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1
Whittle, J. G. "Developing dental services for the elderly mentally ill." Thesis, University of Manchester, 1985. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.374576.
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Marshall, Keith Francis. "Standards and quality assessment in general dental practice." Thesis, King's College London (University of London), 1995. https://kclpure.kcl.ac.uk/portal/en/theses/standards-and-quality-assessment-in-general-dental-practice(8481398c-b8bf-438d-b96b-ab3d5f8d4083).html.
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Grover, Simran. "Racial disparities in dental care provided at community health center clinics." Thesis, Boston University, 2008. https://hdl.handle.net/2144/37812.
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Thesis (MSD)--Boston University, Henry M. Goldman School of Dental Medicine, 2008 (Dept. of Health Policy and Health Services Research).Includes bibliography: leaves 44-48.
0bjective: The objective of this study is to detemine if there are differences by race or ethnicity in dental care provided at community health center clinics resulting in oral health disparities. This study also provides detailed information about the types of dental procedures received by patients at community health center clinics. Methods: This was a retrospective observational study design, consisting of a convenience sample of patients seen and care provided by senior dental students during their ten-week externship at twenty one Boston University Goldman School of Dental Medicine affiliated community health center clinics. The data collected was analyzed SAS version 9.1. Frequencies for categorical variables, means for continuous variable, bivariate analyses and generalized models of logistic regression analysis were performed with the main dependent variable of interest being patient’s race/ethnicity. Results: The total sample was 62,112 observations, of which 56% were females. Regression analysis found that Blacks were 1.23 times and Asians and others were 1.09 times more likely to get diagnostic procedures than Whites. Hispanics were just as likely to receive diagnostic procedures as Whites. Blacks, Hispanics, Asians and others were more likely to get preventive procedures when compared to Whites (p[less than or equal to]0.0001 ). Blacks were less likely to get restorative procedures than Whites (p[less than or equal to]0.0001) whereas Hispanics were as likely to get restorative procedures as Whites. Further generalized logistic regression models to predict specific procedures were performed which indicates that Blacks were 1.99 times, Hispanics were 1.72 times, Asians and others were 1.21 times more likely to get amalgam restorations compared to composite restorations than Whites. However, Blacks were as likely to get root canal therapy compared to extractions as Whites whereas Hispanics were 27% and Asians and others were 37% more likely to get root canal therapy versus extractions than Whites (p[less than or equal to]0.0001). Blacks were 0.55 times, Asians and others were 0.37 times less likely to receive fixed partial dentures compared to removable partial dentures than Whites (p[less than or equal to]0.0001) whereas Hispanics were just as likely to receive fixed Partial dentures as Whites. Conclusion: Disparities were seen in the receipt of dental services provided such as diagnostic, preventive, and restorative procedures based on race at community health center clinics. This surprising finding related to community health center clinics indicate the need for future research focused on reasons for these disparities as community health center clinics are primary care providers for underserved populations.
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Pavi, Elpida. "The dental health needs of individuals living in areas of multiple deprivation in Glasgow." Thesis, University of Glasgow, 1994. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.387919.
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Omar, Suleiman Mohammed. "A point-prevalence investigation of aspects of dental health in rural and urban Libyan children." Thesis, University of Dundee, 1989. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.357189.
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Silalahi, Maria Som-Arch Wongkhomthong. "Assessment of community health volunteers in dental care activities in paktongchai district Nakornrajchasima Thailand /." Abstract, 1999. http://mulinet3.li.mahidol.ac.th/thesis/2542/42E-MariaS.pdf.
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Todd, Rebecca Vera. "An investigation of the dental health and behaviour of Vietmanese refugees in Britain from a cultural perspective." Thesis, King's College London (University of London), 1992. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.309282.
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Khalfe, Abdulrasheed Dawood. "A comparative analysis of delivering different modes of dental care at district level." Thesis, University of the Western Cape, 1995. http://etd.uwc.ac.za/index.php?module=etd&.
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The aim of this study is to analyse and compare the delivery of oral health care services based on the prevailing curative paradigm and WHO-treatment norms for the school-going community of Mitchells Palin district in relation to selected alternative methods of dental care delivery. The optimal use of auxiliary personnel, purchasing care from private dental practitioners and intriducing water fluoridation was examined.
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Ranson, Sonya L. "A study of the dental health status of children participating in the Child Health Investment Partnership." Thesis, This resource online, 1993. http://scholar.lib.vt.edu/theses/available/etd-07292009-090354/.
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Brennan, David S. "Factors influencing the provision of dental services in private general practice /." Title page, contents and abstract only, 1999. http://web4.library.adelaide.edu.au/theses/09PH/09phb838.pdf.
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Suominen-Taipale, Anna Liisa. "Demand for oral health care services in adult Finns." Turku : Turun Yliopisto, 2000. http://catalog.hathitrust.org/api/volumes/oclc/45710669.html.
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Dean, Lesa. "Dental Care in Long-Term Care Facilities of Warren County, Kentucky." TopSCHOLAR®, 1986. https://digitalcommons.wku.edu/theses/2252.
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Many physical changes occur as one ages, including changes associated with the oral cavity. A review of the literature suggests that the provision of dental care to institutionalized elderly patients presents problems due to a variety of factors. The purpose of this study is to assess the level or dental care provided to residents of long-term care facilities located in Warren County, Kentucky. In addition, secondary objectives Include the ascertainment of who provides dental care to residents and the amount or in-service dental training made available to staff members of the facility.
Each administrator of the long term care facilities located in Warren County participated in an *interview conducted by the author. During the interview, information was obtained for a 21 item questionnaire concerning the facility, the number and age range or the residents, and types of dental services provided within the facility.
Results obtained from the questionnaire indicated that 77 percent or the residents in long-tern care facilities in Warren County are 70 years of age or older. No significant differences were noted in the types or dental services provided to residents. However, the dental services provided ranged from those that were obtained in a private dental office via transportation or the resident to outside dental facilities to routine oral hygiene measures carried out by staff members employed by the facility.
The findings revealed significant differences in the dental status of the MRDD residents when compared to the nursing home residents. Other findings indicated that none of the long-term care facilities had dental operatories or dental radiographic equipment on the premises.
Additional research would be required in order to address uncertainties discovered in the study. A followup to the questionnaire Interview with the consulting dentists may be included to determine to what capacity and to what extent they are utilized by the facilities. Other recommendations include the utilization of entrance dental examinations to determine if services offered do meet the needs of the residents and periodic dental examinations to aid in detection and thus reduce the prevalence of dental diseases in this population.
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Bonwell, Patricia Brown. "COHORT MEMBERSHIP, DENTAL INSURANCE AND UTILIZATION OF DENTAL SERVICES IN ADULTS AGE 47 AND OVER RECEIVING DENTAL CARE AT VIRGINIA COMMONWEALTH UNIVERSITY’S SCHOOL OF DENTISTRY." VCU Scholars Compass, 2012. http://scholarscompass.vcu.edu/etd/2823.
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This cross-sectional, non-experimental study evaluates associations between cohort membership, type of dental coverage, and utilization of dental services in all patients age 47 and over who received dental care at Virginia Commonwealth University’s (VCU) School of Dentistry in 2011. Structural Lag Theory poses that society’s institutions lag behind the actuality of a healthy and capable older adult population. The two dynamisms of the Structural Lag Theory were used for this study. The Dynamism of Changing Lives is represented by Cohort differences. Cohort differences include cohort size, people living longer and retaining more of their natural teeth along with different attitudes toward dental care. This dynamism impacts the Dynamism of Structural Change, represented by the institutions of dental coverage and utilization of dental services. Cohort membership is an independent variable. The dependent variable, utilization, is defined as Financial-Total amount spent and Procedural-Routine adult dental prophylaxis. Dental coverage, a dichotomous variable, is used as an independent and dependent variable. Descriptive statistics revealed employer provided dental coverage is the most prevalent type of dental coverage. However, when considered a payment source, out of pocket funding is the primary source of payment for dental services. Using Chi-square and logistic regression, examination of Cohorts (1-Greatest Generation, 2-Silent Generation, 3-Baby Boomer Generation) revealed that Cohort 2 had more dental coverage than Cohort 1, and Cohort 3 had more dental coverage than Cohort 2. Using logistic regression, Cohort 2 showed the highest level of Procedural utilization. Evaluating Financial utilization, multiple regression models showed Cohort 1 utilized more than Cohort 2 and Cohort 2 utilized more than Cohort 3. Those with dental coverage spend more on dental services, fees for routine adult dental prophylaxis make up the majority of the total amount spent, and those with dental coverage utilize more dental services when defined as total amount spent. Because they have experienced different social, political, economic, and technological changes at different times in their life course, the receipt of dental services by new cohorts of older people differs from previous ones. Findings from this study confirm that there is a structural lag in Medicare policy and its coverage of dental services.
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O'Banion, Jean Frank. "Perceived Need for Anesthesia Services Among the Dental Community in the State of Ohio." The Ohio State University, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=osu1407425390.
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Antunes, Denise Silveira. "Assessment of a framework for the allocation of primary dental services." University of the Western Cape, 2017. http://hdl.handle.net/11394/5603.
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Philosophiae Doctor - PhDBackground: Standardized and evidence-based resource allocation frameworks for timely provision of primary dental services may support equitable distribution of comprehensive dental care. However, such frameworks, which can be applicable to primary care settings in Brazil, are not available. The purpose of this study was to explore the complex issue of equity allocation of dental staff for primary dental care services, by estimating time to dental disease progression in order to analyze costs when survival targets are set for patients waiting for primary dental care. The inclusion of wait time benchmarks for dental services in the design of the framework was an attempt to increase knowledge on the quality of access experienced by people living within catchment areas of the Family Health Strategy in Brazil. In view of ever scarce resources for public health services, ethical dilemmas arise in resource allocation when allocation choices require priority setting among individuals who face similar health needs. Since equity of access must be assured for all Brazilian citizens, the present study proposed a rational resource allocation model to help decision-makers in reconciling equity access and budgets. Aim: This study aimed to compare equity of access to dental services and costs of dental staff of two models for primary care settings. Additionally, staffing requirements and staff costs were projected over a three-year time period. Both models comprised three inter-related components: (i) universal access to oral health care, (ii) comprehensiveness of primary dental care and (iii) equity of access to primary dental services. Method: The present study was part empirical and part modeling in design. In the empirical phase, a set of maximum wait times for dental care determined by experts (Model 1) vs. wait times derived from survival analysis (Model 2) was compared. A one-year follow-up of a cohort of dental patients assigned to five primary health care clinics was conducted. The event of interest was clinical deterioration in the waiting time for dental visits. At each consultation with a dentist either for routine or emergency reasons, the oral quadrants of the patient were assessed and classified according to their urgency for dental care (from 1, less urgent to 5, more urgent). In the modeling phase, costs of dental staff were estimated on the basis of survival probabilities found in Model 1 and on survival targets simulated in Model 2. The amount of staff required as calculated by combining data on: dental service needs, activity standards for dental services, workload components in dental care, cost per working hour of dental staff, and probabilities of clinical deterioration in the wait for dental visits. Main Findings: In Model 1 (wait times determined by experts), survival probabilities were found to be unevenly distributed between diagnostic categories: category 4= 0.939 (SE 0.019); category 3= 0.829 (SE 0.035); category 2= 0.351 (SE 0.061) and category 1= 0.120 (SE 0.044). The cost of dental staff in Model 1 was estimated to be R$104 110.88 (BRL). In cost simulations of Model 2, where wait times were derived from the survival analysis study, a similar 0.900 survival probability target for all sampled quadrants (n=7 376) was found regardless of their final classification in the study year. The resulting cost of Model 2 was R$99 305.89 (BRL). Conclusions: From an equity-access perspective, the survival analysis concluded that wait times for dental visits determined by the experts may engender inequitable survival probabilities for oral quadrants classified in different diagnostic categories. From a dental-staff costs perspective, one concluded that less resources were required by setting an equitable 90% survival target for all oral quadrants studied.
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Valencia, Alejandra. "Racial and ethnic disparities in access and utilization of dental services among children in Iowa:." Thesis, University of Iowa, 2010. https://ir.uiowa.edu/etd/754.
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Even though the oral health of Americans has improved greatly in the last 50 years, some specific groups of the population have been left behind. Latinos, children and adults, bear a disproportionate burden of oral diseases. Latino children, the fastest growing minority group of children in the US, are affected disproportionately by oral diseases like dental caries compared to other groups. Understanding the difficulties and barriers that these children have to utilize dental care will help us in the future to develop effective programs to reduce health disparities in this segment of the population.
The purpose of this study is to identify the factors that determine dental services access and utilization by children in the state of Iowa. Emphasis will be given to differences in utilization of dental services among different racial/ethnic groups. Additionally, the study will describe and compare difficulties in utilization of care among Latino children whose parents answered the survey in English (LE) and those who answered it in Spanish (LS). In order to address these objectives existing data from the Iowa Child and Family Household Health Survey 2005 (HHS) were analyzed.
The dependent variable for the study was utilization of dental services. This outcome variable was dichotomized as whether or not the child had a dental visit in the last year. Characteristics of study subjects were first analyzed through descriptive statistics. Bivariate analyses were conducted to assess associations between the dependent variable and independent variables. Multiple logistic regression was used to identify factors associated with utilization of dental services in Iowa's children, and for each different racial and ethnic group.
Seven factors were related to the time of the last dental visit for Iowa children: Having a regular source of dental care, dental insurance status, having a dental need in the past 12 months, brushing habits, the age of the children, and family income. The same seven factors were correlated to having a dental visit for white children. For African-American children, having a regular source of dental care, dental insurance status, and having a dental need in the last 12 months were the factors that were found associated to the time of the last dental check-up. For the Latino Spanish children, having a regular source of dental care and the age of the children were factors associated to dental utilization. Finally, for the Latino English children, the only factor associated with having a dental visit was having a regular source of dental care.
Information from this research gives policy makers, public health workers, and clinicians an overview of oral health disparities affecting children in the state. For those agencies in Iowa interested in the improvement of access and utilization of dental services for minority children, this project gives important inside about the factors related to the use of services for different racial/ethnic groups in the state.
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Leary, Emily Vanessa. "A comparison of sampling, weighting, and variance estimation of techniques for the Oklahoma oral health needs assessment." Oklahoma City : [s.n.], 2006.
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Nascimento, Denise Antunes Do. "A preliminary assessment of a framework for the allocation of comprehensive primary dental services." Thesis, University of the Western Cape, 2010. http://hdl.handle.net/11394/3795.
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Magister Public Health - MPHSummary:The aim of this study was to produce a preliminary assessment of the DRAF by determining its face validity, testing reliability and usability of its diagnostic classification tool, and to produce a set of preliminary recommendations on the viability of the DRAF before it is released for use within the Family Health Programme.
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Sigron, Sabrina Lukretia. "100 Jahre Schulzahnklinik Zürich /." [S.l.] : [s.n.], 2009. http://opac.nebis.ch/cgi-bin/showAbstract.pl?sys=000283460.
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Davies, Michael. "The role of commonsense understandings in social inequalities in health : an investigation in the context of dental health /." Title page, contents and abstract only, 2000. http://web4.library.adelaide.edu.au/theses/09PH/09phd2565.pdf.
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Hak, Sithan Nonglak Pancharuniti. "Dental health preventive behavior among mothers with preschool children in Nakhon Pathom province, Thailand /." Abstract, 2003. http://mulinet3.li.mahidol.ac.th/thesis/2546/4537452.pdf.
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Kwanhatai, Chaiyasuk Boonyong Keiwkarnka. "Dental health service utilization among the elderly people in Chiang Dao district, Chiang Mai province, Thailand /." Abstract, 2008. http://mulinet3.li.mahidol.ac.th/thesis/2551/cd415/5038001.pdf.
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Hashim, Raghad, and n/a. "A quantitative and qualitative study of early childhood caries among young children in the Emirate of Ajman, United Arab Emirates." University of Otago. School of Dentistry, 2008. http://adt.otago.ac.nz./public/adt-NZDU20080521.144521.
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Objectives: The objective of the quantitative research was to estimate the prevalence of Early Childhood Caries (ECC) and severe Early Childhood Caries (s-ECC) and the severity of Early Childhood Caries (ECC) in the primary dentition of young children in Ajman, UAE, and investigate their association with child and family characteristics, dietary habits, fluoride use, oral hygiene practices and dental services utilization. The purpose of the qualitative research was to obtain information that could explain some of the findings of the quantitative stage in order to progress towards determining a strategy to control ECC in this population.
Methods: A two-stage cluster sample was used to randomly select children aged 5 or 6 years old who were enrolled in public or private schools in Ajman, UAE. Clinical examinations for caries were conducted by a single examiner using WHO criteria. Parents completed questionnaires seeking information on child and family characteristics, dietary habits, oral hygiene, fluoride use and dental service utilization. Bivariate and multivariate analyses were used to identify risk markers and risk indicators for caries experience. To complement the quantitative findings, the second (qualitative) stage of the research was conducted with six chosen groups of mothers from different educational backgrounds and different nationalities. Each group contained between six and ten mothers - some of whose children had been examined in the quantitative section of the project. The mothers were invited to comment on the significance for them of those risk indicators identified in the earlier section of the research. The manual thematic coding method of analysis was used. Problems concerning the dental health of children were identified based on the results of both stages.
Results: The total number of children sampled was 1297. Dental examination and questionnaire data were obtained for 1036 (79.9%), of whom 50.0% were female. The prevalence of ECC in 5- and 6-year-old children was 72.9% (95% CI, 61.8, 83.9) and 80.0% (95% CI, 76.0, 84.4) respectively, with mean dmft scores of 4.0 (sd, 4.1) and 4.9 (sd, 4.3) respectively (P<0.05). The overall prevalence of s-ECC was 31.1% (95% CI, 23.6, 38.9). Multivariate analysis indicated that frequency of snacking between meals per day, snack consumption level and the frequency of brushing had a significant effect on the severity of ECC, while only the snack consumption level and the frequency of brushing had a significant effect on plaque score. There was a strong association between plaque score and the severity of ECC. The total number of mothers who contributed to the qualitative study was 42. The findings of the qualitative stage showed that some mothers had a negative perception toward the primary dentition and unhelpful attitudes towards their children�s diets (through promoting a high consumption of cariogenic food), while the use of fluoride (other than in toothpaste) was rare. However, many mothers were in favor of bottled water fluoridation once they understood the benefits of such a scheme and supported the idea of a dental preventive program beng provided through their children�s schools.
Conclusions: The prevalence and severity of ECC in young children in Ajman is high, with child and family characteristics, dietary habits, oral hygiene practices and dental utilization being important determinants. Young children in Ajman would benefit from health promotion strategies directed towards appropriate dietary practices and oral hygiene measures framed within culturally specific guidelines.
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Mansman, Robert William II. "Oral Health Services in a Medical Setting." VCU Scholars Compass, 2007. http://scholarscompass.vcu.edu/etd/753.
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Purpose: The purpose of this study is to examine the baseline oral health status of infants and the level of their caregiver's oral health knowledge for families who received preventive oral health services in a medical setting. Methods: Using a prospective cohort study, children 0-3 years of age received an oral health screening, risk assessment, caregiver education, and a fluoride varnish treatment in an ambulatory pediatric medical clinic. A 16-item oral health knowledge and socio-demographic questionnaire was delivered to the caregiver of child. This questionnaire included knowledge, behavior and opinion items on risk factors for dental diseases, care of child's teeth, and socio-demographic characteristics of the family. Six-months after the medical visit, dental claims were examined to see if children had made a dental visit. Results: One hundred and ninety-five children received preventive oral health services in this clinic. Of these, 103 caregivers agreed to complete the oral health knowledge and socio-demographic questionnaire. Twenty-percent of children screening had visible signs of tooth decay, according to risk-assessment 72% were categorized as high-risk for tooth decay, and 83% received a fluoride varnish treatment. At 6-months, 9% of children were found to have had a dental visit. According to the caregiver questionnaire the likelihood of having a dental visit was correlated with the caregiver's knowledge of when a child should have their first dental visit and having been told by a medical professional when their child should be going to the dentist. Conclusion: Children are more likely to have a dental visit when caregivers are aware of the age 1 dental visit, or when advised to seek care by a medical professional. With increased education of medical providers, starting in medical residency training, more children can be seen for preventive oral health care resulting in an earlier establishment of a dental home.
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Soares, Ana Larissa Fernandes de Holanda. "Fatores determinantes da idade da primeira visita ao cirurgião-dentista nas coortes de nascidos vivos de Ribeirão Preto/SP e São Luís/MA." Universidade de São Paulo, 2011. http://www.teses.usp.br/teses/disponiveis/58/58135/tde-15022012-135311/.
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O módulo de Saúde da Pesquisa Nacional por Amostragem de Domicílios (PNAD), realizado no país, no ano de 1998, mostrou que 77,1% das crianças brasileiras, na faixa etária entre 0 6 anos, nunca haviam visitado um cirurgião-dentista. Em 2003, os dados do PNAD indicaram uma diminuição no percentual de crianças, que, até aquele momento, não havia tido um contato com algum cirurgião-dentista. No entanto, o valor ainda permanecia muito alto. Este trabalho objetiva avaliar os determinantes da idade da primeira visita ao cirurgião-dentista, a partir de duas coortes de nascidos vivos, uma em Ribeirão Preto/SP, 1994 (2004/2005), e outra em São Luís/MA, 1997 (2005/2006). A população final, utilizada para a presente pesquisa, foi composta pelos participantes do seguimento dos estudos, ou seja, 673 crianças em São Luís/MA e 790 em Ribeirão Preto/SP. A análise estatística inicial foi realizada para o desfecho idade da primeira visita ao cirurgião-dentista, tendo como referência a idade de seis anos. As análises bivariadas precederam a regressão logística hierárquica e foi considerado o nível de significância de 0,05 e o intervalo de confiança de 95%. Os resultados demonstraram que 34,1% (EP=1,9) das crianças de Ribeirão Preto/SP e 35,5% (EP=2,2) da amostra de São Luís/MA não tinham visitado um cirurgião-dentista até os seis anos de idade. A idade da primeira visita odontológica obteve significância estatística durante a análise multivariada, nas duas cidades, com a falta de escolaridade da mãe e a ausência de plano de saúde. Além disso, Ribeirão Preto/SP mostrou associação com crianças que moravam sem os pais biológicos (p=0,0005), filhas de mães mais velhas (p=0,0485) e que não realizaram ou fizeram, no máximo, três consultas durante o pré-natal (p=0,0319) Em contrapartida, São Luís/MA, apresentou relação com crianças que possuíam maior número de irmãos (p=0,0296) e sem nenhuma experiência de dor de dente (p=0,0001).Concluindo, podemos perceber que não visitar o cirurgiãodentista, na primeira infância, sofre influência de diversos fatores socioeconômicos, fatores ligados a criança e à mãe, destacando aqui, principalmente, a escolaridade materna e a posse de plano de saúde.The Health module of the National Household Survey Sample (PNAD), conducted in 1998 showed that 77.1% of Brazilian children in the 0-6-year age group had never visited a dentist. In 2003, PNAD data indicated a decreased percentage of children had never had a dental appointment; however, the level remained very high. This study aimed at assessing the determinants of age at first dental visit, based on two cohorts of liveborns, one in Ribeirão Preto, 1994 (2004/2005), and the other in São Luís, 1997 (2005/2006). The final population used for the present research was composed of participants of follow-up studies, that is, 673 children in São Luís and 790 in Ribeirão Preto. Initial statistical analysis was conducted for age at first dental visit, with six years of age as reference. Bivariate analyses preceded hierarchical logistic regression, considering a significance level of 0.05 and confidence interval of 95%. Results demonstrated that 34.1% (SE=1.9) of children from Ribeirão Preto, and 35.5% (SE=2.2) of the sample from São Luís had not visited a dentist by the age of six years. Age at first dental visit was statistically correlated, in multivariate analysis in both cities, with lack of maternal education and absence of a health plan. Furthermore, Ribeirão Preto showed an association with children who did not live with their biological parents (p=0.0005) and daughters of older mothers (p=0.0485) who had undergone none or at most three prenatal consultations (p=0.0319). São Luís also exhibited a relationship with children who had a larger number of siblings (p=0.0296) and had not experienced toothache (p=0.0001). In conclusion, not visiting the dentists in early childhood is influenced by a number of socioeconomic factors linked to both children and their mothers, primarily maternal schooling and having a health plan.
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Baat, Cornelis de. "Een kunstgebit bij ouderen, een kwestie van aanpassen? een onderzoek naar de mondgezondheid en de tandheelkundige behandelingsmogelijkheden van edentate ouderen in een aantal verpleeghuizen in Nederland /." [S.l. : s.n.], 1990. http://books.google.com/books?id=bghqAAAAMAAJ.
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Gonçalves, Juliana Rocha 1967. "Utilização de indicadores para avaliação da qualidade dos serviços odontológicos = The use of indicators for assessing the quality of dental services." [s.n.], 2013. http://repositorio.unicamp.br/jspui/handle/REPOSIP/289147.
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Orientador: Gláucia Maria Bovi AmbrosanoTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba
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Resumo: Pesquisas que trabalham com avaliação da qualidade tem recebido grande destaque devido sua importância na utilização na gestão dos serviços. Por outro lado as organizações que atuam na área odontológica não possuem padronização para avaliar sua atuação junto aos usuários e empresas-clientes. Em geral a avaliação é realizada com vistas à ampliação e à captação de negócios não estando diretamente relacionada à melhoria da saúde bucal da população atendida, que poderia ser o objetivo principal. Os objetivos deste trabalho foram: (1) desenvolver indicadores para avaliar a qualidade do serviço odontológico sob o ponto de vista dos usuários; (2) Estabelecer indicadores para a avaliação da qualidade da assistência odontológica; e (3) Estabelecer métodos estatísticos que serão utilizados na avaliação e gestão de serviços odontológicos. Participaram da pesquisa usuários com idade a partir de 18 anos e prontuários de usuários com tempo de alta inferior a seis meses. Para o calculo amostral os seguintes parâmetros foram utilizado, em um serviço de plano odontológico com uma média de 1200 atendimentos/mês realizados por dentistas credenciados foi estimada uma prevalência de 50% de satisfação do usuário. O nível de confiança foi de 95%, com margem de erro de 5%, estimando-se assim uma amostra de 291 indivíduos por meio do Epi Info 6.0. Considerando uma possível perda de 20% foram selecionados 355 prontuários. Na primeira fase do trabalho utilizando o questionário SERVQUAL com cinco dimensões e também do sociodemografico, foram avaliadas as expectativas sobre o serviço (antes de receberem o tratamento odontológico). Além disso, foi testada uma ferramenta de marketing IPA (Importance Performance Analysis) que permite o direcionamento de ações de acordo com os resultados obtidos. Trezentos e setenta e nove questionários foram preenchidos. Na segunda fase, onde os beneficiários tinham recebido o tratamento odontológico, 155 questionários foram preenchidos. A pesquisa foi realizada em quatro empresas clientes de um serviço de plano odontológico com questionários. Os dados foram tabulados e foram feitos os cruzamentos das variáveis. Após estes procedimentos foi criado um banco de dados para o desenvolvimento do software, utilizando as ferramentas da qualidade. Concluiu-se que Os homens tiveram expectativas mais elevadas do que as mulheres em três dimensões: presteza, segurança e empatia. A presteza foi à única dimensão que as expectativas do serviço oferecido, foram mais elevadas do que a percepção. Na dimensão tangibilidade e confiabilidade, as pacientes do gênero feminino mostraram mais insatisfeitos com o serviço do que os homens. Os mais velhos tiveram maior prevalência de insatisfação com o serviço na dimensão Empatia. E finalizando a ferramenta IPA se mostrou eficaz quando utilizada na gestão do serviço uma vez que destaca os pontos chaves a serem melhorados no serviço
Abstract: Researches that work with quality assessment have received great prominence due its importance in use in the management of services. Moreover organizations working in dentistry have no standardization to assess the performance with users and client companies. In general the evaluation is carried out in order to expand and capture business not directly related to improving the oral health of the population served, which could be the main objective. The objectives of this study were: (1) develop indicators to assess the quality of dental services from the point of view of users, (2) Establish indicators for assessing the quality of dental care, and (3) establish statistical methods that will be used in the evaluation and management of dental services. Participants were from users aged 18 years and records of users with high time less than six months. To calculate sample the following parameters were used in one service dental plan with an average of 1200 calls / month conducted by accredited dentists was estimated a prevalence of 50% user satisfaction. The confidence level was 95%, with a margin of error of 5%, estimating just a sample of 291 individuals using the Epi Info 6.0. Considering a possible loss of 20% were selected 355 charts. In the first phase of work using the SERVQUAL questionnaire with five dimensions and also the sociodemographic, were evaluated expectations about the service (before receiving dental treatment). In addition, we tested a marketing tool IPA (Importance Performance Analysis) which allows the targeting of actions according to the results. Three hundred and seventy-nine questionnaires were completed. In the second phase, where beneficiaries had received dental treatment, 155 questionnaires were completed. The research was conducted in four business customers a service dental plan with questionnaires. Data were tabulated and the crossings were made of variables. After these procedures has created a database for developing the software, using the tools of quality. It was concluded that men had higher expectations than women in three dimensions: responsiveness, assurance and empathy. The promptness was the only dimension that the expectations of the service offered, were higher than the perception. In size tangibility and reliability, the genre of female patients showed more dissatisfied with the service than men. The older had a higher prevalence of dissatisfaction with the service dimension in Empathy. And ending the IPA tool was effective when used in the management of the service once that highlights the key points to be improved in service
Doutorado
Saude Coletiva
Doutora em Odontologia
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Vertel, Nancy. "Access to dental services for children with special health care needs : a pilot study at British Columbia Children's Hospital Department of Dentistry." Thesis, University of British Columbia, 2013. http://hdl.handle.net/2429/44904.
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Objectives: This pilot project, conducted at the Dental Department of BC Children’s Hospital (DD-BCCH), aimed to 1) identify issues that affect access to dental services for Children with Special Health Care Needs (CSHCN), 2) assess parental perceptions of the oral health status of their child and 3) determine the practicality and feasibility of survey research with this patient population
Methods: Caregivers of CSHCN who were patients of the DD-BCCH were recruited by letter, posted advertisement and direct request. Information on caregiver’s perceptions of enabling factors and barriers to dental services and their understanding of their child’s oral health status were collected using a pre-tested survey instrument. In addition, demographic information, referral source, insurance coverage, medical diagnosis, and anticipated dental treatment were gathered from the child’s dental record. Quantitative data was analyzed descriptively and qualitative comments from parents by thematic analysis.
Results: Common medical diagnoses for the sample of CSHCN (n=50) were genetic disorder/syndrome, developmental delay, sensory impairments and autism. Caregivers from mid-to-upper income levels formed 50% of the sample. Payment methods reported by parents included private dental insurance (52%), public benefits (36%), or out-of-pocket funds (24%). Of the sample, 50% were referred by a medical professional and most children (90%) had had a dental appointment within the last year. About 50% of caregivers reported the following barriers to obtaining dental care prior to attending at BCCH: dentist not trained or comfortable treating or managing the child’s behaviour; complexity of child’s medical condition and financial barriers. We were unable to determine a true parental perception of the oral health of the child because many parents answered the survey after the oral examination had been completed.
Conclusions: 1) The complexity of the child’s medical status, limited ability of dental providers to deliver care and financial obstacles were commonly-reported barriers to dental care identified by parents 2) Parental perceptions of the oral health status of the child were not able to be reliably assessed. 3) A mail out survey was not a suitable method to obtain information about issues of access to dental services for CSHCN within the population at the DD-BCCH.
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Lensing, Willene (Willene Crowell). "A Case Study of Social Transformation in Medical Care at the Community Level." Thesis, University of North Texas, 1994. https://digital.library.unt.edu/ark:/67531/metadc277789/.
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This descriptive case study of the transformation in medical care at the community level was carried out with a triangulation approach. Data from documents and surveys using both semi-structured and unstructured interviews were gathered to evaluate and explain how medical care delivery changed from a primarily public system to one predominantly private.
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Menezes, Laura de Freitas 1981. "Relação entre os Centros de Especialidades Odontológicas e o acesso aos serviços secundários no Estado de São Paulo." [s.n.], 2013. http://repositorio.unicamp.br/jspui/handle/REPOSIP/290165.
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Orientadores: Stela Márcia Pereira, Gláucia Maria Bovi AmbrosanoDissertação (mestrado profissional) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba
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Resumo: Este estudo seccional investigou o impacto dos Centros de Especialidades Odontológicas (CEOs) nos indicadores de procedimentos da atenção secundária no Estado de São Paulo, bem como sua relação com variáveis econômicas. A amostra contou com os 645 municípios do estado, divididos segundo a presença e ausência dos CEOs, no ano de 2009. As variáveis dependentes analisadas foram os procedimentos de endodontia, periodontia e cirurgia oral menor e as variáveis independentes selecionadas foram cobertura dos Centros de Especialidades, renda per capita e PIB per capita. A análise estatística dos dados foi feita através de teste Qui-quadrado e regressão logística múltipla, ajustada para a co-variável porte municipal. Como resultado, observou-se que os municípios que têm CEO apresentaram um maior número de procedimentos quando comparados aos que não o possuem (p<0,0001). A presença do CEO (p=0,0001; OR:49,06); (p<0,0001; OR:9,59); (p<0,0001; OR:26,39) foi considerada determinante para o maior número de procedimentos clínicos de Endodontia, Periodontia e Cirurgia Oral Menor, respectivamente. Pode-se concluir que os Centros de Especialidades Odontológicas impactaram, de forma substancial, o acesso aos serviços de atenção secundária no estado de São Paulo, independente do porte municipal
Abstract: This cross-sectional study investigated the impact of Specialized Dental Clinics (SDC) on indicators of secondary care procedures in the state of São Paulo, as well as its relation to economic variables. The sample consisted of the 645 municipalities in the state, with and without SDC in 2009. The dependent variables analyzed were endodontics, periodontics and minor oral surgery procedures and independent variables selected were specialized coverage, per capita income and per capita GDP. The statistical analysis was performed using chi-square test and multiple logistic regression, adjusted for covariate municipal size. Results showed that counties with SDC presented greater number of procedures when compared with those who do not have (p <0.0001). The presence of the SDC (p = 0.0001, OR = 49.06) (p <0.0001, OR: 9.59), (p <0.0001, OR: 26.39) was considered decisive for the largest number of clinical procedures of Endodontics, Periodontics and Minor Oral Surgery, respectively. In conclusion, Specialized Dental Clinics impacted access to secondary care services in the state of São Paulo, regardless of municipal size
Mestrado
Odontologia em Saude Coletiva
Mestra em Odontologia em Saúde Coletiva
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Claas, Bianca Muriel. "Self-reported oral health and access to dental care among pregnant women in Wellington : a thesis presented in fulfilment of the requirements for the degree of Master of Public Health at Massey University, Wellington, New Zealand." Massey University, 2009. http://hdl.handle.net/10179/1205.
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Pregnancy can have important effects on oral health and pregnant women are a population group requiring special attention with regard to their oral health and their babies? health. International research shows that oral health care for pregnant women has been inadequate, especially in relation to education and health promotion and there is some evidence of disparities by SES and ethnicity. Improving oral health is one of the health priorities in the New Zealand Health Strategy (Ministry of Health, 2000) and the Ministry of Health (Ministry of Health, 2006a) has recently identified a need for more information on the oral health and behaviour of pre-natal women. The aims of this study were to gain an understanding of pregnant women?s oral health care practices, access to oral health care information and use of dental care services and to identify any difference by ethnicity and socio-economic position. A self-reported questionnaire was completed by 405 pregnant women (55% response rate) who attended antenatal classes in the Wellington region. The questionnaire was broadly divided into four parts: (1) care of the teeth when the woman was not pregnant; (2) care of the teeth and diet during the pregnancy; (3) sources of oral health information during pregnancy and; (4) demographic information . Data were analysed by age, ethnicity, education and income and odds ratios (OR) and 95% confidence intervals (95%CI) were calculated using logistic regression. The majority of women in this survey were pakeha (80.2%), compared to 19.7% „Others? (8.8% Maori, 1.9% Pacific, 8.6% other). Most of the subjects were aged 31-35 years (34.5%), of high SES (household income and education level). Half of the women reported having regular visits to the dentist previous pregnancy while a significant percentage of women saw a dentist basically when they had problems. The usual dental hygiene habits were maintained during pregnancy. However, during pregnancy more than 60% of women reported bleeding gums. Just 32% of women went to see the dentist during pregnancy and less than half had access to oral health information related to pregnancy. „Others? (OR 0.38, 95% CI 0.15-0.91) and low income (OR 0.27, 95% CI 0.10-0.76) groups were significantly less likely to report access to oral health information compared to pakeha and high income groups (respectively). Women who went to see the dentist during pregnancy were more likely to receive information on dental health. However, low income women were more likely to report the need to see a dentist (OR 2.55, CI 1.08-5.99). Information on dental health and access to oral care should be prioritised to low income women, Maori, Pacific and other ethnic groups. Little attention has previously been given to oral health for pregnant women in New Zealand and there is a need to increase awareness of the importance of this area amongst health practitioners particularly Lead Maternity Carers and Plunket and tamariki ora nurses.
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Chi, Donald Leslie. "The impact of chronic condition status, chronic condition severity, and other factors on access to dental care for Medicaid-enrolled children in Iowa." Diss., University of Iowa, 2009. https://ir.uiowa.edu/etd/345.
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Previous studies suggest that Medicaid-enrolled children have difficulties accessing dental care, which can lead to untreated dental disease, poor oral health, and compromised overall health status. While Medicaid-enrolled children with a chronic condition (CC) encounter additional barriers to dental care, most relevant studies on dental utilization fail to adopt risk adjustment methods. As such, the impact of CC status and CC severity on access to dental care for Medicaid-enrolled children is poorly understood.
The main objectives of this dissertation were to: 1) compare dental utilization for Medicaid-enrolled children with and without a CC; 2) assess the relationship between CC severity and dental utilization; and 3) identify the other factors associated with dental utilization. The 3M Clinical Risk Grouping (CRG) Methods were applied to enrollee-level data from the Iowa Medicaid Program (2003-2008) to identify children with and without a CC and to classify children with a CC into a CC severity level. Three outcome measures were developed: 1) access to an annual dental visit; 2) use of dental services under general anesthesia (GA); and 3) time to the first dental visit after initial enrollment into the Medicaid program. We used multiple variable logistic regression models and survival analytic techniques to test our study hypotheses.
Compared to Medicaid-enrolled children without a CC, those with a CC were more likely to have had an annual dental visit and earlier first dental visits. Having a CC was an important determinant of dental utilization under GA for older but not for younger Medicaid-enrolled children. In terms of CC severity, Medicaid-enrolled children with more severe CCs were less likely to have had an annual dental visit and more likely to have utilized dental services under GA. CC severity was not associated with the rate at which the first dental visit took place. Not residing in a dental Health Professional Shortage Area, previous use of dental care, and previous utilization of primary medical care were all positively associated with dental utilization.
Identifying and understanding the determinants of access to dental care is an important first step in developing clinical interventions and policies aimed at improving access to dental care for all Medicaid-enrolled children. Future work should focus on identifying the socio-behavioral determinants of as well as the clinical outcomes associated with access to dental services for vulnerable children.
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Edvardsson, Kristina, Anneli Ivarsson, Rickard Garvare, Eva Eurenius, Marie Lindkvist, Ingrid Mogren, Rhonda Small, and Monica E. Nyström. "Improving child health promotion practices in multiple sectors : outcomes of the Swedish Salut Programme." Umeå universitet, Epidemiologi och global hälsa, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-60853.
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Background: To improve health in the population, public health interventions must be successfully implemented within organisations, requiring behaviour change in health service providers as well as in the target population group. Such behavioural change is seldom easily achieved. The purpose of this study was to examine the outcomes of a child health promotion programme (The Salut Programme) on professionals' self-reported health promotion practices, and to investigate perceived facilitators and barriers for programme implementation. Methods: A before-and-after design was used to measure programme outcomes, and qualitative data on implementation facilitators and barriers were collected on two occasions during the implementation process. The sample included professionals in antenatal care, child health care, dental services and open pre-schools (n=144 pre-implementation) in 13 out of 15 municipalities in a Swedish county. Response rates ranged between 81% and 96% at the four measurement points. Results: Self-reported health promotion practices and collaboration were improved in all sectors at follow up. Significant changes included: 1) an increase in the extent to which midwives in antenatal care raised issues related to men's violence against women, 2) an increase in the extent to which several lifestyle topics were raised with parents/clients in child health care and dental services, 3) an increased use of motivational interviewing (MI) and separate 'fathers visits' in child health care 4) improvements in the supply of healthy snacks and beverages in open pre-schools and 5) increased collaboration between sectors. Main facilitators for programme implementation included cross-sectoral collaboration and sector-specific work manuals/questionnaires for use as support in everyday practice. Main barriers included high workload, and shortage of time and staff. Conclusion: This multisectoral programme for health promotion, based on sector-specific intervention packages developed and tested by end users, and introduced via interactive multisectoral seminars, shows potential for improving health promotion practices and collaboration across sectors. Consideration of the key facilitators and barriers for programme implementation as highlighted in this study can inform future improvement efforts.
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Yao, Xiaoxi. "Do Long Work Hours Impede Workers’ Ability to Obtain Health Services?" The Ohio State University, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=osu1405356729.
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Aguiar, Dulce Maria de Lucena. "A participação do técnico em saúde bucal na estratégia saúde da família: um olhar em municípios estruturados." Universidade de São Paulo, 2010. http://www.teses.usp.br/teses/disponiveis/6/6135/tde-09112010-094727/.
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Introdução - O técnico em saúde bucal (TSB) é um profissional da equipe de saúde bucal (ESB), a quem compete a execução de ações diretas na assistência odontológica individual e nas ações coletivas de prevenção e promoção da saúde. Embora sua presença possa elevar cobertura e qualidade das ações, estudos apontam para sua subutilização, o que enseja dificuldades no campo da gestão do trabalho. Objetivo - Compreender os fatores que influenciam a prática do TSB na estratégia saúde da família. Procedimentos Metodológicos estudo descritivo, onde foram selecionados quatro municípios que se beneficiaram de Portaria do Ministério da Saúde (MS) que destinava um equipamento odontológico para as ESB com TSB: Maracanaú (CE), Recife (PE), Belo Horizonte (MG) e Curitiba (PR). A amostra intencional foi composta por cirurgiões-dentistas (CD) e TSB de duas ESB de cada município, sendo uma considerada mais afastada e outra mais próxima pelo coordenador municipal de saúde bucal, segundo o modelo proposto pelo MS. Entrevistaram-se ainda gestores mais próximos da dinâmica das ESB. Analisou-se o material discursivo das 24 entrevistas em profundidade, segundo o referencial de Pierre Bourdieu. Os dados foram cotejados com o conteúdo de orientações sobre a prática do TSB e a programação das ESB, quando presentes em documentos normativos dos municípios. Resultados - A maioria dos entrevistados eram mulheres e a idade média foi 38 anos. Entre os CD, 60 por cento possuíam tempo de formação entre 5- 10 anos e 50 por cento eram especialistas em saúde coletiva. Entre os TSB, 50 por cento possuíam tempo de formação entre 2-5 anos. Em alguns casos, foi observada a existência de 6 relação entre a fala de alguns agentes e sua trajetória social. Em nível interpessoal, as principais barreiras para a participação do TSB foram relacionadas ao sentimento de incompetência do CD para supervisionar sua atividade, aliado a reduzida disposição para o trabalho compartilhado. Em nível organizacional, destacaram-se: falta de clareza quanto ao projeto de trabalho proposto para a ESB e incapacidade para colocá-lo em prática, combinado à inexistência de ações de apoio voltadas à superação dos nós críticos. Em nível geral, embora a regulamentação da profissão representasse um expressivo elemento de apoio para sua atuação, as entrevistas refletiram disputas de diferentes projetos para o TSB nos sistemas de educação e no de profissões. Conclusões a participação do TSB na estratégia saúde da família decorre de determinantes interacionais, organizacionais e sistêmicos, mediados pelos interesses e habilidades expressas pelo TSB e pelo cirurgião-dentista. A compreensão desses aspectos pode auxiliar a condução do trabalho nas unidades de atenção primáriaIntroduction - The oral health technician (TSB) is a professional who takes part in the oral health team (ESB) and is responsible for carrying out direct actions in both the individual dental care as in collective actions of prevention and health promotion like a dental hygienist. Although his presence may raise both the coverage and the quality of developed actions, studies in Brazil have pointed out to his underutilization, which entails difficulties in the field of labor management. Aim - To understand the factors that influence the participation of TSB in the teams of family health strategy. Methodological Procedures Descriptive study were we selected four Brazilian cities that have benefited from the decree of the Ministry of Health (MS) 74/2004 which meant dental equipment for the ESB with TSB: Maracanaú (CE), Recife (PE), Belo Horizonte (MG) and Curitiba (PR). The intentional sample was comprised by dentists (CD) and two TSB from each municipality, being one considered more distant and the other considered closest to the model proposed by MS according to the knowledge and view of municipal coordinator of oral health, according to the model proposed by MS. We interviewed the managers of health units to whom the team reported. The discursive material 8 from 24 in-depth interviews was analyzed, considering the referential of Pierre Bourdieu. The data were compared with the contents of the guidelines on the practice of TSB and programming of ESB when present in the normative documents of each municipality. Results - Most respondents were female and the average age was 38 years. Among the CD, 60per cent of respondents had training time between 50-10 years and 50per cent had a specialization in public health. Among the TSB, 50per cent had training time between 2-5 years, 37.5per cent had between 19 and 20 years of training time and one of the interviewees did not answer, saying no recollection of the year when she finished her course. In some cases, relationship was observed between the discourses of some agents and their social trajectory. On the interpersonal level, the main barriers to the participation of TSB were related to feelings of incompetence of the CD to supervise their activity, combined with low degree of intersectoral cooperation. On the organizational level, highlighted a lack of clarity about the work project proposed for the ESB in the ESF, the inability to put it into practice, combined with the lack of support actions aimed at overcoming the bottleneck. On a most general level, although the regulation of the profession has represented a significant element of support for their actions, some of the speeches reflected the disputes of different projects for these professionals in the education system and the system of professions. Conclusions TSBs participation in family health strategy stems from interactional determinants, organizational and systemic, mediated by the interests and abilities expressed by the TSB and dentist. Understanding these aspects may help the conduct of work in primary care
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Pizzatto, Eduardo. "Análise do estado de saúde bucal de adultos trabalhadores : assistência/atenção odontológica /." Araçatuba : [s.n.], 2005. http://hdl.handle.net/11449/104206.
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Orientador: Cléa Adas Saliba GarbinBanca: Edgard Michel Crosato
Banca: Paulo César Pereira Perin
Banca: Eduardo Daruge Júnior
Banca: Renato Moreira Arcieri
Resumo: O presente trabalho tem por objetivo efetuar uma análise no que tange a assistência/atenção odontológica voltada à população adulta trabalhadora, buscando levantar índices epidemiológicos relevantes para área de saúde bucal desta população específica. Foram examinados 240 trabalhadores com idade entre 35 e 44 anos, através do processo de amostragem probabilística aleatória composta por conglomerados, sendo 60 trabalhadores de cada grupo (Grupo I: assistência odontológica em sistema de autogestão; Grupo II: assistência odontológica terceirizada e financiada pelo empregador; Grupo III: assistência odontológica terceirizada e financiada pelo trabalhador; Grupo IV: nenhum tipo de assistência odontológica disponibilizado). O exame clínico intrabucal seguiu o modelo preconizado pela Organização Mundial da Saúde sendo realizado por um único examinador previamente calibrado. O CPO-D médio encontrado para a amostra selecionada foi de 25,47 (3,59), não havendo, porém diferença estatística entre os quatro grupos distintos (p>0,05). Contudo, para todos os grupos avaliados, o componente perdido representou mais que 50% da composição deste índice. Em relação a condição periodontal (CPI) indivíduos pertencentes ao Grupo I apresentam maior número de sextantes hígidos quando comparados aos demais grupos (p<0,001). Porém, quando avaliados sextantes excluídos, não se observa diferença significativa entre os quatro grupos (p>0,05). A respeito do edentulismo, os indivíduos do GI apresentaram maior média de dentes presentes (19,90), já os indivíduos do GIV apresentaram maior necessidade de uso de próteses, tanto superior quanto inferior...(Resumo completo, clicar acesso eletrônico abaixo)
Abstract: The present study aimed to analyze the dental assistance/attention given to an adult worker population, searching for relevant epidemiological indexes of oral health in this specific population. This study involved 240 workers, aged 35 to 44, randomly divided into 4 groups, with 60 workers in each group. Group I - self management dental assistance. Group II - dental assistance financed by employer. Group III - dental assistance financed by worker. Group IV - no dental assistance available. The oral clinical exams were done by a single examiner, previously calibrated, following the WHO guidelines. The mean DMFT found for this sample was 25.47 (sd 3.59), with no significant difference among all groups (p>0.05). However, for all groups the loss component (dental loss) represented more than 50% of the index composition. In relation to periodontal condition (CPI), individuals belonging to Group I presented more healthy sextants when compared to others (p<0.001). While evaluating excluded sextants there were no significant differences among the four groups (p>0.05). Regarding edentulous, GI presented the highest mean for the need of prosthesis usage, either superior or inferior. Based on the epidemiological aspects it was found relevant the implantation and/or restructure of the attention services in oral health of the adult workers population studied, seeking for the increase of life quality of these workers as their work capacity. It must be observed that the simple offering of dental assistance services does not bring benefits in terms of health to the worker; it is necessary a correct planning of actions to be developed, which may be connected to other health attention programs to workers.
Doutor
37
Neves, Matheus. "Associação entre resiliência e satisfação com os serviços odontológicos acessados por idosos." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2011. http://hdl.handle.net/10183/56467.
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O perfil epidemiológico da população idosa brasileira evidencia um quadro de extensas perdas dentárias e problemas de saúde bucal. A fim de reverter este quadro, observa-se o desenvolvimento de diversas políticas públicas de saúde cujo objetivo está em garantir atenção integral à saúde da população idosa, com ênfase no envelhecimento saudável e ativo. Porém, no que diz respeito aos Serviços de Saúde Bucal, poucos estudos têm sido desenvolvidos na ambição de conhecer a satisfação deste grupo etário com tais serviços. O objetivo deste estudo foi investigar a associação entre a resiliência e a satisfação com os Serviços Odontológicos, levando em consideração variáveis exógenas, determinantes primários, comportamentos e condições de saúde. Investigou-se a hipótese de que a resiliência está associada à satisfação com os Serviços Odontológicos acessados pelos idosos. O lócus da pesquisa foi a gerência distrital Lomba-Partenon, em Porto Alegre – RS, onde 771 idosos foram identificados em seus domicílios por meio de amostragem por conglomerado. Os indivíduos responderam a um questionário sócio-demográfico e de comportamentos em saúde, à Escala de Resiliência e a questões relativas ao Serviço Odontológico acessado e à satisfação com o mesmo; além disso, foi realizado um breve exame bucal para contagem do número de dentes e identificação do uso de prótese dentária. Baseado em uma abordagem hierárquica realizada através de Regressão Logística Multivariada, as odds ratios estimadas das variáveis que ficaram significativamente associadas com o desfecho em estudo, satisfação com o Serviço Odontológico, após a análise totalmente ajustada, foram: 1) obtenção de consulta odontológica classificada como regular: OR= 1,85, 95% IC (1,10 a 3,12); 2) obtenção de consulta odontológica classificada como ruim: OR= 2,17, 95% IC (1,05 a 4,50) e 3) alto potencial de resiliência: OR= 0,60, 95% IC (0,37 a 0,97). Portanto, os resultados confirmam a hipótese de associação entre elevado potencial de resiliência e satisfação com os Serviços Odontológicos acessados por idosos.The epidemiological profile of the elderly population shows a picture of extensive tooth loss and oral health problems. In order to reverse this situation, there is the development of various public health policies whose aim is to ensure comprehensive health care of the elderly population, with an emphasis on healthy aging and active. However, with regard to Dental Health Services, few studies have been developed to meet the satisfaction of this age group with such services. The objective of this study was to investigate the association between satisfaction with the resilience and Dental Services, taking into account exogenous variables, the primary determinants, behaviors and health conditions. It was investigated the hypothesis that resilience is associated with satisfaction with dental services accessed by older people. The locus of this research was the district management Lomba-Partenon, in Porto Alegre – RS, where 771 seniors were identified in their homes through cluster sampling. The subjects answered a questionnaire for socio-demographic and health behaviors, Resilience Scale and questions regarding the dental care accessed and satisfaction with it. In addition, there was a brief oral examination to count the number of teeth and identify the use of dental prosthesis. Based on a hierarchical approach performed by multivariate logistic regression, the estimated odds ratios of variables that were significantly associated with the outcome under study, satisfaction with dental care services, fully adjusted after analysis, where: 1) obtaining a dental visit classified as regular: OR= 1,85, 95% IC (1,10 a 3,12); 2) obtaining a dental visit classified as bad: OR= 2,17, 95% IC (1,05 a 4,50) and 3) high potential for resilience: OR= 0,60, 95% I C (0,37 a 0,97). Therefore, the results confirm the hypothesis of an association between high potential for resilience and satisfaction with dental services accessed by older people.
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Zanin, Maria Alice Siqueira. "Cárie dentária, desenvolvimento humano e serviços odontológicos no estado de São Paulo, Brasil, 2000-2006." Universidade de São Paulo, 2008. http://www.teses.usp.br/teses/disponiveis/17/17139/tde-11032009-143115/.
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O Estado de São Paulo concentra grande número de cirurgiões-dentistas, mas a desigualdade social e de renda presentes e as diferenças na distribuição dos profissionais pelas suas regiões não colabora para a equidade na oferta e no acesso aos serviços odontológicos da Atenção Básica. Este estudo ecológico teve como objetivo descrever a relação entre indicadores de experiência da cárie dentária, desenvolvimento social, oferta e acesso aos serviços odontológicos, no período de 2000 a 2006, analisados segundo a área de abrangência dos Departamentos Regionais de Saúde do Estado de São Paulo (DRS). Foram utilizados indicadores obtidos a partir da revisão de documentos e consultas aos bancos de dados da Fundação Sistema Estadual de Análise de Dados (SEADE), do Departamento de Informática do SUS (DATASUS), do Instituto de Pesquisa Econômica Aplicada (IPEA), Instituto Brasileiro de Geografia e Estatística (IBGE) e da Secretaria de Estado da Saúde de São Paulo (SES-SP). As informações reunidas foram o indicador CPO-D (12 anos), Índice Desenvolvimento Humano dos municípios paulistas (IDHM), o número de cirurgiões-dentistas (CD) registrados no CRO-SP, o número de CD atuantes na área de saúde municipal e os Indicadores do Pacto da Atenção Básica 2006 para a saúde bucal. Os dados foram organizados em mapas, utilizando-se análise de distribuição espacial, o que permitiu a observação visual de suas relações. Os menores valores do CPO-D foram encontrados em DRS (DRS I, DRS IV) que possuem maiores indicadores de desenvolvimento humano. Na região de baixo IDHM (DRS XII) foi observada menor relação de CD registrados no CRO-SP, no serviço público e menor oferta e acesso aos serviços básicos de saúde bucal. DRS localizados em regiões de melhor IDH-M e mais populosos (DRS I, DRS IV, DRS VII) também demonstram certa dificuldade na oferta e acesso a esses serviços. A oferta foi maior nos DRS localizados ao norte do Estado e de menor tamanho populacional. Tanto em DRS de baixo como alto IDH-M a ação escovação dental supervisionada foi ofertada, mas com baixa cobertura. O percentual de procedimentos odontológicos especializados em relação às ações odontológicas individuais foi maior nos DRS localizados em regiões de alto IDH e naqueles que possuem Centro de Especialidades Odontológicas (CEO) instalados. A experiência de cárie dentária no Estado de São Paulo, no período de 2000 a 2006, mostrou correlação significativa com o indicador de desenvolvimento humano. A melhoria dos indicadores da saúde bucal depende de políticas abrangentes, direcionadas para o desenvolvimento humano e, também, de ações estratégicas voltadas para as populações de regiões que apresentam baixos indicadores socioeconômicos.The State of Sao Paulo has a high concentration of dental surgeons, but the social and financial inequality presented there and the difference in the distribution of professionals throughout the region do not collaborate for equity in the offering and access to the odontological services in Primary Health Care. The aim of this ecological study was to describe the relationship between the indicators of dental caries experience, social development and offer and access to odontological services, during the period of 2000 to 2006, analyzed according to the areas covered by the Regional Health Departments of the State of Sao Paulo (DRS). Indicators were used from a review of documents and from consultation of the data base of the Foundation of the State System of Data Analysis (SEADE), of the Informatics Department of SUS (DATASUS), of the Institute of Economic and Applied Research (IPEA), of the Brazilian Institute of Geography and Statistics (IBGE) and of the State Health Secretary of Sao Paulo (SES-SP). The information gathered was, the Indicator CPOD (12 years), Human Development Index of the municipalities of Sao Paulo (IDHM), the number of dental surgeons (CD) registered at the Regional Council of Odontology of the State of Sao Paulo (CRO-SP), the number of CD in the area of health in the municipality and the Basic Care Indicators Pact 2006 for oral health. The data were organized in maps, using the analysis of spatial distribution, which allowed visual observation of its relationships. The lowest values of CPO-D were found in DRS (DRS I, DRS IV) that had higher indicators of human development. In the region of low IDH-M (DRS XII), lower numbers of CDs registered at the CROSP, within the public service and less offers and access to the basic services of oral health were observed. DRS located in the regions with better IDH-M and with higher populations (DRS I, DRS IV, DRS VII) also showed some difficulties in the offering of and access to these services. The offer was greater at DRS located in the north of the State and with smaller population sizes. Even at the DRS with low IDHM, as with higher, the supervised action of tooth brushing was offered, but with low cover. The percentage of specialized odontological procedures in relation to individual odontological actions was greater at the DRS located in the regions of high IDH and at the ones that have a Center of Odontological Specialties (CEO). The experience of dental caries in the State of Sao Paulo, during the period of 2000 to 2006, showed significant correlation to the indicator of human development. The improvement on oral healths indicators depends on comprehensive policies, having as target the human development and also strategic actions to the populations from regions that present low socioeconomic indicators.
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Luna, Antonio Katherine Estefany. "Comparación del nivel de satisfacción de los pacientes que acuden a un servicio odontológico en una clínica privada con un hospital público." Bachelor's thesis, Universidad Peruana de Ciencias Aplicadas (UPC), 2020. http://hdl.handle.net/10757/651869.
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Objetivo: Comparar el nivel de satisfacción en pacientes mayores de edad que acudieron a un servicio odontológico en una clínica privada con un hospital público.
Materiales y métodos: La muestra estuvo constituida por 100 pacientes mayores de 18 años en cada establecimiento (público y privado). Ellos fueron encuestados bajo determinados criterios después de su consulta odontológica. Se empleó como instrumento de investigación un cuestionario con 15 preguntas distribuidas en 7 dimensiones tales como: trato personal; eficacia en la atención; información recibida; accesibilidad y oportunidad; seguridad y privacidad; instalaciones, equipos y materiales; atención general. El análisis univariado se obtuvo mediante estadística descriptiva, frecuencia absoluta y relativa. Por otro lado, para el análisis bivariado se empleó la prueba de Chi-cuadrado y prueba exacta de Fisher.
Resultados: Se encontró una satisfacción del 97% de pacientes en la clínica privado y un 85% en el hospital público. Además, se encontraron diferencias estadísticamente significativas en el nivel de satisfacción con cada centro (p=0.003) y con las diferentes dimensiones del instrumento empleado. Por otro lado, se observó asociación de la edad y experiencia de dolor con la percepción de satisfacción de pacientes del sector privado. Mientras que en el ámbito público no se encontró asociación alguna.
Conclusiones: Se encontró un alto nivel de satisfacción en ambos centros, 97% en el ámbito privado y un 85% en el público. Además, se evidenciaron diferencias estadísticamente significativas al compararlos.Objective: To compare the level of satisfaction in patients of legal age who attended a dental service in a private clinic with a public hospital. Materials and methods: The sample consisted of 100 patients over 18 years of age in each establishment (public and private). They were surveyed under certain criteria after their dental consultation. A questionnaire with 15 questions distributed in 7 dimensions such as personal treatment was used as a research tool; effectiveness in care; information received; accessibility and opportunity; security and privacy; facilities, equipment and materials; general attention. The univariate analysis was obtained through descriptive statistics, absolute and relative frequency. On the other hand, the Chi-square test and Fisher's exact test were used for the bivariate analysis. Results: A satisfaction of 97% of patients was found in the private center and 85% in the public. In addition, statistically significant differences were found in the level of satisfaction with each center (p = 0.003) and with the different dimensions of the instrument used. On the other hand, there was an association between age and experience of pain with the perception of satisfaction of patients in the private sector. While in the public sphere no association was found. Conclusions: A high level of satisfaction was found in both centers, 97% in the private sector and 85% in the public. In addition, statistically significant differences were evidenced when compared.
Tesis
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Rios, Leonardo Essado. "Atenção às urgências odontológicas em unidades de pronto-atendimento do sistema único de saúde." Universidade Federal de Goiás, 2013. http://repositorio.bc.ufg.br/tede/handle/tede/3502.
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The pain of dental origin has high prevalence, presents itself as a public health problem and cause negative impact on quality of life of people. Because of that, attention to dental emergencies has particular importance in the health care of the population, however there is little research on this topic. In the present study it was aimed to analyze dental care in Emergency Care Units of the Unified Health System (SUS) in optics of dentists workers in this service. It was a study of mixed methods and data were collected through a questionnaire with assertions of polar agreement and disagreement (Likert scale). Participated as subjects dentists (N = 44) workers in the emergency dental service of the Emergency Care Units of SUS from Goiânia, GO. There was a tendency to full concordance (average percentage of agreement above 76%) about this type of service answering to a spontaneous demand with complaints of pain and trauma and also about the affirmation that basic procedures of urgency such as dental extractions, alveolitis and bleeding treatments, drainage of intraoral abscesses and medicalization must be performed there. Tendency to concordance (average percentage between 26% and 75%) was verified in relation to the statement that the service aims to relief the suffering of the population with pain of dental origin. Propensity to indifference (average percentage among -25% and 25%) occurred on the host with risk classification while service feature, and still about patients that should be referred to more complex units for emergency care. Tendency to disagreement (average percentage among -26% and -75%) was verified in relation to the attendance of non-urgent patients and the performance of dental restorative procedures. There was no tendency to full disagreement (average percentage above -75%) about any of the items. In the view of respondents the emergency dental care in emergency units of SUS are intended for the relief of typically urgent situations, in cases where there is no risk of advanced infections, by performance of procedures characteristically related to situations of urgency and that require basic technical fitness from the professional. There’s a lack on the policy of humanization and teamwork at the service. As a product of the study, it was designed a proposal for an update course of dental care to the professionals in the Emergency Care Units.
A dor de origem dental possui alta prevalência, apresenta-se como um problema de saúde pública e causa impacto negativo na qualidade de vida das pessoas. Em função disto, a atenção às urgências odontológicas possui especial importância na assistência à saúde da população, entretanto há poucas pesquisas sobre este tema. No presente estudo, visou-se analisar a atenção às urgências odontológicas em Unidades de Pronto-Atendimento do Sistema Único de Saúde (SUS) na ótica de cirurgiões-dentistas lotados nestes serviços. Tratou-se de um estudo de métodos mistos e os dados foram levantados através de um questionário com afirmações polares de concordância e discordância (escala Likert). Participaram como sujeitos Cirurgiões-Dentistas (N=44) lotados no Serviço de Atenção às Urgências das Unidades de Pronto-Atendimento do SUS de Goiânia, GO. Houve tendência à plena concordância (percentual médio de concordância acima de 75%) acerca de que este serviço atende uma demanda espontânea com queixas de dor e traumatismo e de que ali devem ser executados procedimentos básicos de urgência como exodontias, tratamentos de alveolite e hemorragia, drenagem de abscessos intra-oral e prescrição medicamentosa. Tendência à concordância (percentual médio entre 26% e 75%) foi verificada em relação à afirmação de que o serviço visa o alívio ao sofrimento da população com dor de origem dental. Propensão à indiferença (percentual médio entre -25% e 25%) ocorreu acerca do acolhimento com classificação de risco enquanto característica do serviço e sobre encaminhamento de pacientes com necessidades especiais a unidades mais complexas para atendimento de urgência. Tendência à discordância (percentual médio entre -26% e -75%) foi verificada em relação ao atendimento de pacientes com queixas não urgentes e à realização de procedimentos de restauração dental. Não houve tendência à plena discordância (percentual médio acima de -75%) acerca de nenhum dos itens. Na visão dos entrevistados a atenção às urgências odontológicas nas Unidades de Pronto-Atendimento se destina ao alívio de situações genuinamente urgentes, em casos onde não há risco de infecções avançadas, mediante a execução de procedimentos tipicamente voltados às situações de urgência e que requerem preparo técnico básico do profissional. Falta a efetivação de uma política de humanização e trabalho em equipe. Como produto do estudo, elaborou-se uma proposta de curso de atualização para a atenção odontológica nas Unidades de Pronto-Atendimento.
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Pizzatto, Eduardo [UNESP]. "Análise do estado de saúde bucal de adultos trabalhadores: assistência/atenção odontológica." Universidade Estadual Paulista (UNESP), 2005. http://hdl.handle.net/11449/104206.
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O presente trabalho tem por objetivo efetuar uma análise no que tange a assistência/atenção odontológica voltada à população adulta trabalhadora, buscando levantar índices epidemiológicos relevantes para área de saúde bucal desta população específica. Foram examinados 240 trabalhadores com idade entre 35 e 44 anos, através do processo de amostragem probabilística aleatória composta por conglomerados, sendo 60 trabalhadores de cada grupo (Grupo I: assistência odontológica em sistema de autogestão; Grupo II: assistência odontológica terceirizada e financiada pelo empregador; Grupo III: assistência odontológica terceirizada e financiada pelo trabalhador; Grupo IV: nenhum tipo de assistência odontológica disponibilizado). O exame clínico intrabucal seguiu o modelo preconizado pela Organização Mundial da Saúde sendo realizado por um único examinador previamente calibrado. O CPO-D médio encontrado para a amostra selecionada foi de 25,47 (3,59), não havendo, porém diferença estatística entre os quatro grupos distintos (p>0,05). Contudo, para todos os grupos avaliados, o componente perdido representou mais que 50% da composição deste índice. Em relação a condição periodontal (CPI) indivíduos pertencentes ao Grupo I apresentam maior número de sextantes hígidos quando comparados aos demais grupos (p<0,001). Porém, quando avaliados sextantes excluídos, não se observa diferença significativa entre os quatro grupos (p>0,05). A respeito do edentulismo, os indivíduos do GI apresentaram maior média de dentes presentes (19,90), já os indivíduos do GIV apresentaram maior necessidade de uso de próteses, tanto superior quanto inferior...
The present study aimed to analyze the dental assistance/attention given to an adult worker population, searching for relevant epidemiological indexes of oral health in this specific population. This study involved 240 workers, aged 35 to 44, randomly divided into 4 groups, with 60 workers in each group. Group I - self management dental assistance. Group II - dental assistance financed by employer. Group III - dental assistance financed by worker. Group IV - no dental assistance available. The oral clinical exams were done by a single examiner, previously calibrated, following the WHO guidelines. The mean DMFT found for this sample was 25.47 (sd 3.59), with no significant difference among all groups (p>0.05). However, for all groups the loss component (dental loss) represented more than 50% of the index composition. In relation to periodontal condition (CPI), individuals belonging to Group I presented more healthy sextants when compared to others (p<0.001). While evaluating excluded sextants there were no significant differences among the four groups (p>0.05). Regarding edentulous, GI presented the highest mean for the need of prosthesis usage, either superior or inferior. Based on the epidemiological aspects it was found relevant the implantation and/or restructure of the attention services in oral health of the adult workers population studied, seeking for the increase of life quality of these workers as their work capacity. It must be observed that the simple offering of dental assistance services does not bring benefits in terms of health to the worker; it is necessary a correct planning of actions to be developed, which may be connected to other health attention programs to workers.
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Percebo, Fernando de Castro. "O sistema de referência e contrarreferência em saúde bucal segundo a percepção de profissionais e usuários." Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/108/108131/tde-03082016-111005/.
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Os serviços oferecidos pelo Sistema Único de Saúde (SUS) estão organizados em rede, de forma a oferecer a seus usuários uma atenção integral. Com esse propósito, a configuração desta rede de serviços deve privilegiar o acesso do usuário ao nível de atenção que possa oferecer resolução ao seu caso, disponibilizando um adequado sistema de referência e contrarreferência para o usuário que necessite ser encaminhado de um nível de atenção a outro. Sendo assim, este estudo tem por objetivo avaliar a percepção dos profissionais e usuários referente ao sistema de referência e contrarreferência, e como este sistema funciona no cotidiano das unidades envolvidas neste estudo. Trata-se de um estudo qualitativo, cujos dados foram coletados através da aplicação de um questionário que visava obter as representações sociais de profissionais e usuários sobre o tema proposto, bem como alguns aspectos operacionais sobre o funcionamento deste sistema nestas unidades. Posteriormente os resultados foram apresentados e analisados na forma do Discurso do Sujeito Coletivo e permitiram concluir que profissionais e usuários têm a mesma percepção a respeito dos problemas que afetam o bom funcionamento deste sistema, tais como falta de profissionais, demora no atendimento, falta de resolutividade da atenção básica, disponibilidade de serviços na atenção secundária em desacordo com as necessidades da população, dificuldades na comunicação entre os profissionais dos diferentes níveis de atenção, e uma deficiência no controle do fluxo dos usuários, fazendo com que o sucesso dos encaminhamentos dependa muitas vezes do empenho pessoal dos profissionais e do esforço pessoal dos próprios pacientes.The services offered by the Unified Health System (SUS) are organized in a network in order to offer its users an integral attention. For this purpose, the configuration of this services network should prioritize the users access to the health care level that can provide the solution to his case, and a suitable reference and counter reference system to the user that needs to be sent from a health care level to another. Thus, this study aims to evaluate the perception of professionals and users concerning the reference and counter reference system, and how this system works daily in the health units involved in this study. This is a qualitative study, where data were collected through the application of a questionnaire aimed to obtain the social representations of professionals and users about the proposed subject, as well as some operational aspects about the operation of this system at these health units. Subsequently the results were presented and analyzed in the form of Collective Subject Discourse and allow us to conclude that professionals and users have the same perception about the problems that affect the proper functioning of this system, such as lack of professionals, delay in treatment, lack of resoluteness of the primary health care, availability of services in secondary care at odds with people\'s needs, difficulties in communication between professionals of different health care levels, and a deficiency in controlling the flow of users, making the success of referrals dependent often on personal commitment of the professionals involved and of the patient\'s own efforts.
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Jahnke, Maiara Mundstock. "Análise da interface entre a atenção básica e a especializada na rede de saúde bucal do Sistema Único de Saúde." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2016. http://hdl.handle.net/10183/157451.
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Os sistemas de saúde são respostas a demandas das sociedades, devendo ser articulados pelas necessidades de saúde. A Saúde Bucal está inserida no programa de Saúde da Família desde o ano 2000, porém foi em 2004, com o lançamento da Política Nacional de Saúde Bucal, que ocorreu uma reorganização dos serviços em todos os níveis de atenção, com ampliação e qualificação da Atenção Básica e implantação da Atenção Especializada. Considerando que houve uma forte expansão no acesso aos serviços de saúde bucal, é de fundamental importância estudar a relação presente entre estes dois serviços. Os objetivos deste estudo foram verificar a prevalência da presença de interface entre a Atenção Básica (AB) e os Centros de Especialidades Odontológicas (CEO) no Brasil, de acordo o Programa de Melhoria do Acesso e da Qualidade, e avaliar se esta interface está relacionada à características do contexto municipal e variáveis dos serviços. Trata-se de um estudo multinível de abrangência nacional, do qual participaram os 927 CEO. A avaliação externa foi realizada em 2014 com um instrumento padronizado. O estudo contou com duas variáveis dependentes que refletiam a existência de interface entre AB e CEO - interface mínima e interface abrangente, com presença de protocolos, referência e contrarreferência. Os aspectos sociodemográficos incluíram as macrorregião, IDH-M e cobertura municipal de ESB. As variáveis do serviço envolveram planejamento, acesso e matriciamento. Foram realizadas análises das frequências absolutas e relativas, regressão de Poisson Multinível para obtenção das razões de prevalências brutas e ajustadas com intervalos de confiança de 95% e nível de significância de 5%, com o software Stata 11. A modelagem utilizada foi hierárquica em dois estágios. Para análise de ajuste dos modelos foram utilizados os parâmetros deviance, AIC e BIC. 52,53% (IC 95% 49,31-55,75) dos CEO apresentavam a interface mínima e 34,51% (IC 95% 31,45- 37,58) interface abrangente. Na análise ajustada em ambos os desfechos, as regiões Sul e Sudeste apresentaram maior prevalência do desfecho que a região Norte e o mesmo ocorreu para a faixa de IDH mais elevado. As equipes que realizaram planejamento nos últimos 12 meses tiveram uma probabilidade 60% maior de apresentar uma interface mínima, sendo que o matriciamento aumentou essa probabilidade em 30% e o acesso exclusivamente agendado em 31%. Estes resultados se assemelham na interface abrangente. A relação entre a AB e os CEO traduzida na interface implica na produção de cuidados mais equânimes, integrais, eficientes e efetivos, o que está de acordo com os princípios do SUS. Com os achados deste estudo, ficam evidenciadas as desigualdades existentes entre os serviços de saúde, demonstrando que ainda há muito o que investir na qualificação da gestão e formação destes serviços. Apesar de a Rede de Atenção à Saúde Bucal estar melhor estruturada ainda há muito o que avançar.Health systems are the answers to social demands and must be articulated by health needs. Oral Health has been inserted in Family Health program in 2000, but in 2004, with the National Oral Health Policy, there was a reorganization of services at all levels of health care, with the extension and qualification of Primary Care and implementation of Specialized Attention. The strong expansion inthe access to oral health services demands studies about the relationship between the Primary Care and Specialized Dental Services. This study aimed to verify the prevalence of the interface between a Primary Health Care(PHC) and Specialized Dental Care(SDC) in Brazil, using data of the Program of Improvement of Access and Quality of SDC, and to evaluate if this interface isrelated to the municipal context and variablesrelated tothe services. This was a multi-level study of national scope including 927 municipal SDC. An external evaluation was carried out in 2014 through the application of a standardized instrument. The study had two dependent variables that reflected the interface between PHC and SDC - minimal interface and comprehensive interface. The sociodemographic aspects included the variables: macro-region, HDI-M and municipal Primary Care Dentistrycoverage. Service variables included planning, access and matrix support. Absolute and relative frequency analyzes and multi-level Poisson regression were performed to obtain prevalence raw ratios and adjusted with 95% confidence intervals and significance level of 5% (software Stata 11 ©). The modeling was hierarchical in two stages.There were used the deviance parametersfor adjustment analysis of the models, AIC and BIC. 52.53% (95% CI 49.31- 55.75) of the SDC presented a positive endpoint for the minimal interface and 34.51% (95% CI 31,45-37,58) for the comprehensive interface.The adjusted analysis shown that in both outcomes South and Southeast regions presented higher prevalence than theNorth region .The relationship between PHC and CEO,as represented by the interface, may lead to more equitable, comprehensive, efficient and effective care, in acordance with SUS principles. In conclusion, inequalities in dental health services are evidenced, showing that there is still much to invest in qualification of the management of these services.
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Martins, Aline Blaya. "Atenção primária à saúde voltada às necessidades das pessoas idosas : da política à evidência." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2012. http://hdl.handle.net/10183/143803.
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A população mundial vem envelhecendo, diante dessa premissa a Organização Mundial de Saúde (OMS), bem como, o Ministério da Saúde (MS) do Brasil, vem buscando adaptar-se a esta realidade através de políticas públicas capazes de promover o envelhecimento ativo e da atenção à saúde adaptada às necessidades da população idosa. A OMS propôs a adequação da Atenção Primária à Saúde (APS) às necessidades dos idosos. O Brasil, por sua vez, segue as orientações da OMS, dentro da linha de cuidado voltada para a saúde dos idosos, na Estratégia de Saúde da Família e dentro da Política de Atenção à Saúde da Pessoa Idosa. No entanto, ainda não há evidências quanto à avaliação da adequação destas políticas e de sua relação com a forma como os idosos percebem sua saúde geral e bucal. Desta forma, esta pesquisa teve como objetivo verificar a extensão do cuidado em saúde que é acessado por idosos moradores de dois distritos de Porto Alegre/RS, em relação ao preconizado para efetividade da Atenção Primária à Saúde, e realizar um censo das unidades de saúde de APS dos mesmos distritos a fim de estabelecer uma relação entre os dados empíricos levantados e: i) Políticas de Saúde relacionadas com a Atenção Primária à Saúde voltadas às necessidades das pessoas idosas, ii) autoavaliação de saúde geral e iii) percepção de saúde bucal. A metodologia do estudo contou com um estudo teórico realizado através de um levantamento de documentos, um estudo epidemiológico de base populacional de delineamento transversal e um censo de unidades de saúde. Os resultados deste estudo apontam para uma realidade distinta entre o que as Políticas voltadas para os idosos preconizam e o que é oferecido para os idosos. Foram observadas limitações em relação ao acesso, longitudinalidade, integralidade e qualidade do cuidado. Além disso, foi possível observar que em relação à autoavaliação de saúde os resultados mostraram associações entre a avaliação positiva da saúde e fatores psicossociais (sintomatologia depressiva), características pessoais (nº de morbidades) e ambientais (orientação do serviço para a APS). Já em relação à percepção de saúde bucal, os resultados apontaram associação com determinantes primários (satisfação com último atendimento odontológico, resiliência e renda suficiente para as necessidades da família), comportamentos em saúde (hábito tabágico) e condições de saúde bucal (número de dentes e presença de restos radiculares). A conclusão que se chegou a partir de tais resultados é que há uma necessidade premente de ampliação do acesso e qualificação do cuidado para que a Atenção Primária disponibilizada para os idosos que vivem nos distritos Lomba do Pinheiro e Partenon em Porto Alegre possa ser realmente considerada adequada às necessidades dos idosos. Além disso, é necessário que se leve em consideração o papel da Atenção Primária a saúde na avaliação da sua própria saúde e na percepção de saúde bucal por parte de idosos.The world population is aging. In response to those trends the World Health Organization (WHO), as well as the Brazilian Ministry of Health (MH), are aiming at tackling such matters through public policies that promote active aging through health care adapted to the needs of the elderly population. The WHO has proposed an Age-friendly Primary Health Care (PHC) that lies in accordance with the needs of the elderly. In Brazil, the WHO guidelines are followed within older people care provision, in the Family Health Strategy, and within the National Health Policy for the Elderly Person. However, there is still no evidence concerning the assessment of adequacy of these policies and its association with how older people perceive their general and oral health. Thus, this study aimed to verify the extension towards primary health care provided by health services accessed by older persons living in two sanitary districts of Porto Alegre/RS in relation with the recommendation in terms of effectiveness of primary health care. In addition, a census of the primary health care services of the two sanitary districts was carried out forming, along with the epidemiological survey, the basis of the empirical data that allowed establish a relationship with: i) Health Policies related to Primary Health Care and targeting on the needs of older persons, ii) self-rated health and iii) self-perceived oral health. The methodology included: theoretical study made by a documental research, a cross-sectional population-based epidemiological study and a health PHC services census. The results of this study show a distinct reality between what policies targeting older persons recommend and what is actually provided, limitations in terms of access, longitudinally, comprehensiveness and quality of care were observed. Furthermore, it was observed that positive self-rated health was associated with psychosocial factors (depressive symptomatology), personal characteristics (number of morbidities) and environmental characteristics (orientation towards PHC Attributes). Self-perceived oral health was associated with primary determinants of health (satisfaction with prior dental appointment, resilience and income that was enough to meet family needs), 17 health behaviors (smoking habit) and oral health status (number of teeth and of root remnants). Concluding, there is an urgent need to increase access and to qualify care so that Primary Health Care services made available for older people, at least for those who live in the Lomba do Pinheiro and Partenon sanitary districts of Porto Alegre/RS, reach its goals of providing adequate and resolutive care that is adequate to the needs of the elderly. Furthermore, it is necessary to take into account the role of Primary Health Care on the rate of health and perception of oral health by the elderly. Still, advances in relation to equity and quality of care in respect to primary health care professionals continued education attainment were observed.
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Palència, Fernàndez Laia. "Socioeconomic inequalities in the use of health care services in Europe : the role of public coverage and population-based cancer screening programmes." Doctoral thesis, Universitat Pompeu Fabra, 2012. http://hdl.handle.net/10803/104154.
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The aim of this thesis was to describe inequalities in the use of different health care services according to socioeconomic position (SEP) in Catalonia, Spain and Europe. In addition, we intended to assess whether the public coverage of the services, in particular dental health care, has an influence on the magnitude of inequalities in the use of such services. Finally, we aimed to determine the influence of population-based female cancer screening programmes on the prevalence of screening and on the extent of inequality. To accomplish these objectives four studies were carried out. The sources of information of the four studies were, respectively: several editions of the Catalan Health general practitioner (GP) services are equitable or manual classes use them to a greater extent. However, there are marked SEP inequalities in the use of outpatient specialist services, especially in dental care. Socioeconomic inequalities in use of dental care services exist throughout Europe, but they are larger in countries in which dental care is not covered at all by the public health care system than in countries in which dental care is partially covered. In Europe, socioeconomic inequalities in breast and cervical cancer screening are not found in countries with population-based screening programmes but they are found in those countries with only regional or pilot programmes and in those countries with opportunistic screening.L'objectiu d'aquesta tesi era descriure les desigualtats en l'ús de diferents serveis sanitaris segons la posició socioeconòmica a Catalunya, Espanya i a Europa. A més a més, es volia avaluar si la cobertura pública dels serveis, en particular la dels serveis dentals, infuencia la magnitud de les desigualtats socioeconòmiques en l'ús d'aquests serveis. Finalment, es va voler determinar la influència dels programes poblacionals de cribratge dels càncers de mama i cèrvix en la prevalença de cribratge i en la magnitud de les desigualtats. Per tal d'assolir aquests objectius es van dur a terme 4 estudis. Les fonts d'informació d'aquests estudis van ser, respectivament: diferents edicions de l'Enquesta de Salut de Catalunya (ESCA), diferents edicions de l'Enquesta Nacional de Salut d'Espanya (ENS), l'Enquesta de Salut, Envelliment i Jubilació a Europa (SHARE) 2006 i dades dels països europeus que van participar a l'Enquesta Mundial de la Salut de l'OMS l'any 2002. Els dos primers estudis eren estudis de tendències mentre que els dos últims van ser transversals. En tots els estudis les desigualtats socioeconòmiques es van mesurar mitjançant índexos relatius (RII) i absoluts (SII) de desigualtat. Els resultats d'aquests estudis mostren que a Catalunya i a Espanya els serveis d'atenció primària són equitatius o fins i tot les persones de classes manuals en presenten una major proporció d'ús. Tanmateix, hi ha marcades desigualtats en visites a l'especialista, en especial en les visites al dentista. Les desigualtats socioeconòmiques en la utilització dels serveis dentals existeixen a tota Europa, però són més grans en aquells països on l'atenció dental no està coberta pel sistema públic de salut que en aquells països on aquesta està parcialment coberta. A Europa, no es troben desigualtats socioeconòmiques en el cribratge dels càncers de mama i cèrvix en aquells països amb programes poblacionals de cribratge, però sí que es troben en aquells països amb programes pilot o regionals o amb només cribratge oportunista.
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Hirooka, Lucila Brandão. "A saúde bucal em uma região de saúde do estado de São Paulo por diferentes perspectivas a partir do programa de melhoria do acesso e da qualidade da atenção básica." Universidade de São Paulo, 2018. http://www.teses.usp.br/teses/disponiveis/17/17139/tde-14022019-102409/.
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O objetivo deste estudo foi identificar os principais avanços e desafios ocorridos na atenção à saúde bucal na Rede Regionalizada de Atenção à Saúde 13 (RRAS 13), sob a perspectiva da integralidade do cuidado, por meio de dois estudos transversais. O Estudo 1, ecológico, contou com dois momentos: o primeiro se valeu do banco de dados proveniente do instrumento de coleta das Avaliações Externas das equipes dessa região, participantes do 1º e/ou 2º ciclo do Programa de Melhoria do Acesso e da Qualidade (PMAQ-AB). O segundo momento abrangeu os indicadores de atenção básica de saúde bucal da região, propostos no Contrato Organizativo de Ação Pública (2013-2015) e os pactuados para o monitoramento do 1º e 2º ciclo do PMAQ-AB, obtidos nos bancos do Departamento de Informática do Sistema Único de Saúde. O Estudo 2, tipo survey, teve como instrumento de pesquisa um questionário aplicado aos cirurgiões-dentistas que integram as ESB da região em estudo que participaram do 1º e/ou 2º ciclo do PMAQ-AB. Os resultados mostram que as unidades de saúde com equipes de saúde bucal da RRAS 13, possuem, de forma geral, consultórios odontológicos com características estruturais e ambiência adequadas aos padrões estabelecidos pelo programa, bem como equipamentos, instrumentais e insumos suficientes para a realização de atividades clínicas, exceto os relacionados à confecção de próteses dentárias e RX. As equipes de saúde bucal realizavam a maior parte dos procedimentos para o atendimento clínico de saúde bucal, com exceção da reabilitação protética, que permanece principalmente inserida nos serviços especializados e pouco acessível aos usuários. Apesar dos avanços, foram identificadas barreiras no acesso dos usuários e a necessidade de expansão e fortalecimento das ESB, extensão do horário de funcionamento, bem como da reorganização das práticas no que se refere ao trabalho em equipe, apoio da gestão, planejamento das ações, atividades de educação permanente, matriciamento e realização de visitas domiciliares. Fragilidades no fluxo e o longo tempo de espera para atendimento especializado evidenciam a necessidade de estruturação da rede de atenção e fortalecimento da AB como coordenadora do cuidado, na busca pela integralidade do cuidado. O interesse dos cirurgiões-dentistas nesse processo se reflete na alta taxa de retorno dos questionários e na perspectiva positiva, de modo geral, em relação a proposta avaliativa do programa federal. Com os avanços e desafios mostrados nesse estudo, na sua singularidade, espera-se contribuir para o fortalecimento e consolidação da Política Nacional de Saúde Bucal no âmbito do Sistema Único de Saúde e para que o PMAQ-AB cumpra com sua função indutora no sentido de ampliar o acesso e a qualidade das ações de saúde bucal desenvolvidas nesta região, na perspectiva da construção de uma cultura avaliativa, ainda incipiente na área da saúde em nosso paísThe aim of this study was to identify the main advances and challenges in oral health care in the Regional Health Care Network 13, from the perspective of comprehensive care, through two cross-sectional studies. Study 1, is a ecological study, which was divided into two sections: the first used the database of the External Evaluation instrument of health teams of this region that participated of the 1st and/or 2nd cycle of the Brazilian National Program for Improving Access and Quality of Primary Care. The second section covered the indicators of basic oral health care of this regions proposed in the Organizational Contract of Public and Health Action (COAP 2013-2015) and those agreed for the monitoring of the 1st and 2nd cycle of the PMAQ-AB obtained in the database of the Brazilian National Health System iformation system. Study 2, is a survey study, had as a research instrument a questionnaire applied to generalist dental surgeon that integrate the health team of the study region that participated in the 1st and / or 2nd cycle of PMAQ-AB. It was identified that the oral health units of RRAS 13 generally have dental offices with structural characteristics and ambience adequate to the standards established by the program, as well as sufficient equipment, instruments and supplies to carry out clinical activities, except those for dental prostheses and RX. Oral health teams performed most of the procedures for clinical oral health care, except for prosthetic rehabilitation, possibly due the permanence os this servisse in secondary care and not accessible to users. Despite the advances, barriers were identified in the access of users and the need to expand and strengthen of the oral health teams, extension of working hours, as well as the reorganization of the practices regarding teamwork, management support, action planning, activities of permanent education, specialist orientation and home visits. Fragilities in the interactions between first and secondary care as the long waiting time for specialized care point out that advances in access and coverage by oral health services are still necessary for structuring the care network and strengthening Primary Health Care as a care coordinator, in the search for integral care. The interest of generalist dental surgeon in this process is reflected in the high rate of return of the questionnaires and in the positive perspective, in general, in relation to the evaluative proposal of the federal program. With the advances and challenges shown in this study, in its singularity, it is hoped to contribute to the strengthening and consolidation of the National Oral Health Policy within the Brazilian Unified Health System and for PMAQ-AB to fulfill its inductive function in the sense of to increase the access and quality of the public oral health actions developed in this region, in the perspective of the construction of an evaluative culture, still incipient in the health area in Brazil
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Edvardsson, Kristina. "Health promotion in pregnancy and early parenthood : the challenge of innovation, implementation and change within the Salut Programme." Doctoral thesis, Umeå universitet, Epidemiologi och global hälsa, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-70172.
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Background: In 2005, the Västerbotten County Council launched a child health promotion programme, “the Salut Programme”, in response to an alarming prevalence of overweight and obesity, and trends of increased dental caries, among young county citizens. The programme, initially developed in four pilot areas, is built on multidisciplinary and cross-sectoral collaboration and aims to support and strengthen health promotion activities in health care, social services and school settings. It targets children and adolescents (0-18 years of age) and their parents, and starts during pregnancy. This thesis focuses on interventions provided by antenatal care, child health care, dental services, and open pre-schools, directed to expectant parents and families with children aged 0-1 ½ years. Within the programme context, the aim was to explore socio-demographic patterns of overweight and obesity in expectant parents (Paper I), firsttime parents’ experiences of health promotion and lifestyle change during pregnancy and early parenthood (Paper II), professionals’ experiences of factors influencing programme implementation and sustainability (Paper III and IV), and early programme outcomes on professionals’ health promotion practices and collaboration following countywide dissemination and implementation (Paper IV). Methods and results: A population based cross-sectional study among expectant parents showed overweight and obesity in 29% of women (pre-pregnancy) and in 53% of men (n=4,352♀, 3,949♂). The likelihood for obesity was higher in expectant parents with lower levels of education, among those unemployed or on sick leave, and those living in rural areas. In 62% of couples, at least one of the partners was overweight or obese; a positive partner correlation was also found for BMI (I). An interview study with 24 first-time parents (n=12♀, 12♂) revealed that they primarily undertook lifestyle changes to secure the health of the fetus in pregnancy, and to provide a healthy environment in childhood. Parents described themselves as highly receptive to information about how their lifestyle could influence fetal health, and they frequently discussed pregnancy risks related to tobacco and alcohol, as well as toxins and infectious agents in foods. However, parents did not seem inclined to make lifestyle changes primarily to promote their own health. The antenatal and child health care services were perceived as being mainly directed towards women, and parents described a lack of a holistic view of the family which included experiences of fathers being treated as less important (II). An interview study undertaken with professionals (n=23) in the Salut Programme pilot areas indicated programme sustainability at most sites, two years after implementation, although less adherence was described within child health care. Factors influencing programme sustainability, as described by professionals, were identified at multiple organisational levels (III). A before-and-after survey among professionals (n=144) measured outcomes of the county-wide implementation of the Salut Programme in 13 out of 15 county municipalities. Results showed significant improvements in professionals’ health promotion practices and collaboration across sectors. A number of important implementation facilitators and barriers, acting at different organizational levels, were also identified via a survey comprised of open-ended questions (IV). Conclusion: The Salut Programme, developed with high involvement of professionals, and strongly integrated in existing organisational structures and practices, shows potential for improving health promotion practices and cross-sectoral collaboration. The findings can inform further development of the Salut Programme.as well as new health promotion initiatives, and inform policy practice and future research. These aspects include approaches in health promotion and prevention, father involvement during pregnancy and early parenthood, and factors influencing implementation and sustainability of cross-sectoral health promotion programmes.Bakgrund: År 2005 lanserade Västerbottens läns landsting en hälsofrämjande satsning “Salut” som svar på en oroande förekomst av övervikt och fetma samt trender till ökad förekomst av karies hos barn i länet. Satsningen, som initialt utvecklades i fyra pilotområden, bygger på tvärprofessionellt och verksamhetsövergripande samarbete och syftar till att stödja och stärka hälsofrämjande insatser inom landstinget och länets kommuner. Satsningen riktar sig till barn och unga (0-18 år) och deras föräldrar, med start under graviditeten. Denna avhandling fokuserar på insatser som erbjuds via mödrahälsovård, barnhälsovård, tandvård och öppen förskola riktade till blivande föräldrar och familjer med barn i åldern 0-1 ½ år. Med utgångspunkt från Salut-satsningen syftar avhandlingen till att undersöka socio-demografiska mönster av övervikt och fetma hos blivande föräldrar (I), förstagångsföräldrars upplevelser av hälsofrämjande insatser och förändrade levnadsvanor under graviditet och tidigt föräldraskap (II), personalens upplevelser av underlättande och hindrande faktorer för satsningens införande och uthållighet (III, IV), samt förändringar i arbetssätt och samarbete mellan verksamheterna efter den länstäckande spridningen av satsningen (IV). Metod och resultat: En populationsbaserad tvärsnittsstudie bland blivande föräldrar visade på övervikt och fetma hos 29% av kvinnorna (vikt före graviditet) och hos 53% av männen (n=4352♀, 3949♂). Lägre utbildningsnivå, arbetslöshet och sjukskrivning samt att bo utanför städerna visade sig öka sannolikheten för fetma. Hos en övervägande del av paren (62%) fanns minst en partner med övervikt eller fetma och samband kunde även påvisas mellan kvinnans och mannens BMI (I). En intervjustudie med 24 förstagångsföräldrar (n=12♀, 12♂) visade att föräldrarna främst förändrade sina levnadsvanor för att säkra hälsan hos fostret under graviditeten och för att skapa en hälsosam miljö för barnet under uppväxten. Föräldrarna beskrev sig själva som mycket mottagliga för information om hur deras levnadsvanor kunde påverka fostrets hälsa och de diskuterade ofta graviditetsrisker i relation till tobak och alkohol samt gifter och smittoämnen i livsmedel. Föräldrarna var dock mindre angelägna att förändra sina levnadsvanor med tanke på sin egen hälsa. De upplevde att mödrahälsovårdens och barnhälsovårdens insatser i huvudsak riktades till kvinnor och beskrev en avsaknad av helhetssyn på familjen, vilket även avspeglades i upplevelser av att papporna behandlades som mindre viktiga (II). En intervjustudie med personal (n=23) inom pilotområdena, två år efter utveckling och införandet av Saluts insatser, indikerade god uthållighet av satsningen, även om en lägre följsamhet till insatserna beskrevs inom barnhälsovården. Faktorer som av personalen beskrevs påverka uthålligheten identifierades på flera organisatoriska nivåer (III). En före- och efterstudie bland personal (n=144) mätte effekter av den länstäckande spridningen av satsningen i 13 av länets 15 kommuner. Resultaten visade på flera signifikanta förbättringar av de hälsofrämjande arbetssätten och ett ökat samarbete mellan verksamheterna. En enkät med öppna frågor riktad till personalen belyste också faktorer på flera organisationsnivåer som ansågs underlätta respektive hindra införandeprocessen (IV). Slutsats: Salut-satsningen, som är utvecklad i nära samarbete med verksamheternas personal och väl integrerad i redan existerande organisatoriska strukturer och arbetssätt, visar på potential att förbättra hälsofrämjande arbetssätt och samarbete mellan verksamheter. Aspekter som beskrivits och diskuterats kan vägleda satsningens fortsatta utveckling såväl som framtida nya initiativ. Resultaten och slutsatserna kan även användas i syfte att påverka policy, praxis och framtida forskning. Detta avser framförallt hälsofrämjande och sjukdomsförebyggande metoder, pappans roll under graviditet och tidigt föräldraskap samt kunskaper om faktorer som kan ha betydelse för genomförande och uthållighet av verksamhetsövergripande hälsofrämjande insatser.
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Soares, Felipe Fagundes. "Desigualdade na utilização de serviços odontológicos: da atenção básica à especializada, do público ao privado." Instituto de Saúde Coletiva, 2014. http://repositorio.ufba.br/ri/handle/ri/16342.
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Objetivo. Identificar fatores associados à utilização dos serviços odontológicos, públicos (básicos e especializados) e privados. Método. Realizou-se um inquérito populacional de base domiciliar em dois municípios da Bahia com 100% de cobertura da Estratégia Saúde da Família. Informantes-chave forneceram dados sociodemográficos e de utilização dos serviços odontológicos. Estratificou-se a amostra quanto à organização do serviço. A associação entre o uso e as variáveis independentes foi aferida pela regressão logística politômica. Resultados. Analisaram-se dados de 1290 indivíduos que procuraram algum serviço odontológico.Ter menor escolaridade (OR=1,47; IC95%: 1,03-2,10) e residir em município com pior organização do serviço (OR=1,74; IC95%: 1,22-2,48) foram associados ao menor uso da atenção pública especializada (AE). Conclusão.A desigualdade na utilização do serviço público odontológico pode significar focalização dos serviços de atenção primária para grupos mais vulneráveis e de AE para aqueles que possivelmente têm mais capital para romper as barreiras de acesso.
Objective.Identify factors associated with use of public dental services (primary and specialized) and private. Methods. A population-based household survey was carriedin two cities of Bahia with 100% coverage of the Family Health Strategy. Key informants provided demographic and utilization of dental services data. The sample was stratifiedaccording to the service organization. the association between the use and the independent variables was measured by polytomous logistic regression. Results.Data from 1290 subjects who sought dental services, were analyzed. Having lower education (OR=1,47; 95%CI 1,03-2,10) and residing in a city with the worst service organization (OR=1,74; 95%CI 1,22-2,48) were associated to lower use of secondary publichealth care (SC). Conclusion. The inequality in use of public dental services can mean focalization of primary care to the most vulnerable groups and of SC for who possibly have more capital to break the accessibility barriers.
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Noro, Luiz Roberto Augusto. "Acesso aos servi?os odontol?gicos e incid?ncia de c?rie em adolescentes e fatores de risco em munic?pio do Nordeste Brasileiro, 2006." Universidade Federal do Rio Grande do Norte, 2008. http://repositorio.ufrn.br:8080/jspui/handle/123456789/13113.
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Previous issue date: 2008-04-18The aims of this study were to analyze the access of dental services by child population, to determine the prevalence of dental caries, gingivitis and malocclusion in resident children from the municipal district of Sobral Cear? and to evaluate the incidence of the dental decay in adolescents associated with the factors related to socioeconomic condition, access to health services and self-perception. This study had as main factor the multidisciplinary represented by the participation of health professional (doctors, dentists, nurses) in the development of the survey's initial reference; student from Human Sciences area to apply the structured questionnaire in domiciliary visits; statistics professionals in the orientation of the analysis to be held and family health team (community health agents, dentists and dental clinic assistants) in the scheduling of domiciliary visits and the accomplishment of oral exam. The sample was determined from the domicile record that included children born between 1990 and 1994 to develop the research Children health conditions in the municipal district of Sobral Cear? . The first sample comprised 3425 parents of children from 5 to 9 years old, living in the urban area at the municipal district of Sobral Cear?, aiming at identifying the most important factors associated to the access to dental service. From this sample, 1021 children were selected in a systematic way, for the accomplishment to the epidemiological study of decay, gingivitis and malocclusion. In the study's third phase, in order to arrange the group to be followed, 688 adolescents were examined and interviewed, by means of the active search from the 1021 individuals that had been previously examined. It was observed that 50.9% of the children had access to dental service at least once in a lifetime. Of this total, 65.3% accomplished it during the last year, and 85.4% of these did in public services, what allows to identify the importance of this sector in the access to dental services. It was observed that the factors that most affected the access to dental 129 services were related to socioeconomic condition, such as the access to health plan, the possession of toothbrush, garbage collecting, mother s schooling, sewerage treatment and malnutrition. In relation to oral diseases, an increase in the DMF-T index according the age was observed, from 0.10 in five years old to 1.66 in the nine years old, while with the dmf-t index, the inverse happened, since the index decreased from 3.59 in five years old to 2.69 in nine years old. In relation to gingivitis, an average 32.7% of the children presented gum bleeding. In what concerns malocclusion, it was observed that 60.3% of the children didn't present any problem, 30.17% had light malocclusion and 9.5% severe malocclusion. The average incidence of dental caries was 1.86 teeth per youngster. Among the studied variables, tooth pain in the last six months, mother's income and school snack, adjusted by the perception about the need of treatment, the mother's schooling and the dentist's appointment at least once in a lifetime, were the variables that presented positive relationship with the high incidence of dental caries on this population by logistic regression. Variables of socioeconomic nature, related to the access to health services and behavior and biological variables presented a relationship with the high caries incidence. The study point out to the need of developing health actions in a humanized way, by an oral health team effectively bound to the population's interest, with the great objective to provide, with the public health services managers, adequate conditions to improve oral health
Os objetivos do presente trabalho foram analisar o acesso da popula??o infantil ao servi?o odontol?gico, identificar a preval?ncia de c?rie, gengivite e maloclus?o em crian?as residentes no munic?pio de Sobral Cear? e avaliar a incid?ncia da c?rie dent?ria em adolescentes, associando-a a fatores relativos ? condi??o s?cio-econ?mica, acesso ? servi?os de sa?de e estilo de vida. O presente estudo teve como fator preponderante a multidisciplinaridade representada pela participa??o de profissionais de sa?de (m?dicos, cirurgi?es-dentistas, enfermeiros) na constru??o do referencial inicial da pesquisa, estudantes de cursos da ?rea de Ci?ncias Humanas, na aplica??o do question?rio estruturado para entrevista domiciliar; estat?sticos na orienta??o das an?lises a serem realizadas e equipe de sa?de da fam?lia (agentes comunit?rios de sa?de, cirurgi?es-dentistas e auxiliares de consult?rio dent?rio) no agendamento e realiza??o dos exames bucais domiciliares. A amostra foi definida a partir do cadastro de domic?lios que inclu?a crian?as nascidas entre 1990 e 1994 para desenvolvimento da pesquisa Condi??es de sa?de das crian?as no munic?pio de Sobral Cear? . A primeira amostra foi composta por 3425 pais de crian?as entre 5 e 9 anos de idade residentes no munic?pio de Sobral Cear?, visando identificar os principais fatores relacionados ao acesso a servi?o odontol?gico. A partir desta amostra, foram selecionadas 1021 crian?as, de forma sistem?tica, para realiza??o do levantamento epidemiol?gico de c?rie, gengivite e maloclus?o. Na terceira fase do estudo, visando ? composi??o da coorte a ser acompanhada, foram examinados e entrevistados 688 adolescentes, a partir da busca ativa dos 1021 indiv?duos que haviam sido preliminarmente examinados. Observou-se que 50,9% das crian?as tiveram acesso ao tratamento odontol?gico pelo menos uma vez na vida. Deste total, 65,3% o realizaram no decorrer do ?ltimo ano pesquisado, sendo que 85,4% destes na rede p?blica, o que permite identificar a import?ncia deste segmento no acesso aos servi?os odontol?gicos. Observou-se que os fatores que mais afetaram o acesso ao servi?o odontol?gico foram os vinculados ? condi??o s?cio-econ?mica como acesso ? plano de sa?de, posse de escova dent?ria, coleta de lixo, escolaridade da m?e, tratamento do esgoto e desnutri??o. Em rela??o ?s doen?as bucais observou-se um aumento do CPO-D com a idade, de 0,10 aos cinco anos para alcan?ar 1,66 aos nove anos de idade, ocorrendo o inverso em rela??o ao ?ndice ceo-d, uma vez que aos cinco anos o ?ndice de 3,59 decai para 2,69 aos nove anos. Quanto ?s altera??es gengivais, em m?dia, 32,7% das crian?as apresentavam sangramento gengival. Quanto ? maloclus?o, observou-se que 60,33% das crian?as n?o apresentavam problema, 30,17% apresentavam problemas leves e 9,5% problemas severos de maloclus?o. A incid?ncia m?dia de c?rie foi de 1,86 dentes por adolescente. Entre as vari?veis estudadas, dor de dente nos ?ltimos seis meses, renda da m?e e merenda escolar, ajustadas pela percep??o sobre necessidade de tratamento, escolaridade da m?e e consulta ao dentista pelo menos uma vez na vida, foram as vari?veis que apresentaram rela??o positiva com a alta incid?ncia de c?rie dent?ria desta popula??o, a partir da regress?o log?stica. Vari?veis de natureza s?cio-econ?mica, relativas ao acesso aos servi?os de sa?de, comportamentais e biol?gicas apresentaram rela??o com a alta incid?ncia de c?rie. O estudo aponta para a necessidade de implanta??o de servi?os odontol?gicos vinculados ao desenvolvimento de a??es de sa?de de forma humanizada, desenvolvidas por equipes de sa?de bucal efetivamente vinculadas aos interesses da popula??o, que tenham como grande objetivo proporcionar, junto com os gestores dos servi?os p?blicos de sa?de, condi??es adequadas para melhoria da sa?de bucal
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Peixoto, Marcílio Otávio Brandão. "A prática da atenção integral em saúde bucal na estratégia de saúde da família de Alagoas." Universidade Federal de Alagoas, 2013. http://www.repositorio.ufal.br/handle/riufal/1305.
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The practice of dentists in the Family Health Strategy (FHS) needs to be consistent with the principles of the Unified Health System (UHS). Aimed to analyze the performance of these professionals in the FHS, acording integral atencion in oral health (IAOH). It was performed a study quantitative, analytical, observational and cross-sectional, with 59 dentists from FHS of Alagoas, who answered to a semi-structured questionnaire. In the answers, 66.1% indicated that they did not do all the actions IAOH. Prevention and promotion health was unique action reported by everyone. The work conditions were cited inadequate by 40.5% and 64% not feel prepared by university. It was not found significant statistical difference (p 0.05 >) for greater realization of IAOH in relation to gender, age, time of undergraduate and professional performance in FHS, postgraduate studies, the kind of the entry in the FHS, satisfaction in the job and preparation in the graduation. There was a trend (p = 0.06) to IAOH be more he ld when reported better working conditions and greater significance (p = 0.01) for IAOH realization when worked in other places in addition to the FHS. These data were presented at a meeting in order to sensitize people in the performance of duties of representation of Dentistry, as a product of intervention, in order to enhance the professional practice of the FHS way ever closer to the guidelines and principles of the UHS and therefore improving Alagoas people’s health. In conclusion, the most dentists is not developing IAOH and factors related to working conditions and education are related to possible improvements in their practices, necessitating reflection / action of the representatives of the dental profession in this direction.A prática dos Cirurgiões-dentistas (CDs) na Estratégia de Saúde da Família (ESF) precisa estar coerente com os princípios do Sistema Único de Saúde (SUS). Objetivou-se analisar a atuação desses profissionais na ESF, tendo como base a Atenção Integral em Saúde Bucal (AISB). Realizou-se estudo quantitativo, analítico, observacional, de corte transversal, com 59 CDs da ESF de Alagoas, que responderam a um questionário semiestruturado. Entre os participantes, 66,1% informaram que não praticavam todas as ações da AISB, sendo as ações de prevenção e promoção as únicas que todos referiram executar. As condições de trabalho foram citadas como inadequadas por 40,5% e 64% não se sentiram preparados pela graduação. Não foi encontrada diferença estatística significante (p>0,05) para maior realização de AISB em relação ao gênero, idade, tempos de graduação e de atuação profissional na ESF, realização de pós-graduação, tipo de ingresso na ESF, satisfação no trabalho e preparo na graduação. Encontrou-se uma tendência (p=0,06) para que a AISB fosse mais realizada quando relataram ter melhores condições de trabalho e significância (p=0,01) para uma maior realização de AISB quando trabalhavam em outros locais além da ESF. Estes dados foram apresentados em reunião no intuito de sensibilizar pessoas no exercício de cargos de representação da Odontologia, como produto de intervenção, no sentido de aprimorar a prática profissional na ESF de forma cada vez mais próxima às diretrizes e princípios do SUS e, consequentemente, a melhoria da saúde da população alagoana. Conclui-se que a maioria dos CDs não está desenvolvendo AIBS e que fatores ligados a condições de trabalho e formação acadêmica estão relacionadas a possíveis melhorias nas suas práticas, necessitando-se reflexão/ação dos representantes da classe odontológica neste sentido.