior, F.I.; de Lima, K.C.; Teixeira, A.K. Toothache and social and economic conditions among adolescents in northeastern Brazil. Ciência Saúde Coletiva 2014, 19, 105–113. [Google Scholar] [CrossRef] [PubMed]
- Souza, G.C.; Lopes, M.L.D.S.; Roncalli, A.G.; Medeiros-Júnior, A.; do Céu Clara-Costa, I. Referência e contra referência em saúde bucal: Regulação do acesso aos centros de especialidades odontológicas. Revista de Saúde Pública 2015, 17, 416–428. [Google Scholar] [CrossRef]
- Gomes, R.; Schraiber, L.B.; Couto, M.T.; Valença, O.A.A.; Silva, G.S.N.; Figueiredo, W.S.; Barbosa, R.M.; Pinheiro, T.F. O atendimento à saúde de homens: Estudo qualitativo em quatro estados brasileiros. Physis: Revista de Saúde Coletiva 2011, 21, 113–128. [Google Scholar]
- Knauth, D.R.; Couto, M.T.; Figueiredo, W.S. A visão dos profissionais sobre a presença e as demandas dos homens nos serviços de saúde: Perspectivas para a análise da implantação da política nacional de atenção integral à saúde do homem. Ciência Saúde Coletiva 2012, 17, 2617–2626. [Google Scholar] [CrossRef] [PubMed]
- Soares, F.F.; Chaves, S.C.L.; Cangussu, M.C.T. Governo local e serviços odontológicos: Análise da desigualdade na utilização. Cadernos de Saúde Pública 2015, 31, 586–596. [Google Scholar] [CrossRef] [PubMed]
- Lima, A.C.S.; Cabral, E.D.; Vasconcelos, M.M.V.B. Satisfação dos usuários assistidos nos centros de especialidades odontológicas do município do Recife, Pernambuco, Brasil. Cadernos de Saúde Pública 2010, 26, 991–1002. [Google Scholar] [CrossRef] [PubMed]
- Sixma, H.J.; Spreeuwenberg, P.M.; van der Pasch, M.A. Patient satisfaction with the general practitioner: A two-level analysis. Med. Care 1998, 36, 212–229. [Google Scholar] [CrossRef] [PubMed]
- Weiss, G.L. Patient satisfaction with primary medical care. Evaluation of sociodemographic and predispositional factors. Med. Care 1988, 26, 383–392. [Google Scholar] [CrossRef] [PubMed]
- Skillman, S.M.; Doescher, M.P.; Mouradian, W.E.; Brunson, D.K. The challenge to delivering oral health services in rural America. J. Public Health Dent. 2010, 70 (Suppl. 1), S49–S57. [Google Scholar] [CrossRef] [PubMed]
- Bulgareli, J.V.; Faria, E.T.; Ambrosano, G.M.B.; Vazquez, F.L.; Cortellazzi, K.L.; Meneghim, M.C.; Mialhe, F.L.; Pereira, A.C. Informações da atenção secundária em odontologia para avaliação dos modelos de atenção à saúde. Revista de Odontologia da UNESP 2013, 42, 229–236. [Google Scholar] [CrossRef]
- Peres, M.A.; Iser, B.P.M.; Boing, A.F.; Yokota, R.T.C.; Malta, D.C.; Peres, K.G. Desigualdades no acesso e na utilização de serviços odontológicos no brasil: Análise do sistema de vigilância de fatores de risco e proteção para doenças crônicas por inquérito telefônico (vigitel 2009). Cadernos de Saúde Pública 2012, 28, s90–s100. [Google Scholar] [CrossRef] [PubMed]
- Santos, M.P. Avaliação da qualidade dos serviços públicos de atenção a saúde da criança sob a ótica do usuário. Revista Brasileira de Enfermagem 1995, 48, 109–119. [Google Scholar] [CrossRef] [PubMed]
Dependent Variables | Independent Variables |
---|---|
Social classification Income Education Occupation | Service evaluation Type of service sought Waiting time for 1st consultation Waiting time for last consultation Referral for examination Difficulties in performing examinations Intending to return to primary care Means of transport to get the SDC Geographical access |
Variable/Dimensions | Classification of SDC’s Oral Health Services | p-Value | ||
---|---|---|---|---|
Favorable | Unfavorable | |||
SDC where the interview was held | Center | 229 | 36 | 0.76 |
Outskirts | 262 | 62 | ||
Gender of interviewee | Male | 173 | 38 | 0.56 |
Female | 318 | 60 | ||
Age of interviewee | Up to 44 years | 314 | 70 | 0.165 |
Over 44 years | 177 | 28 | ||
Education level | Up to complete elementary | 189 | 32 | 0.305 |
From high school to higher | 302 | 66 | ||
Profession/work of interviewee | Economically active | 266 | 52 | 0.736 |
Not economically active | 207 | 44 | ||
Social classification | Favorable | 93 | 18 | 1.000 |
Unfavorable | 398 | 80 |
Variable/Dimensions | Statistical Evaluation | p-Value | ||
---|---|---|---|---|
OR | CI (95%) | |||
Age of interviewee | Up to 44 years | 1.4378 | 0.742–2.782 | 0.283 |
Over 44 years | 1 | |||
Location difficult to access | Yes | 1.148 | 0.375–3.514 | 0.809 |
No | 1 | |||
Making an appointment is difficult | Yes | 1.306 | 0.461–3.703 | 0.615 |
No | 1 | |||
There are queues | Yes | 1.781 | 0.812–3.908 | 0.150 |
No | 1 | |||
Opening hours do not meet my needs | Yes | 0.606 | 0.208–1.768 | 0.359 |
No | 1 | |||
Lack of medication | Yes | 1.538 | 0.460–5.144 | 0.485 |
No | 1 | |||
Difficulty in getting dental treatment | Yes | 4.659 | 2.212–9.814 | <0.001 |
No | 1 | |||
Missing material or broken equipment | Yes | 0.846 | 0.373–1.922 | 0.690 |
No | 1 | |||
Lack of supervision | Yes | 0.739 | 0.000 | 1.000 |
No | 1 | |||
The service or treatment I need is not available | Yes | 3.903 | 0.567–26.852 | 0.166 |
No | 1 | |||
Not well accepted | Yes | 0.008 | 0.000 | 1.000 |
No | 1 | |||
Were you made welcome in the SDC? | Yes | 0.308 | 0.056–1.698 | 0.176 |
No | 1 | |||
Long treatment waiting time | Yes | 1.719 | 0.770–3.836 | 0.186 |
No | 1 | |||
Service only with form | Yes | <0.001 | 0.000 | 0.998 |
No | 1 |
Variable/Dimensions | Resolutive Nature of SDC Oral Health Services | p-Value | ||
---|---|---|---|---|
Favorable | Unfavorable | |||
SDC where interview took place | Center | 244 | 21 | 0.559 |
Suburb | 293 | 31 | ||
Gender of interviewee | Male | 190 | 21 | 0.545 |
Female | 347 | 31 | ||
Age of interviewee | Up to 44 years | 348 | 36 | 0.648 |
Over 44 years | 189 | 16 | ||
Education level | Up to complete elementary | 206 | 15 | 0.230 |
From high school to higher | 331 | 37 | ||
Profession/work of interviewee | Economically active | 281 | 37 | 0.007 |
Not economically active | 238 | 13 | ||
Social classification | Favorable | 97 | 14 | 0.136 |
Unfavorable | 440 | 38 |
Variable/Dimensions | Statistical Variables | p-Value | ||
---|---|---|---|---|
OR | CI (95%) | |||
Profession/work of interviewee | Economically active | 2.21 | 1.070–4.600 | 0.032 |
Not economically active | 1 | |||
Social classification | Favorable | 1.143 | 0.512–2.551 | 0.744 |
Unfavorable | 1 | |||
Location is difficult to access | Yes | 3.454 | 1.003–11.894 | 0.049 |
No | 1 | |||
Making appointments is difficult | Yes | 1.517 | 0.413–5.572 | 0.531 |
No | 1 | |||
Difficult to get dental treatment | Yes | 1.197 | 0.471–3.042 | 0.706 |
No | 1 | |||
There are queues | Yes | 3.685 | 1.411–9.621 | 0.008 |
No | 1 | |||
Opening hours don’t meet my needs | Yes | 0.778 | 0.238–2.545 | 0.678 |
No | 1 | |||
Lacking medication | Yes | 0.741 | 0.129–4.261 | 0.737 |
No | 1 | |||
Lacking material or broken equipment | Yes | 3.817 | 1.449–10.056 | 0.007 |
No | 1 | |||
The service or treatment I need is not available | Yes | 0.603 | 0.048–7.497 | 0.694 |
No | 1 | |||
Not well accepted | Yes | <0.001 | 0.000 | 0.999 |
No | 1 | |||
Were you made welcome in the SDC? | Yes | 0.633 | 0.84–4.779 | 0.658 |
No | 1 | |||
Long treatment waiting time | Yes | 0.596 | 0.201–1.765 | 0.350 |
No | 1 |
© 2016 by the authors; licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/).
Share and Cite
De Castro, R.D.; Rangel, M.D.L.; Da Silva, M.A.A.; De Lucena, B.T.L.; Cavalcanti, A.L.; Bonan, P.R.F.; Oliveira, J.D.A. Accessibility to Specialized Public Oral Health Services from the Perspective of Brazilian Users. Int. J. Environ. Res. Public Health 2016, 13, 1026. https://doi.org/10.3390/ijerph13101026
De Castro RD, Rangel MDL, Da Silva MAA, De Lucena BTL, Cavalcanti AL, Bonan PRF, Oliveira JDA. Accessibility to Specialized Public Oral Health Services from the Perspective of Brazilian Users. International Journal of Environmental Research and Public Health. 2016; 13(10):1026. https://doi.org/10.3390/ijerph13101026
Chicago/Turabian StyleDe Castro, Ricardo Dias, Marianne De Lucena Rangel, Marcos André Azevedo Da Silva, Brunna Thaís Lucwu De Lucena, Alessandro Leite Cavalcanti, Paulo Rogério Ferreti Bonan, and Julyana De Araújo Oliveira. 2016. "Accessibility to Specialized Public Oral Health Services from the Perspective of Brazilian Users" International Journal of Environmental Research and Public Health 13, no. 10: 1026. https://doi.org/10.3390/ijerph13101026