Encouraging the work process of oral health teams can favour the planning of their actions in Primary Health Care

Abstract

Background The social determinants of health are strongly related to dental care needs. Therefore, oral health services in primary health care (PHC) must be planned to be more responsive to the needs of their local populations. The aim of this study was to evaluate the variables that are associated with planning actions by oral health teams (OHTs) in PHC. Methods This analytical, cross-sectional study used data from the external evaluation of the third cycle of the National Program for Improving Access and Quality of Primary Care (PMAQ-AB), carried out between 2017 and 2018, in Brazil. The final sample consisted of 22,268 OHTs from 4,679 Brazilian municipalities. The outcome variable was action planning by the OHTs and the independent variables included characteristics of the OHTs and municipal PHC Management, in addition to municipal socioeconomic indicators. Five models were sequentially built for statistical analysis, namely: an empty model (with the intercept, only), a multiple model with variables related to OHTs, a multiple model with variables related to municipal management in PHC, a multiple model with the municipal indicators, and a multilevel logistic regression model with variables at the level of OHTs and municipalities. Results It was observed that 32.5% of the OHTs did not plan their actions. In the final adjusted model the characteristics of OHTs were more significant for the outcome than the variables related to municipal PHC Management and municipal socioeconomic indicators. Moreover, participating in meetings together with the PHC team and carrying out case and therapeutic project discussions were the variables with the greatest effect on the outcome, that is, adjusted OR of 3.75 (95%CI: 3.42–4.10) and adjusted OR of 3.74 (95%CI: 3.46–4.05), respectively. Conclusions It is concluded that the indicators complicating the planning of actions by the OHTs were mainly the characteristics inherent to the work process of the OHTs, particularly the failure to hold meetings together with the PHC team, case and therapeutic project discussions, self-assessment, as well as the embracement protocols.