O tratamento odontológico hospitalar para pacientes com necessidades especiais no Sistema Único de Saúde do estado de Minas Gerais

Abstract

This work seeks to examine the interface between patients with impairments and patients with special needs requiring dental services. The aim of this work was to understand the profile of dental treatment services performed under sedation or general anesthesia, as well as the profile of people who received dental treatment in the Unified Health System of the State of Minas Gerais (SUS-MG) between July 2011 and June 2012. This research can be categorized as a census, descriptive, and exploratory study. The results and discussion are presented in the form of two articles. The study identified the demographic characteristics of the individuals and the characteristics of dental treatment services performed under sedation and/or general anesthesia in a SUS-MG hospital environment. This work analyzed all Hospital Admission Authorizations (HAA) for the execution of Dental Treatment for Patients with Special Needs during the aforementioned time period. Demographic and service variables for each dental service were also measured. The rate of hospital admissions per 10,000 inhabitants and the rendering of dental services carried out in the state of Minas Gerais as a whole and in each specific Expanded Healthcare Region were calculated. The descriptive analysis of the variables was performed by calculating the frequency and by measuring the core tendency and variability. The cluster analysis was also applied to determine the groups of characteristics of the 1,063 HAA. Four demographic and service variables referent to the patients who received dental services were analyzed. The age was dichotomized by the median value, while the gender was categorized as either male or female. The medical diagnosis was dichotomized in mental and behavioral disorders and nervous system diseases, which, in sum, represented the largest proportion of diagnoses (78.8%) among the patients who received dental services. In the category of others, this diagnosis represented the other diagnoses pertaining to the 11 ICD-10 groups. In addition, the work also analyzed whether or not the dental services had been exclusively performed by the clinical dentist or if there was the additional presence of a specialist. The rate of hospital admissions per 10,000 inhabitants was 0.54. The majority of individuals were adult males, with the diagnosis of mental and behavioral disorders who resided in 27.7% of the municipalities of Minas Gerais. The procedures were carried out in 39 municipalities and were executed, in most cases, by clinical dentists. The rate of dental service coverage was of 1.58%. Three clusters were grouped, analyzed, and then stratified within each of the 13 Expanded Healthcare Regions of Minas Gerais. Cluster 1 was characterized by the absence of the diagnosis of mental and behavioral disorders and NS diseases. Cluster 2 presented the largest HAA group. Cluster 3 was the least common group in the Expanded Healthcare Regions. The clusters proved to be distributed unequally among the Expanded Healthcare Regions of the State of Minas Gerais. This study therefore revealed a classic profile of patients who received dental services. Difficulties in establishing a network of dental care services were also identified.