Crise econômica, austeridade e seus efeitos sobre o financiamento e acesso a serviços públicos e privados de saúde bucal

Rossi, Thaís Régis Aranha; Sobrinho, José Eudes de Lorena; Chaves, Sônia Cristina Lima; Martelli, Petrônio José de Lima

doi:10.1590/1413-812320182412.25582019

Cited by 28 publications

(35 citation statements)

References 22 publications

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“…Um exemplo disso foi o aumento das ESB e a expansão dos CEO verificados, a despeito da persistência de várias dificuldades com relação à utilização de serviços nos municípios e o financiamento dessas ações. Rossi, Sobrinho, Chaves, & Martelli (2019) (Rossi et al, 2018;Menezes, Moretti, & Reis, 2019).…”

Section: Discussionunclassified

Fatores associados a metas de utilização de serviços em municípios da Bahia com Centros de Especialidades Odontológicas, de 2013 a 2019

Carvalho

Rossi

Coelho

et al. 2021

RSD

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Objetivo: Identificar os fatores associados ao cumprimento de meta de utilização dos serviços odontológicos na atenção básica e atenção especializada dos municípios com CEO do estado da Bahia, de 2013 a 2019. Metodologia: Este estudo é do tipo transversal, exploratório e analítico, utilizando dados secundários obtidos do Sistema de Informação Ambulatorial, da plataforma WEB e-Gestor Atenção Básica, do Sistema de Informações sobre Orçamentos Públicos em Saúde e do 1º ciclo do Programa Nacional de Melhoria do Acesso e da Qualidade dos Centros de Especialidades Odontológicas. Foram analisados 73 municípios da Bahia com equipe de saúde bucal implantada e com CEO, através dos indicadores de utilização propostos para saúde bucal pelo Ministério da Saúde. As variáveis foram relacionadas às características demográficas, financiamento e oferta dos serviços, sendo a variável resposta o cumprimento de 50% de dois padrões da Portaria Nº 1.631 de 1 de outubro de 2015. Resultados: Na amostra final, 58,90% dos municípios eram de pequeno porte, 50,68% mostraram acima de 85,9% de participação das transferências intergovernamentais na receita total, 49,32% tinham cobertura de saúde bucal na atenção básica acima de 77,7% e 43,83% possuíam CEO tipo I. Houve significância estatística na associação entre cobertura de saúde bucal e cumprimento de 50% ou mais da meta. Conclusão: Foi evidenciado que municípios de menor porte, com participação das transferências intergovernamentais na receita total acima de 85,9%, com cobertura de saúde bucal acima de 77% e com CEO tipo I, obtiveram maior cumprimento de meta. Conclui-se que a baixa cobertura de saúde bucal contribui para o não cumprimento de 50% da meta.

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Section: Discussionunclassified

Fatores associados a metas de utilização de serviços em municípios da Bahia com Centros de Especialidades Odontológicas, de 2013 a 2019

Carvalho

Rossi

Coelho

et al. 2021

RSD

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“…Oral health has been considered a part of integral health, and Brazilian policies stipulate the inclusion of dentists in primary health care, as the largest part of the population covered by primary care remains without the coverage of oral health professionals [19]. This reality has been aggravated by the Brazilian economic crisis and by austerity measures, which are reducing POHS coverage in primary health care [20]. The low coverage of the POHS highlights the inequity of access to health services.…”

Section: Discussionmentioning

confidence: 99%

Practice-based analysis of direct posterior dental restorations performed in a public health service: Retrospective long-term survival in Brazil

et al. 2020

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The aim of this retrospective study was to evaluate the survival and associated factors for the longevity of direct posterior restorations and to verify whether the geographic location of public health units could influence the long-term survival of such restorations. Data were extracted from electronic patient files of the Brazilian public oral health services. The sample comprised 2,405 class I and II restorations performed 4 to 24 years ago (mean, 8.9 years) in 351 patients (6.8 teeth/patient) across 12 public health units located in different city regions (42 professionals—55 restorations). The restoration was considered successful if it had not been repaired or replaced at the time of evaluation; failure was defined as replacement of the restoration, the need for endodontic treatment, tooth/restoration fracture or tooth extraction. Data were analyzed using the Kaplan-Meier test for restoration survival and Cox regression to evaluate the factors associated with failure. The majority of the restorations involved the use of amalgam (85%), involved a single face (70%), and were without pulp/dentin capping (85%). The overall survival rate was 95%, and the mean observation time was 8.9 years. The restoration survival was 79% (95% CI: 60.6–89.5) over 24 years, and the mean survival time was 22.2 years (95% CI: 21.9–22.6 years). The annual failure rate up to 24 years was 0.9%. After the adjustment, only the number of restored faces and the geographic location where the restoration was performed remained associated with failure of the restoration. The direct posterior restorations performed at the evaluated public health service units presented high survival rates. The restorations of people with lower access to POHS had lower survival rates. Class I restorations presented higher survival rates than class II restorations with two or more faces, regardless of the restorative material used.

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“…In a recent pre-pandemic scenario, Brazil showed an increase in the number of OHT, although accompanied by a drop in the quantity of FPDC, between 2015 and 2017 [18]. A reduction in the OHC in Primary Care was also observed as of 2016 [19]. Factors such as political instability and freezing of investments in health provided by the advance of austerity policies have had a negative impact on access to oral health care in recent years [19,20].…”

Section: Discussionmentioning

confidence: 99%

“…A reduction in the OHC in Primary Care was also observed as of 2016 [19]. Factors such as political instability and freezing of investments in health provided by the advance of austerity policies have had a negative impact on access to oral health care in recent years [19,20]. These effects, when added to the impacts of the pandemic, result in a worrying panorama.…”

Section: Discussionmentioning

confidence: 99%

“…Although oral health coverage is still far from reaching the entire Brazilian population, it is known that the public health system serves the majority of the most vulnerable population [10,23]. Therefore, setbacks in the expansion of the Brazilian National Health System dental care could contribute to an increase in oral health inequities [11,19].…”

Section: Discussionmentioning

confidence: 99%

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Offer and Use of Oral Health in Primary Care Before and After the Beginning of the COVID-19 Pandemic in Brazil

Lucena

Freire

et al. 2020

Pesqui. Bras. Odontopediatria Clín. Integr.

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To compare the offer and use of oral health services in primary care, before and after the beginning of the COVID-19 pandemic in Brazil. Material and Methods: An observational study with a cross-sectional ecological design, using data from the Health Information System for Primary Care. Data regarding the number of Oral Health Teams (OHT), Oral Health Coverage in Primary Care (OHC), number of First Programmatic Dental Consultations (FPDC), and number of visits due to dental abscess and toothache were collected. Data regarding the 26 Brazilian states and Federal District were collected, as consolidated of the first quarter (January to April) of 2019 and of 2020. The median of the difference (MD) and the percentage of variation (%V) were obtained for each variable and were compared by Wilcoxon test (α<0.05). Results: An increase in the number of OHT was observed in 25 states (MD=45; %V=6.13; p<0.001), whilst the OHC increased in 17 states (MD=1.01; %V=1.62; p=0.035) between the 2019 and 2020. We also verified a significant reduction in the number of FPDC (MD=-42.806; %V=-38.70; p<0.001), as well as in the number of visits due to dental abscess (MD=-1.032; %V=-29.04; p=0.002) and due to toothache (MD=-14.445; %V=-32.68; p<0.001). Conclusion: Although an expansion of OHT and OHC between 2019 and 2020 was verified, the offer and use of oral health services in primary care has decreased due to the COVID-19 pandemic.

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Crise econômica, austeridade e seus efeitos sobre o financiamento e acesso a serviços públicos e privados de saúde bucal

Cited by 28 publications

References 22 publications

Fatores associados a metas de utilização de serviços em municípios da Bahia com Centros de Especialidades Odontológicas, de 2013 a 2019

Fatores associados a metas de utilização de serviços em municípios da Bahia com Centros de Especialidades Odontológicas, de 2013 a 2019

Practice-based analysis of direct posterior dental restorations performed in a public health service: Retrospective long-term survival in Brazil

Offer and Use of Oral Health in Primary Care Before and After the Beginning of the COVID-19 Pandemic in Brazil

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