Acesso efetivo aos serviços odontológicos em áreas cobertas pela Estratégia Saúde da Família em município brasileiro

• Autor(a) principal: Freire, Deborah Ellen Wanderley Gomes
• Data de Publicação: 2018
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UEPB
• Texto Completo: http://tede.bc.uepb.edu.br/jspui/handle/tede/3414
• topic: Estratégia Saúde da Família; Serviços de saúde bucal; Acesso aos serviços de saúde; Access to health services; Family Health Strategy; Oral health services; SAUDE COLETIVA::SAUDE PUBLICA

Access to oral health services has been increasing in recent years; However, improvements are still necessary to consolidate policies that are capable on reducing inequalities in oral health. Monitoring health conditions, access and use of these services is important in order to better guide public policies in the country. OBJECTIVES: To evaluate the effective access to oral health services in areas covered by the Family Health Strategy (ESF). MATERIALS AND METHODS: This study was a quantitative and analytical one, with a cross-sectional, population-based design, carried out in the city of Patos-PB. The sample was a probabilistic one and consisted in 609 individuals. The selection of the sample occurred in multiple stages, following the flow: census sectors - households - individuals, considering the areas covered by the Family Health Strategy. For the collection of data, it was used an intensive direct observation technique through a digital form adapted from the aggregation of previously validated forms. After the data collection, a descriptive statistical analysis of the data was performed using the software SPSS version 20.0 and then the associations were tested using Pearson's Chi-square, considering a level of 5% as significant. From this, a dichotomous variable was created aiming to use bivariate and multivariat e Poisson regression analysis with robust variance (α <0.05) to determine the association between the dependent variable obtaining full access to health services and the independent variables. A hierarchical approach procedure was used in the multivariate regression model to select the variables that reached a value of p <0.20 in the bivariate analysis. The variables with p-value <0.05 in the adjusted analysis were maintained in the final regression model. RESULTS: The sample consisted mostly of female subjects, in the age group corresponding to adults in the reproductive phase, married or with a partner, with a level of education up to the complete primary education, familiar income of up to1 minimum salary and with no registration in minimum income programs. In the two years before the survey there was a greater use of private oral health service. In the bivariate analysis, the variables that were associated with access were: respondent’s age (p<0.001), respondent and familiar income (p<0.001), education level (p<0.001), self- perception of oral health (p=0.028) and toothache report in life (p=0.012) and in the last 6 months (p=0.023). There was no association: gender of the individual and register in a minimum income program. In the multivariate model, remained the association with the variable respondent’s age, in which younger individuals had more chance to get a full access to oral health actions. CONCLUSIONS: The results show that, despite the advances related to the expansion of access to oral health services, it is still not possible to guarantee the equity and integrality of care. There are still inequalities in the access, and we realize that the increase in the coverage of the Oral Health Teams did not represent, in fact, a change in the work process, since much still needs to be done to reduce inequities and increase access to actions of health promotion and prevention of oral diseases in this city.