Avaliação do desempenho das equipes de saúde bucal na atenção primária á saúde no Brasil

Abstract

Research and knowledge about the performance of oral health teams (OHT) provide subsidies to health management aimed at guiding decision making, resulting in improvements in the results of public oral health services at national and / or local level. This study aimed to evaluate the performance of OHT in primary health care according to indicators of access, resolution and coverage of services and the temporal variation of indicators of primary health care and oral health services between Brazilian municipalities and evaluate differences in indicators according to the municipal Human Development Index (HDI) and population size. A national type ecological study was developed based on the use of secondary data. A descriptive analysis of the indicators available from 2008 to 2015 was carried out, aggregating the data by municipality of the 27 Brazilian states. The indicators used were coverage of oral health care (COHC), supervised tooth brushing (STB), proportion of tooth extraction (TE) and coverage of primary health care (CPHC). It was observed that there was an average increase of 5.7% and 6.9% in CSB and CAPS, regardless of the Human Development Index (HDI) and population size (PS). Municipalities with high HDI had COHC and CPHC, on average 2.2% and 2.1% lower than those with low HDI. There was an average reduction in the proportion of TE from 1.42 in 2008 to 4.03 in 2015. The proportion of TE was lower in municipalities with medium and high HDI and higher among municipalities with a population size between 10 and 100 thousand inhabitants. Significant average increase in STB was observed until 2011. There was an increase in CPHC and COHC; TE reduction; oscillation of STB with a tendency to stabilize and inequality in the expansion of COHC and CPHC, which varied according to the HDI and PS. It is estimated that, in general, there was an expansion of the coverage of primary care and oral health services in Brazilian municipalities and that the pro-equity guidelines of public policies should be encouraged. New time series studies of oral health indicators should be carried out to follow trends in service performance. Between 2008 and 2015, Brazil presented an increase in the coverage of Primary Care and Oral Health; reduction in the proportions of tooth extraction and oscillation of the average of supervised tooth brushing with a tendency to stabilization. Municipalities with the highest HDI presented the best performances in the TE and STB indicators, revealing the persistence of inequity in access and in the organization of services.