The equity of access to primary dental care in São Paulo, Brazil: A geospatial analysis

Yuen, Aidan; Rocha, Carla Martins; Kruger, Estie; Tennant, Marc

doi:10.1111/idj.12336

Cited by 14 publications

(20 citation statements)

References 27 publications

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“…The lack of appropriate personnel carrying out these activities, inadequate insurance to cover the costs and inability to pay for services are the most significant factors that shape the accessibility to dental services (Mitts & Hernández-Cancio, 2016;Bintabara, et al, 2018;De Gutierrez, et al, 2018;McKernan, et al, 2018;). Socio-economic barriers, distance, health literacy of the population and distrust in the health system are also essential factors (Mitts & Hernández-Cancio, 2016;Yuen, et al, 2018aYuen, et al, , 2018b. Financial constraints are mentioned as the most crucial factor affecting dental service accessibility, while other factors vary in importance in terms of geographical position and demographic groups (Prevolnik Rupel, 2016).…”

Section: Discussionmentioning

confidence: 99%

Factors affecting dental services accessibility

Forjanic¹,

Dermol

Rupel

2019

Obzor Zdrav Neg

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Introduction: Access to dental services is a basic right included in the compulsory health insurance for patients and thus an important part of the healthcare system in Slovenia. The purpose of this research was to identify and explore the factors that have the greatest impact on the accessibility of dental services from the perspective of the system stakeholders in Slovenia.Methods: A qualitative study was conducted based on the focus group method. The focus group consisted of relevant system stakeholders, namely two representatives of the regulator, provider and payer, a total of six participants. A thematic analysis was carried out in order to identify the patterns and themes within thequalitative data obtained.Results: The results of the focus group revealed the views of system stakeholder on the accessibility of dental services in Slovenia. According to the system stakeholders' perspective, accessibility of dental services in Slovenia is not optimal and significant changes in terms of financing and organisation are required.Discussion and conclusion: We found that the lack of adequate human resources, insufficient health insurance and payment for services are the crucial factors in providing adequate access to dental health in Slovenia. In order to increase its accessibility, the dental programme needs to be expanded and the number of teams for its implementation increased.

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Section: Discussionmentioning

confidence: 99%

Factors affecting dental services accessibility

Forjanic¹,

Dermol

Rupel

2019

Obzor Zdrav Neg

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“…The authors observed that primary dental care clinics close to residency of colour/race minorities were more distant to high-frequency public transportation than to clinics close to white majority. 34,35 Level of service infrastructure was also observed to have a significant impact on the use of public dental service in a Brazilian Southeast State when several characteristics of dental service were considered such proportion of dentist and oral health coverage in primary care. 20 However, in this present study, differences between groups were not affected by these characteristics.…”

Section: Ta B L Ementioning

confidence: 99%

“…Full details of the sampling selection can be found elsewhere. 21 SB Brazil 2010 had five target age groups (5,12,(15)(16)(17)(18)(19)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44) and 65-74 years old). The adult population was selected for being the last group to retain many natural teeth, opposed to elderly Brazilians who are observed to have excessive tooth loss, 14 which may further influence the use of dental service.…”

Section: Introductionmentioning

confidence: 99%

Racial inequalities in public dental service utilization: Exploring individual and contextual determinants among middle‐aged Brazilian adults

Constante

2020

Comm Dent Oral Epid

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Objectives To investigate differences between Pardos (mixed) and Blacks with their White counterparts in the use of public dental service among a sample of Brazilian adults taking into consideration the role of individual and contextual characteristics. Methods A total of 6196 adults aged 35‐44 years were sampled from the 2010 Brazilian National Oral Health Survey and nested in one of 27 Brazilian State Capitals. Binary multilevel logistic analyses were conducted. Use of public dental service in the last visit was the outcome, and self‐reported colour/race (Pardo, Black, White) was the explanatory variable. Individual covariates were sex, level of education, family income, self‐reported need for treatment, dental pain in the last 6 months, presence of decayed, filled and missing teeth. The State Capital covariates were proportion of Pardos/Blacks, Human Development Index, Gini coefficient, Integration of dental teams into Brazil Family Health Program and dentist per population rate. Results Pardos and Blacks were 1.25 (95% CI 1.10‐1.42) and 1.73 (95% CI 1.41‐2.11) times, respectively, more likely to visit the public dental service than Whites. Adjustments for level of education and income were more relevant in affecting the estimates between groups than any other covariate, but differences persisted. Colour/race was independently associated with the type of service used in the last dental visit after fully adjusted for individual and State Capital characteristics. Conclusions Racial differences in dental service utilization were evident for middle‐aged adults in Brazil. The results found highlight the importance of investments in public dental service as Pardos and Blacks relied more on this type of service than Whites.

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“…Geographic information systems (GIS) have also been used in dentistry since the 1960s, in part to investigate issues of competition, as well as access to dental care . For example, several studies have assessed the distribution of dental clinics and how they could impact access to dental care in Australia, Brazil, New Zealand and Malaysia . In Canada specifically, the distribution of dental clinics described by Meyer in Ontario, the country's most populated province, revealed that dentists concentrate in large cities where they benefit from higher population growth rates, higher median family incomes and lower average ages.…”

Section: Introductionmentioning

confidence: 99%

Does competition affect the clinical decision‐making of dentists? A geospatial analysis

Ghoneim

Lawrence

et al. 2019

Comm Dent Oral Epid

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Objectives To investigate the association between dentists' geographic density and perceptions of market competition with clinical decision‐making among a representative sample of dentists in Ontario, Canada's most populated province. Methods Competition was quantified using dentist density, defined as the number of dental clinics lying within a one kilometre radius around the respondents' clinic address and by self‐reported perceived pressure from other dental clinics. The outcome (clinical decision‐making or treatment intensity) was measured using a set of clinical scenarios, which categorized dentists as either relatively aggressive or conservative. Associations were assessed using bivariate analysis and logistic and linear regression. Results Dentists who perceived large competitive pressure from other dentists (OR = 1.63, 95% CI: 1.07‐2.49) were relatively more aggressive in their treatment choices. Interestingly, dentists located in very low dentist density areas (OR = 1.31, 95% CI: 1.03‐1.68) were also relatively more aggressive in their treatment choices. Conclusion This study is the first to explore the impact of competition on the clinical decision‐making of dentists in a Canadian context. It presents a valuable addition to the competition literature and helps to understand current dynamics in the Canadian dental care market.

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The equity of access to primary dental care in São Paulo, Brazil: A geospatial analysis

Abstract: Primary dental clinics are maldistributed in São Paulo city, with disadvantaged populations having less spatial access than their advantaged counterparts.

Cited by 14 publications

References 27 publications

Factors affecting dental services accessibility

Factors affecting dental services accessibility

Racial inequalities in public dental service utilization: Exploring individual and contextual determinants among middle‐aged Brazilian adults

Does competition affect the clinical decision‐making of dentists? A geospatial analysis

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