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Oral health care for people with disabilities in Brazil: Transition from the specialized dental services between 2014 and 2018

Objective To identify changes in the dental service provision to people with disabilities (PD) in the Dental Specialties Centers (acronym CEO in Portuguese‐Centro de Especialidades Odontológicas) between the first and second cycles of the Program for the Improvement of Access and Quality of CEO and...

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Published in:Community dentistry and oral epidemiology 2022-02, Vol.50 (1), p.48-57
Main Authors: Queiroz, Rejane Christine de Sousa, Oliveira, Izabel Cristina Vieira de, Silva, Núbia Cristina da, Borges, Tassia Silvana, Nunes, Ana Margarida Melo, Figueiredo, Nilcema, Thomaz, Erika Barbara Abreu Fonseca
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creator Queiroz, Rejane Christine de Sousa
Oliveira, Izabel Cristina Vieira de
Silva, Núbia Cristina da
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Nunes, Ana Margarida Melo
Figueiredo, Nilcema
Thomaz, Erika Barbara Abreu Fonseca
description Objective To identify changes in the dental service provision to people with disabilities (PD) in the Dental Specialties Centers (acronym CEO in Portuguese‐Centro de Especialidades Odontológicas) between the first and second cycles of the Program for the Improvement of Access and Quality of CEO and analyse factors associated with any changes. Methods This nationwide ecological time series study adopted the CEO as the analysis unit. The 827 CEO who participated in the two program's cycles (2014 and 2018) were included. Data on the structure and the work process were considered to identify features of providing services to PD in both cycles. Latent transition analysis (LTA) was performed to identify latent status (LS) with similar features and model the transition between LS over time. Models with five variables and with two to five LS were tested, considered best conceptual interpretability and best model fit parameters: human resources structure (dentist working exclusively with PD) and work process that identified guarantee of PD treatment at the CEO, the CEO’s interface with primary care, and the interface with tertiary care. Spatial analysis was performed to identify spatial patterns of LS in the Brazilian territory with choropleth maps. A multinomial logistic regression model was performed to identify factors associated with changes in the provision of CEO (improved, remained or worsened). Findings The best‐fit model identified four LS: ‘Better’, ‘Medium better’, ‘Medium worse’ and ‘Worse’. CEO remained in the LS ‘Better’ (94%), LS ‘Medium’ (5.3%) and LS ‘Worse’ (78.4%). It is noteworthy that the highest proportion of CEO, in both cycles, was in the LS ‘Better’, featured by the CEO, characterized by all the CEO guaranteeing treatment to users with PD, high proportions of professionals working exclusively with PD, and most CEO articulated with primary care and with tertiary care. However, there is a decrease in the number of postgraduate professionals specializing in this service profile (1.3%). The higher the population growth, the greater the likelihood of the CEO achieving ‘improved’ in the LS. Moreover, the higher the number of goals, the lower the likelihood of the CEO getting ‘worse’ in the LS. Conclusion Advances in dental service provision were observed, with more significant transitions to the ‘Better’ class, with improvements mainly in the interface with primary and tertiary care. Disability will be an even more significant concern as the popu
doi_str_mv 10.1111/cdoe.12719
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Methods This nationwide ecological time series study adopted the CEO as the analysis unit. The 827 CEO who participated in the two program's cycles (2014 and 2018) were included. Data on the structure and the work process were considered to identify features of providing services to PD in both cycles. Latent transition analysis (LTA) was performed to identify latent status (LS) with similar features and model the transition between LS over time. Models with five variables and with two to five LS were tested, considered best conceptual interpretability and best model fit parameters: human resources structure (dentist working exclusively with PD) and work process that identified guarantee of PD treatment at the CEO, the CEO’s interface with primary care, and the interface with tertiary care. Spatial analysis was performed to identify spatial patterns of LS in the Brazilian territory with choropleth maps. A multinomial logistic regression model was performed to identify factors associated with changes in the provision of CEO (improved, remained or worsened). Findings The best‐fit model identified four LS: ‘Better’, ‘Medium better’, ‘Medium worse’ and ‘Worse’. CEO remained in the LS ‘Better’ (94%), LS ‘Medium’ (5.3%) and LS ‘Worse’ (78.4%). It is noteworthy that the highest proportion of CEO, in both cycles, was in the LS ‘Better’, featured by the CEO, characterized by all the CEO guaranteeing treatment to users with PD, high proportions of professionals working exclusively with PD, and most CEO articulated with primary care and with tertiary care. However, there is a decrease in the number of postgraduate professionals specializing in this service profile (1.3%). The higher the population growth, the greater the likelihood of the CEO achieving ‘improved’ in the LS. Moreover, the higher the number of goals, the lower the likelihood of the CEO getting ‘worse’ in the LS. Conclusion Advances in dental service provision were observed, with more significant transitions to the ‘Better’ class, with improvements mainly in the interface with primary and tertiary care. Disability will be an even more significant concern as the population ages. Initiatives that can remove barriers and empower PD are potent in the provision of oral health services.</description><identifier>ISSN: 0301-5661</identifier><identifier>EISSN: 1600-0528</identifier><identifier>DOI: 10.1111/cdoe.12719</identifier><identifier>PMID: 34967965</identifier><language>eng</language><publisher>Denmark: Blackwell Publishing Ltd</publisher><subject>Brazil ; delivery of dental care ; Delivery of Health Care ; Dental Care ; Disabled Persons ; Health care ; Humans ; Oral Health ; Oral hygiene ; People with disabilities ; people with disability ; Population growth ; Primary care ; public health dentistry</subject><ispartof>Community dentistry and oral epidemiology, 2022-02, Vol.50 (1), p.48-57</ispartof><rights>2021 The Authors. published by John Wiley &amp; Sons Ltd.</rights><rights>2021 The Authors. Community Dentistry and Oral Epidemiology published by John Wiley &amp; Sons Ltd.</rights><rights>2021. 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Methods This nationwide ecological time series study adopted the CEO as the analysis unit. The 827 CEO who participated in the two program's cycles (2014 and 2018) were included. Data on the structure and the work process were considered to identify features of providing services to PD in both cycles. Latent transition analysis (LTA) was performed to identify latent status (LS) with similar features and model the transition between LS over time. Models with five variables and with two to five LS were tested, considered best conceptual interpretability and best model fit parameters: human resources structure (dentist working exclusively with PD) and work process that identified guarantee of PD treatment at the CEO, the CEO’s interface with primary care, and the interface with tertiary care. Spatial analysis was performed to identify spatial patterns of LS in the Brazilian territory with choropleth maps. A multinomial logistic regression model was performed to identify factors associated with changes in the provision of CEO (improved, remained or worsened). Findings The best‐fit model identified four LS: ‘Better’, ‘Medium better’, ‘Medium worse’ and ‘Worse’. CEO remained in the LS ‘Better’ (94%), LS ‘Medium’ (5.3%) and LS ‘Worse’ (78.4%). It is noteworthy that the highest proportion of CEO, in both cycles, was in the LS ‘Better’, featured by the CEO, characterized by all the CEO guaranteeing treatment to users with PD, high proportions of professionals working exclusively with PD, and most CEO articulated with primary care and with tertiary care. However, there is a decrease in the number of postgraduate professionals specializing in this service profile (1.3%). The higher the population growth, the greater the likelihood of the CEO achieving ‘improved’ in the LS. Moreover, the higher the number of goals, the lower the likelihood of the CEO getting ‘worse’ in the LS. 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Calcified Tissue Abstracts</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Community dentistry and oral epidemiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Queiroz, Rejane Christine de Sousa</au><au>Oliveira, Izabel Cristina Vieira de</au><au>Silva, Núbia Cristina da</au><au>Borges, Tassia Silvana</au><au>Nunes, Ana Margarida Melo</au><au>Figueiredo, Nilcema</au><au>Thomaz, Erika Barbara Abreu Fonseca</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Oral health care for people with disabilities in Brazil: Transition from the specialized dental services between 2014 and 2018</atitle><jtitle>Community dentistry and oral epidemiology</jtitle><addtitle>Community Dent Oral Epidemiol</addtitle><date>2022-02</date><risdate>2022</risdate><volume>50</volume><issue>1</issue><spage>48</spage><epage>57</epage><pages>48-57</pages><issn>0301-5661</issn><eissn>1600-0528</eissn><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><abstract>Objective To identify changes in the dental service provision to people with disabilities (PD) in the Dental Specialties Centers (acronym CEO in Portuguese‐Centro de Especialidades Odontológicas) between the first and second cycles of the Program for the Improvement of Access and Quality of CEO and analyse factors associated with any changes. Methods This nationwide ecological time series study adopted the CEO as the analysis unit. The 827 CEO who participated in the two program's cycles (2014 and 2018) were included. Data on the structure and the work process were considered to identify features of providing services to PD in both cycles. Latent transition analysis (LTA) was performed to identify latent status (LS) with similar features and model the transition between LS over time. Models with five variables and with two to five LS were tested, considered best conceptual interpretability and best model fit parameters: human resources structure (dentist working exclusively with PD) and work process that identified guarantee of PD treatment at the CEO, the CEO’s interface with primary care, and the interface with tertiary care. Spatial analysis was performed to identify spatial patterns of LS in the Brazilian territory with choropleth maps. A multinomial logistic regression model was performed to identify factors associated with changes in the provision of CEO (improved, remained or worsened). Findings The best‐fit model identified four LS: ‘Better’, ‘Medium better’, ‘Medium worse’ and ‘Worse’. CEO remained in the LS ‘Better’ (94%), LS ‘Medium’ (5.3%) and LS ‘Worse’ (78.4%). It is noteworthy that the highest proportion of CEO, in both cycles, was in the LS ‘Better’, featured by the CEO, characterized by all the CEO guaranteeing treatment to users with PD, high proportions of professionals working exclusively with PD, and most CEO articulated with primary care and with tertiary care. However, there is a decrease in the number of postgraduate professionals specializing in this service profile (1.3%). The higher the population growth, the greater the likelihood of the CEO achieving ‘improved’ in the LS. Moreover, the higher the number of goals, the lower the likelihood of the CEO getting ‘worse’ in the LS. Conclusion Advances in dental service provision were observed, with more significant transitions to the ‘Better’ class, with improvements mainly in the interface with primary and tertiary care. Disability will be an even more significant concern as the population ages. Initiatives that can remove barriers and empower PD are potent in the provision of oral health services.</abstract><cop>Denmark</cop><pub>Blackwell Publishing Ltd</pub><pmid>34967965</pmid><doi>10.1111/cdoe.12719</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-0809-2152</orcidid><orcidid>https://orcid.org/0000-0001-6181-8728</orcidid><orcidid>https://orcid.org/0000-0003-4156-4067</orcidid><orcidid>https://orcid.org/0000-0002-0983-5261</orcidid><orcidid>https://orcid.org/0000-0003-4019-2011</orcidid><orcidid>https://orcid.org/0000-0001-8027-3372</orcidid><oa>free_for_read</oa></addata></record>
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source Wiley-Blackwell Journals
subjects Brazil
delivery of dental care
Delivery of Health Care
Dental Care
Disabled Persons
Health care
Humans
Oral Health
Oral hygiene
People with disabilities
people with disability
Population growth
Primary care
public health dentistry
title Oral health care for people with disabilities in Brazil: Transition from the specialized dental services between 2014 and 2018
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