Objectives This study aimed to analyze the development stage of the oral health care network of the Brazilian Unified Health System in the state of Minas Gerais, Brazil. Methods A cross‐sectional descriptive and analytical study was conducted with 205 municipal oral health coordinators from the state. Data collection was carried out through a validated questionnaire to analyze the state of development of the oral health care network. Descriptive and cluster analysis were performed, and two clusters were generated. Results The total median score of the questionnaires classified Minas Gerais as a state with incipient oral health care networks and a minimal capacity to operate such networks, reflected in the predominance of cluster 1 in the sample. There was no statistical association between age, time since graduation, and time spent working as a coordinator and the clusters (Mann–Whitney test). The coordinators’ gender and educational level were also not statistically associated with the clusters (Pearson's chi‐square and Fisher's exact, respectively). Conclusion There is a great need to improve the organization of services of the oral health care network in Minas Gerais. This can be done through improvements in its operational structure, as well as investment in management training.
Objetivo: O presente estudo teve como objetivo principal, descrever os aspectos metodológicos do Projeto SB Minas Gerais e os resultados principais sobre problemas bucais da população do estado de Minas Gerais Métodos: Trata-se de um inquérito epidemiológico de saúde bucal realizado no ano de 2012 com representatividade estadual cuja amostra foi realizada por conglomerados e com múltiplos estágios de sorteio. Capital e municípios do interior de Minas Gerais compõem os três domínios da amostra. Avaliou-se a situação da população mineira em relação à cárie, condição periodontal, necessidades de próteses, condições da oclusão e ocorrência de dor de dente, dentre outros aspectos nas idades de 5 e 12 anos e nas faixas etárias de 15-19, 35-44 e 65-74 anos. Resultados: Em relação à cárie, a média ceo/CPO-D para o estado foi de 2,1 na idade de 5 anos, 1,8 aos 12 anos, 3,9 nos adolescentes, 15,9 em adultos e 28,7 nos idosos. Os problemas periodontais aumentam com a idade, sendo 1,60 vezes maior o número de adultos acometidos em relação ao número de adolescentes. Em relação às oclusopatias, aos 5 anos, 54,7% possuíam pelo menos um dos problemas avaliados. O percentual de crianças aos 12 anos e de adolescentes que apresentaram algum tipo de oclusopatia foi de 33,8% e 26,7%, respectivamente. Em relação à prótese dentária, a faixa etária de 65-74 anos foi a que apresentou maior percentual de indivíduos com necessidade de prótese total nos dois maxilares. Conclusão: Associando os indicadores de saúde bucal avaliados às variáveis socioeconômicas, os resultados apontam para importantes desigualdades regionais que devem ser levadas em consideração para elaboração das estratégias de planejamento e avaliação.Descritores: Saúde bucal. Inquéritos epidemiológicos. Políticas públicas.
RESUMOOBJETIVO: Validar a versão saúde bucal do Instrumento de Diagnóstico do Estágio de Desenvolvimento da Rede de Atenção à Saúde. MATERIAIS E MÉTODOS: A amostra foi composta pelos coordenadores de saúde bucal de 154 municípios do estado de Minas Gerais, Brasil, escolhidos por conveniência. A versão saúde bucal do Instrumento passou previamente pela etapa de adaptação e, em seguida, foram conduzidas as fases de teste de campo e o estudo das propriedades psicométricas do Instrumento (confiabilidade e validade). Os questionários foram enviados aos coordenadores por e-mail. RESULTADOS: A consistência interna mostrou índices adequados para o escore total (coeficiente alfa de Cronbach = 0,97) e domínios (coeficiente alfa de Cronbach = 0,77-0,94). O teste-reteste teve boa estabilidade, conforme a análise do escore total (coeficiente de correlação intraclasse -CCI = 0,88) e domínios (CCI = 0,83-0,91). A mensuração das concordâncias dos itens demonstrou validade de constructo, variando de regular à quase perfeita (r s entre 0,25 e 0,81). Para a validade discriminante, o escore total e os domínios "População", "Sistemas logísticos" e "Sistema de governança da rede" distinguiram os grupos conforme o tempo de formado (p ≤ 0,05). CONCLUSÃO: A versão saúde bucal do Instrumento mostrou propriedades psicométricas adequadas quanto à confiabilidade e à validade do constructo e discriminante. The sample was comprised of the oral health coordinators from 154 municipalities in Minas Gerais State, Brazil, chosen for convenience. The oral health version of the Instrument was previously submitted to the adaptation stage, and then the field test phases and the study of the psychometric properties of the Instrument (reliability and validity) were conducted. Questionnaires were sent to the coordinators by email. RESULTS: Internal consistency for the total score (Cronbach's alpha coefficient = 0.97) and domains (Cronbach's alpha coefficient = 0.77-0.94) was demonstrated. Test-retest reported good stability based on the analysis of the total score (intraclass correlation coefficient -ICC = 0.88) and domains (ICC = 0.83-0.91). Percentage agreement of the items showed construct validation, varying from regular to almost perfect (r s between 0.25 and 0.81). For discriminant validity, total score and three domains, Population, Logistical systems and Network Governance System distinguished the groups according to the time of formation (p ≤ 0.05). CONCLUSION: The oral health version of the Instrument showed adequate psychometric properties regarding the reliability and validity of the construct and discriminant.
Aim: The present study analyzed the association between the development stage of the oral health care network in a Brazilian state and oral health coverage of Primary Health Care (PHC). Methods: A cross-sectional descriptive and analytical study was conducted with 205 municipal oral health coordinators of a state in the southeast of Brazil. Data collection was carried out through a validated questionnaire. Descriptive and cluster analysis were performed. Variables oral health coverage (total PHC and in the Family Health Strategy – FHS), allocation factor (AF) of financial resources, and expanded health area of municipalities were compared with the clusters (p < 0.05). Results: Cluster 1 was classified as containing incipient health care networks (n = 109), and cluster 2 was classified as containing advanced health care networks (n = 96). Descriptive analysis showed that oral health coverage in total PHC was 100% and in FHS was 78.1%. The majority of municipalities were classified in quartiles AF 1 and 2. The expanded health areas with the highest number of municipalities were South and Southeast. Clusters were associated with total PHC coverage (p = 0.038) and FHS (p = 0.009), and no association between clusters with AF (p = 0.754) and expanded health area of municipalities (p = 0.519). Conclusion: The municipalities’ PHC coverage was related to the effectiveness of oral health network implantation.
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