A organização do processo de trabalho das equipes de saúde bucal e o acesso à atenção odontológica na atenção básica: análise a partir do 3º ciclo do PMAQ-AB

• Autor(a) principal: Alencar, Moângela Alves de Sousa
• Data de Publicação: 2021
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UFPB
• Texto Completo: https://repositorio.ufpb.br/jspui/handle/123456789/22312
• topic: Processo de trabalho; Atenção primária à saúde; Saúde bucal; Avaliação em saúde; Work process; Primary health care; Oral health; Evaluation in health; CNPQ::CIENCIAS DA SAUDE::SAUDE COLETIVA

In order to strengthen the institutionalization of evaluation in Primary Care (known by the acronym AB), the National Program for Improving Access and Quality of Primary Care (known by the acronym PMAQ-AB) was created, whose objective was to induce the expansion of the access and the improvement of the AB’s quality. From its launch in 2011, until its closure, in 2019, three cycles of the program were carried out. Given the above, the following observational, analytical and cross-sectional, secondary-based study aimed to assess whether the organization of the work process of the Oral Health teams (known by the acronym eSB) of the AB is associated with the access and the user’s waiting time to oral health services in Brazil and in its regions, based on data from the 3rd cycle of the PMAQ-AB. Variables from Module III were used - referring to the users' answers and from Module VI - referring to the eSB professionals’ answers. Descriptive analysis and inferential analysis were performed using the logistic regression for outcome 1 “access” and multinomial logistic regression for outcome 2 “waiting time” categorized in 1 - waiting up to 5 days (reference); 2 - waiting 6 to 15 days; 3 - waiting for more than 15 days. Odds Ratio (OR) were estimated for both outcomes (α=0.05). As results of the study, it was found that, in Brazil, 40.9% of AB users manage to make an appointment with the dentist at the UBS, with an average of 10 days of waiting for an appointment. In the regions, the Northeast is the region in which more users are able to make an appointment with the dentist (48.4%) and the shortest waiting time for an appointment (6.5 days), while in the Southeast, fewer users are able to make an appointment with the dentist (33.9%) and with longer waiting time (17.2 days). The regression models demonstrate characteristics of the eSB's work process associated with access and waiting time (categories 2 and/or 3) of the user to the dental care, in Brazil and its regions. For Brazil, the factors were: the eSB act in two eAB (OR=0.45/ OR=1.53; OR=2.46) and in three eAB (OR=0.32/OR=1.88; OR=4.34); eSB not receiving support from the CEO (OR=1.62/ OR=0.86; OR=0.76); eSB does not carry out actions articulated with other equipment of the territory (OR=0.80/ OR=1.17; OR=1.24); eSB does not reserve a place in the schedule for the user to show exam results (OR=0.69/ OR= not significant,; OR=1.60); eSB does not perform host together with the eSB (OR=0.87/ OR=1.40; OR=1.70); the main flow for reception is not through queue and sheet (OR=1.09/OR=1.59; OR=1.85) and not be by risk/vulnerability classification (OR=0.83/ OR= 1.23; OR=1.35); the main form of booking the 1st dental appointment is in the office itself (OR=0.86 /OR=1.10; OR= not significant) and by the community agent (OR=0.83 /OR=1.08; OR=0.85); the main way to schedule an appointment for continuity of the treatment is by the eSB to schedule and then communicate to the user (OR=1.29/OR= not significant; OR=0.79). Due to the diversity of Brazil, it is observed that these factors differ between geographic regions. It is concluded that characteristics of the eSB's work process compromise the user's access to dental care, demanding actions that enable the reorganization of the work process, aiming at expanding access and improving health actions and services.