Regional differences in infection control conditions in a sample of primary health care services in Brazil

Abreu, Mauro Henrique Nogueira Guimarães de; Resende, Vera Lúcia Silva; Lee, Kyu Ha; Matta-Machado, Antônio Thomaz Gonzaga da; Starr, Jacqueline R.

doi:10.1590/0102-311x00072416

Cited by 4 publications

(11 citation statements)

References 22 publications

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“…37,38 In PHCs, the existence of guidelines was also associated with a better performance of dental teams, 39 reinforcing its importance for the Brazilian oral healthcare network. Finally, regional differences and social inequalities in Brazil 1,4,13,16 can explain the different covariates that have influenced MSS in the different regions. Beside these differences, human resources and management factors had an effect on MSS in all five Brazilian regions, similar to the findings throughout the country.…”

Section: Discussionmentioning

confidence: 99%

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Role of management and human resource factors on matrix support in secondary oral health care in Brazil

Abreu

Amaral

Zina

et al. 2021

Comm Dent Oral Epid

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Objectives To investigate the association between health management and human resource factors on matrix support (MS) in a nationally representative sample of Dental Specialty Centres (DSCs) in Brazil. Methods This survey included 1042 DSCs (Response rate = 94.99%) in the second cycle of the National Program for the Improvement of the Quality and Access to the Dental Specialty Centres (PMAQ‐CEO, in Portuguese) in 2018. Previously trained interviewers extracted information on MS, health management and human resources of the DSC by using a structured instrument. An MS score was created by adding the number of positive answers to the 10 MS questions. Negative binomial regression models were used to estimate the unadjusted and adjusted rate ratios (RR) and corresponding 95% confidence interval (CI). Results Of all the DSCs (n = 1042), 116 (11.1%) performed all 10 MS procedures. Those DSCs with a manager who had a higher education degree in the area of Public Health or Public Management (RR = 1.01, 95% CI, 1.01–1.02) and with human resources that received incentives, bonuses or financial awards for performance related to the PMAQ‐CEO result (RR = 1.01 95% CI 1.01–1.02) are more likely to perform MS, when compared to the reference categories. The DSCs that are more likely to perform MS include those that developed actions as a result of periodic planning and evaluation with confirmatory documentation (RR = 1.06, 95% CI; 1.01–1.10); those that received support for planning and organizing the work scheme (RR = 1.03, 95% CI; 1.01–1.05); those that monitored and analysed the goals set for each specialty offered at the DSC, with (RR = 1.06, 95% CI; 1.01–1.10) or without confirmatory documentation (RR = 1.06, 95%CI; 1.02–1.11); those whose team periodically performed self‐assessment processes, using the Ministry of Health's formal self‐assessment (AMAQ in Portuguese) (RR = 1.04, 95% CI; 1.02–1.05); those who followed clinical guidelines (with confirmatory documentation) regarding the referral of patients from primary care to the DSC (RR = 1.02, 95% CI; 1.01–1.04). On the contrary, DSCs that did not use the results achieved in previous PMAQ cycles in the organization of the DSC's team work scheme proved to be less likely to perform MS (RR = 0.98, 95% CI; 0.96–0.99). Conclusions Matrix support is associated with human resources and management factors in secondary oral health care in Brazil. Continuing professional development and some management characteristics are important for secondary dental care quality and could be considered in health policy initiatives.

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Section: Discussionmentioning

confidence: 99%

“…A variable called the ‘MS Score’ (MSS) was developed in relation to the 10 MS questions, much like the method used in another study 16 . Each ‘yes’ answer in the above items resulted in one point.…”

Section: Methodsmentioning

confidence: 99%

Role of management and human resource factors on matrix support in secondary oral health care in Brazil

Abreu

Amaral

Zina

et al. 2021

Comm Dent Oral Epid

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“…13 The low availability of autoclaves can be explained by the sterilization process of dental instruments occurring outside the health service in some municipalities, in a centralized sterilization facility. 14 disinfection of critical instruments to prevent and control cross-infection in dentistry 15 . Due to this recommendation, the low amount of dry heat sterilizers available in the evaluated services (22.5%) is justified, since dry heat is recommended only for oils and powders in the medical field and for some types of burs and orthodontic pliers in dentistry.…”

Section: Discussionmentioning

confidence: 99%

Structural characteristics of oral health services in Brazilian Primary Health Care

et al. 2021

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This study aimed to describe the structure of oral health services in primary health care in Brazil with centers participating in the second cycle of the 'National Program for Improving Access and Quality of Primary Care' (PMAQ-AB), the largest health service evaluation program ever instituted in the country. This cross-sectional study evaluated 16,202 oral health services, regarding 22 pieces of dental equipment and 25 dental supplies. The presence of each piece of equipment/dental supply generated a score for services. The sum of these scores was compared among different regions in Brazil. Quantitative data were described by quartiles and categorical data by frequencies, using the SPSS, version 25. Most of the evaluated centers presented adequate equipment in good using conditions and sufficient dental supplies for primary oral health care. Data also showed a lack of some equipment, such as X-rays, bicarbonate jet, and ultrasound devices, while for dental supplies, a lack of amalgam (capsule and manual preparation), anesthesia without vasoconstrictors, and intracanal medication was found. The services presented a median of 14 pieces of equipment and 22 dental supplies. Of the Brazilian regions, the South presented the highest median, while the North and Northeast regions presented the lowest one. The oral health services presented dental offices with good availability of equipment and dental supplies to perform clinical activities. However, differences in the structure of services among the Brazilian regions was still observed.

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“…Compared to a previous study with national data from 2013 to 2014 [ 1 ], an improvement of 9.9% was found, which is very positive. Dental care generates a significant amount of aerosols that can be contaminated with microorganisms, especially SARS-CoV-2, the virus responsible for COVID-19, and a ventilation system, whether natural or mechanical, can reduce the concentration of infectious aerosols [ 3 – 6 ]. Moreover, it is essential that health care facilities have safe and appropriate conditions, including the availability of treated water, sanitation, hygiene, energy, waste management, and PPE to promote the health of patients and staff [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

“…Brazilian Ministry of Health used a formula that qualified each PHC team based on an overall score that is a weighted average on their participation in the self-assessment activities, health indicators, adequate use of electronic health records, and a group of indicators from the external evaluation [ 2 ]. A previous study with 16,202 OHT, evaluated by the second cycle of the PMAQ (2013-2014), identified that only 208 (1.3%) teams performed all 12 infection control structures and that 1,078 units had worse structures for infection control [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

A Description of Infection Control Structure in Primary Dental Health Care, Brazil

Fonseca

Pereira

Palmier

et al. 2021

BioMed Research International

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Objective. This study is aimed at describing a score to assess infection control structures in Oral Health Teams (OHT) in Primary Health Care (PHC) in Brazil. Methods. Secondary data from a national external evaluation of PHC conducted in 2017 and 2018 were analyzed. The construction of the score used 14 variables, divided into the following: structural characteristics of the PHC, infection control equipment under conditions of use, and biosafety supplies in sufficient quantity. The questions were mostly dichotomous (yes/no). Descriptive analyses were carried out to characterize the OHT and factor analyses to reduce the number of observed variables to a specific number of factors. Results. Among 20,301 health units with OHT, 4,510 (22.2%) units did not have washable floors, ceilings, and walls; 8,406 (41.4%) did not have a sealer; 16,780 (82.7%) did not have taps with noncontact activation, and 4,663 (23.0%) units did not have rubber gloves. Regarding personal protective equipment (PPE), 1,618 (8.0%) units did not have a sufficient quantity of basic PPE. Three factors were defined to explain the 14 evaluated variables. The South region had the best score of infection control, while the North had the worst. Conclusions. Regional inequalities in the failures in infection control structures identified in PHC with OHT were related to the physical structure, equipment, and supplies used for infection control and the absence of PPE for OHT.

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Regional differences in infection control conditions in a sample of primary health care services in Brazil

Cited by 4 publications

References 22 publications

Role of management and human resource factors on matrix support in secondary oral health care in Brazil

Role of management and human resource factors on matrix support in secondary oral health care in Brazil

Structural characteristics of oral health services in Brazilian Primary Health Care

A Description of Infection Control Structure in Primary Dental Health Care, Brazil

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