Análise econômica do serviço público de próteses dentárias totais no município de Curitiba

• Autor(a) principal: Silva, Sávio Marcelo Leite Moreira da
• Data de Publicação: 2011
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Repositório Institucional PUCRS
• Texto Completo: http://hdl.handle.net/10923/426
• topic: PRÓTESE DENTÁRIA; ANÁLISE DE CUSTOS (CONTABILIDADE); ODONTOLOGIA; QUALIDADE DE VIDA; SISTEMA ÚNICO DE SAÚDE

The aim of this study was to evaluate the production of complete dentures by the public health system (Sylvio Gevaerd Dental Specialty Center) of Curitiba city, PR, Brazil, in the years 2007, 2008 and 2009, as well as to develop a model to study the cost-effectiveness and cost-utility of complete denture treatment. After obtaining the total number of complete dentures produced in the study period of time, a sample was calculated and drawn to collect data on conditions of use and impact of dentures. A total of 555 patients wearing 899 dentures were interviewed using structured questionnaires. The cost of the denture manufacturing was calculated according to the methods and guidelines of the National Program of Cost Management of the Healthy Ministry of Brazil. The effectiveness index of the treatment was calculated by dividing the number of dentures in continuous use by the total number of installed dentures. The utility index was obtained based on a modified score of OHIP-EDENT. The mean cost of the denture manufacture was R$772. 09, with variations by year: in 2007 the average manufacture cost per denture was R$537. 41; in 2008 this cost was R$625. 31; and in 2009 it was R$1627. 05. Considering the clinical and laboratorial items, the costs with human resources were the most representative item in the denture cost. The average clinical cost of denture manufacturing during the 3-year period was 62. 61%, while the laboratory cost per year was 37. 39%. A total of 66. 96% of the installed dentures were in continuous use, 22. 13% were discarded and 10. 90% were eventually used. The frequency of discarded mandibular dentures (27. 93%) was higher than that of the maxillary dentures (17. 97%). Among the discarded dentures, 65. 33% of the patients quit wearing at least one of the dentures before the first month. The most cited reasons for not using the dentures were injuries to the bearing mucosa (45. 71%) and lack of retention and stability (42. 14%). The cost-effectiveness per denture fabricated by the Dental Specialty Center during the 3-year study period was R$1153. 05; the annual cost-utility was R$1377. 55. The public health service should focus on increasing the number of dentures produced for the given fixed costs, as well as reorganized the manufacturing process to improve the prosthesis effectiveness in terms of adaptation to the bearing area, comfort, retention and stability.