Planejamento e organização dos serviços odontológicos na atenção básica no Brasil

Abstract

Management and organization of oral health services at Brazilian Primary Care Despite advances in Brazilian oral health, the Unified Health System (UHS) still challenges in order to establish universal access to health. As a result, the Ministry of Health has launched the National Program for Improving the Quality of Primary Care (PMAQ-AB) (2011). With the goal to develop both in quality and in quantity the Brazilian public services. Therefore, the aim of this study was to analyze the planning and organization of the work process of the OHT in the Brazilian APS. This cross-sectional census descriptive study evaluated the data from the external evaluation phase, interview with the professional (dentists) of the OHT participants of the 2nd cycle of PMAQ-AB, which happened between the years of 2013 and 2014. During this period, there were 23,150 OHT implanted in Brazil. Of these, 19,946 OHT were voluntarily subscribed to the PMAQ and 18,114 OHT were classified through the program. The data were analyzed descriptively and by cluster analysis comparing between Brazilian macro regions (North, Northeast, Midwest, Southeast and South) through the SPSS v.22.0 program. Just over half of the OHT (51.0%) reported that they perform monthly planning and scheduling activities with a document to prove it. The majority of OHT monitored and analyzed oral health indicators (66.4%), received support for planning and organizing the work process (79.0%), received permanent institutional support from a team or person from the Municipal Health (82.4%), carried out a self-assessment in the last 6 months to program their actions (67.5%) and used the results of the self-assessment to plan and program their actions (71.4%), offered oral health education in the territory (90.6%) and guaranteed return care for users in treatment (91.9%). In general, OHT grouped in Cluster 1 presented better results in the planning and organization of the work process, followed by Cluster 2 OHT, and the worst performances represented by Cluster 3 OHT. In relation to the Brazilian macro-regions, the Southeast regions (87.5%) Northeast (85.4%), and South (82.7%) had more OHT grouped in Cluster 1, indicating better planning and organization of the work process. Most OHT had satisfactory management and planning. However, there is inequality in the organization of these services throughout the Brazilian territory, some OHT need to improve mainly the planning and programming of actions based on health indicators and self-assessment. The planning of the actions in public services is necessary aiming at a service oriented to the reality of the population, and with the goal of incorporating a care beyond the curative needs, providing the promotion and prevention of the diseases. Keywords: Primary care. Evaluation of health services. Oral health system.