Fatores associados à oferta de prótese dentária nas equipes de saúde bucal da estratégia saúde da família

Abstract

Tooth extraction rates have decreased in Brazil lately. However, a high percentage of the population needs prosthetic rehabilitation to restore masticatory and aesthetic functions. The objective of the present study was to analyze the factors associated with the performance of dental prosthesis procedures by the Oral Health Teams (OHT) in Primary Health Care in Brazil, between 2013 and 2014. This is a cross sectional analytical study using a structured applied in 18,114 OHT. The dependent variable studied was the performance of any type of prosthesis. Independent variables involved questions related to human resources and health service management. Descriptive statistics followed by a cluster analysis were performed. Data were also submitted to simple and multiple binary logistic regression with odds ratio calculation, 95% confidence intervals and p-values. The results showed that a smaller number of teams (N = 5,531) is part of cluster 1, which is the one that performs prostheses more frequently. Geographic distribution of clusters reveals that the largest proportion of cluster 1 teams is located in the Northeast and Southeast regions of the country (33.9% and 33.6%), followed by the South (31.1%) and Central West regions (20.3%). The lowest proportion of these teams performing prosthetic services was found in the Northern Region (9.3%). Most OHT (57%) does not perform any type of dental prosthesis. However, the teams that have greater chance of accomplishing are those with the following characteristics: (1) professional ticket form in the service by means of public competition (2) professionals with a career plan; (3) which are involved in continuing and permanent education actions related to the team needs; (4) monitors health indicators; (5) perform actions to identify the need for prosthesis in the target population; (6) receive support for planning and organization of the service; (7) that involve interns from institutions of higher education in the team tasks; (8) have permanent institutional support and, finally, (9) counts with a service of a Center of Dental Specialties, that allows them to send patients to secondary care. The present findings demonstrate that the management of human resources and the aspects related to the support of the municipal management and organization of the work process is of great importance for the improvement of the health care. In addition, those aspects directly impact accomplishment of dental prostheses to the population.