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Publications

Journal Article Epublish

PubMed: 41361453 DOI: 10.1186/s12913-024-12017-5

The relationship between oral health teams in primary care in Brazil and the healthcare network.

BMC Health Serv Res 25(1):1581

Authors: Clarissa Fialho Hartmann, Cesar de Oliveira, Luiz Augusto Facchini, Elaine Tomasi, Elaine Thumé, Anaclaudia Gastal Fassa

Affiliations

  • Department of Social Medicine, Federal University of Pelotas (UFPEL), Marechal Deodoro, 1160 - 3rd floor, Zipcode 96020-220, Pelotas, Rio Grande Do Sul, 464, Brazil.
  • Department of Epidemiology & Public Health, University College London (UCL), 1-19 Torrington Place, London, WC1E 6BT, UK.
  • Department of Social Medicine, Federal University of Pelotas (UFPEL), Marechal Deodoro, 1160 - 3rd floor, Zipcode 96020-220, Pelotas, Rio Grande Do Sul, 464, Brazil.
  • Department of Nursing in Collective Health, Federal University of Pelotas (UFPEL), Marechal Deodoro, 1160 - 3rd floor, Zipcode 96020-220, Pelotas, Rio Grande Do Sul, 464, Brazil.

Abstract

BACKGROUND

An efficient relationship between the various levels of the healthcare network is crucial for ensuring high-quality care. This study analysed the OHT's working process in primary health care in Brazil, examining its relationship with the healthcare network according to geopolitical regions, population size, the Human Development Index (HDI), and oral health coverage in municipalities.

METHODS

A cross-sectional study of 22,993 OHTs that participated in the third cycle of the External Evaluation of the Program for Improvement of Access and Quality in Primary Care (PMAQ-AB) (2017/2018) was carried out in Brazil. The prevalence and the association between the contextual variables of the included municipalities and the OHT working process were assessed.

RESULTS

The provision of reference services for OHTs and the use of protocols for referrals are nearly universal. However, 53% of the teams indicated that emergency services are unavailable outside OHTs' working hours, and 30% did not have records of users referred or received referral feedback. Less than 73% of healthcare networks and specialities offered matrix support to OHTs. Most evaluated aspects showed lower prevalence in the Northern region, in cities with lower HDI and smaller populations.

CONCLUSIONS

Emergency dental services must be expanded, matrix support strengthened, and counter-referral implemented. Guaranteed access to computers, the Internet, telephone, system interoperability, and regionalisation can facilitate networking. Priority should be given to remote regions and small municipalities. This would increase primary care's solubility, continuity, and comprehensiveness and promote equity.

MeSH

Oral Health, Health Services Research, Prevalence