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: | |
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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 |
Resumo: | 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. |
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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-ABProcesso de trabalhoAtenção primária à saúdeSaúde bucalAvaliação em saúdeWork processPrimary health careOral healthEvaluation in healthCNPQ::CIENCIAS DA SAUDE::SAUDE COLETIVAIn 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.NenhumaCom o intuito de fortalecer a institucionalização da avaliação na Atenção Básica (AB), foi criado o Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica (PMAQ-AB) cujo objetivo era induzir a ampliação do acesso e a melhoria da qualidade da AB. Do seu lançamento, em 2011, até o encerramento, em 2019, foram realizados três ciclos do programa. Diante do exposto, o presente estudo de desenho observacional, analítico e transversal, de base secundária, teve como objetivo avaliar se a organização do processo de trabalho das equipes de Saúde Bucal (eSB) da AB está associada ao acesso e o tempo de espera do usuário aos serviços de saúde bucal, no Brasil, e nas suas regiões, a partir dos dados do 3º ciclo do PMAQ-AB. Foram utilizadas variáveis do Módulo III - referente às respostas dos usuários e do Módulo VI – referente às respostas dos profissionais das eSB. Realizou-se análise descritiva e análise inferencial por meio da regressão logística, para o desfecho 1 “acesso” e regressão logística multinomial, para o desfecho 2 “tempo de espera” categorizado em 1 - espera de até 5 dias (referência); 2 - espera de 6 à 15 dias; 3 - espera de mais de 15 dias. Foram estimadas as Razões de Chances (Odds Ratio – OR) para ambos os desfechos (α=0,05). Como resultados do estudo, verificou-se que, no Brasil, 40,9% dos usuários da AB conseguem marcar atendimento com o dentista na UBS, com uma média de 10 dias de espera para consulta. Nas regiões, o Nordeste é a região em que mais usuários conseguem marcar atendimento com o dentista (48,4%) e o menor tempo de espera para consulta (6,5 dias), enquanto no Sudeste menos usuários conseguem marcar atendimento com o dentista (33,9%) e com maior tempo de espera (17,2 dias). Os modelos de regressão demonstram características do processo de trabalho das eSB associadas ao acesso e tempo de espera (categorias 2 e/ou 3) do usuário à atenção odontológica, no Brasil e suas regiões. Para o Brasil, os fatores foram: A eSB atuar em duas eAB (OR=0,45/ OR=1,53; OR=2,46) e em três eAB (OR=0,32/ OR=1,88; OR=4,34); eSB não receber apoio do CEO (OR=1,62/ OR=0,86; OR=0,76); eSB não realizar ações articuladas com outros equipamentos do território (OR=0,80/ OR=1,17; OR=1,24); eSB não reservar vaga na agenda para o usuário mostrar resultados de exames (OR=0,69/ OR= não significante ; OR=1,60); eSB não realizar acolhimento conjuntamente com a eSB (OR=0,87/ OR=1,40; OR=1,70); o principal fluxo para acolhimento não ser por meio de fila e ficha (OR=1,09/ OR=1,59; OR=1,85) e não ser pela classificação de risco/vulnerabilidade (OR=0,83/ OR=1,23; OR=1,35); a principal forma de marcação da 1º consulta odontológica é no próprio consultório (OR=0,86 /OR=1,10; OR= não significante) e pelo agente comunitário (OR=0,83 /OR=1,08; OR=0,85); a principal forma de marcação da consulta para continuidade do tratamento ser pela eSB agendar e depois comunicar ao usuário (OR=1,29/ OR= não significante; OR=0,79). Devido a diversidade do Brasil, observa-se que estes fatores diferem entre as regiões geográficas. Conclui-se que características do processo de trabalho das eSB comprometem o acesso do usuário à atenção odontológica demandando ações que possibilitem a reorganização do processo de trabalho visando à ampliação do acesso e a melhoria das ações e serviços de saúde.Universidade Federal da ParaíbaBrasilCiências Exatas e da SaúdePrograma de Pós-Graduação em Modelos de Decisão e SaúdeUFPBValença, Ana Maria Gondimhttp://lattes.cnpq.br/3186920393443928Macambira, Ana Flávia Uzêda dos Santoshttp://lattes.cnpq.br/7669386495556144Alencar, Moângela Alves de Sousa2022-03-07T19:16:27Z2021-11-082022-03-07T19:16:27Z2021-09-23info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesishttps://repositorio.ufpb.br/jspui/handle/123456789/22312porAttribution-NoDerivs 3.0 Brazilhttp://creativecommons.org/licenses/by-nd/3.0/br/info:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da UFPBinstname:Universidade Federal da Paraíba (UFPB)instacron:UFPB2022-04-26T12:03:10Zoai:repositorio.ufpb.br:123456789/22312Biblioteca Digital de Teses e Dissertaçõeshttps://repositorio.ufpb.br/PUBhttp://tede.biblioteca.ufpb.br:8080/oai/requestdiretoria@ufpb.br|| diretoria@ufpb.bropendoar:2022-04-26T12:03:10Biblioteca Digital de Teses e Dissertações da UFPB - Universidade Federal da Paraíba (UFPB)false |
dc.title.none.fl_str_mv |
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 |
title |
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 |
spellingShingle |
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 Alencar, Moângela Alves de Sousa 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 |
title_short |
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 |
title_full |
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 |
title_fullStr |
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 |
title_full_unstemmed |
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 |
title_sort |
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 |
author |
Alencar, Moângela Alves de Sousa |
author_facet |
Alencar, Moângela Alves de Sousa |
author_role |
author |
dc.contributor.none.fl_str_mv |
Valença, Ana Maria Gondim http://lattes.cnpq.br/3186920393443928 Macambira, Ana Flávia Uzêda dos Santos http://lattes.cnpq.br/7669386495556144 |
dc.contributor.author.fl_str_mv |
Alencar, Moângela Alves de Sousa |
dc.subject.por.fl_str_mv |
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 |
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 |
description |
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. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021-11-08 2021-09-23 2022-03-07T19:16:27Z 2022-03-07T19:16:27Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/masterThesis |
format |
masterThesis |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://repositorio.ufpb.br/jspui/handle/123456789/22312 |
url |
https://repositorio.ufpb.br/jspui/handle/123456789/22312 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.rights.driver.fl_str_mv |
Attribution-NoDerivs 3.0 Brazil http://creativecommons.org/licenses/by-nd/3.0/br/ info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Attribution-NoDerivs 3.0 Brazil http://creativecommons.org/licenses/by-nd/3.0/br/ |
eu_rights_str_mv |
openAccess |
dc.publisher.none.fl_str_mv |
Universidade Federal da Paraíba Brasil Ciências Exatas e da Saúde Programa de Pós-Graduação em Modelos de Decisão e Saúde UFPB |
publisher.none.fl_str_mv |
Universidade Federal da Paraíba Brasil Ciências Exatas e da Saúde Programa de Pós-Graduação em Modelos de Decisão e Saúde UFPB |
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reponame:Biblioteca Digital de Teses e Dissertações da UFPB instname:Universidade Federal da Paraíba (UFPB) instacron:UFPB |
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Universidade Federal da Paraíba (UFPB) |
instacron_str |
UFPB |
institution |
UFPB |
reponame_str |
Biblioteca Digital de Teses e Dissertações da UFPB |
collection |
Biblioteca Digital de Teses e Dissertações da UFPB |
repository.name.fl_str_mv |
Biblioteca Digital de Teses e Dissertações da UFPB - Universidade Federal da Paraíba (UFPB) |
repository.mail.fl_str_mv |
diretoria@ufpb.br|| diretoria@ufpb.br |
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1801842988507201536 |