Abstract:
:The study aimed to: (1) describe the work process in Brazil's oral health teams, based on the essential attributes of primary health care, according to geographic region, type of team, and the municipality's socioeconomic characteristics and (2) verify whether the data in the work process of the oral health teams in the Brazilian National Program to Improve Access and Quality in primary health (PMAQ-AB) were capable of measuring such attributes. This was a nationwide ecological study with data from cycle I of PMAQ-AB. The study included descriptive, exploratory factor, and confirmatory factor analyses (α = 5%). Constructs were analyzed in light of the essential attributes of primary health care (first contact, coordination of care, comprehensiveness, and continuity). The first three constructs and a fourth factor were formed, called dental prosthesis actions. However, the continuity attribute was not formed. The models' goodness-of-fit measures were satisfactory. Factor loads were greater than 0.5, except for the two variables in factor 3. The actions most frequently performed by the oral health teams (> 60%) were in first contact, and the least frequent were those in comprehensiveness, highlighting referrals to specialties (7.6%). There were differences in the work process in oral health teams between regions of the country, type of team, and certification strata (p < 0.05). In conclusion, data on the work process in oral health teams from cycle primary health care in the services' work routine. Further research is recommended on continuity of care. In addition, the oral health teams participating in cycle I of PMAQ-AB should make further progress in actions related to comprehensiveness and coordination of care. :Os objetivos do estudo foram: (1) descrever o processo de trabalho das equipes de saúde bucal (ESB) do Brasil, com base nos atributos essenciais da atenção primária à saúde, segundo regiões, tipo de equipe e características socioeconômicas dos municípios; e (2) verificar se os dados do processo de trabalho das ESB do Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica (PMAQ-AB) foram capazes de aferir tais atributos. Estudo ecológico, de abrangência nacional, com dados do ciclo I do PMAQ-AB. Foram feitas análises descritivas, fatoriais exploratória e confirmatória (α = 5%). Os construtos formados foram analisados à luz dos atributos essenciais da atenção primária à saúde (primeiro contato, coordenação do cuidado, integralidade e longitudinalidade). Formaram-se os três primeiros construtos e um quarto fator, denominado ações em prótese dentária. Porém, o atributo longitudinalidade não foi conformado. As medidas de ajuste dos modelos foram satisfatórias. As cargas fatoriais foram maiores que 0,5, exceto para duas variáveis do fator 3. As ações mais realizadas pelas ESB (> 60%) foram as do primeiro contato e as menos comuns foram as da integralidade, destacando-se ter referência para especialidades (7,6%). Houve diferenças no processo de trabalho das ESB entre as regiões, tipo de equipe e estrato de certificação (p < 0,05). Conclui-se que os dados de processo de trabalho das ESB do ciclo I do PMAQ-AB foram capazes de discriminar três dos quatro atributos essenciais da atenção primária à saúde na rotina dos serviços. Sugere-se aprofundar a avaliação da longitudinalidade. Ademais, as ESB participantes do ciclo I do PMAQ-AB precisam avançar nas ações relacionadas à integralidade e coordenação do cuidado. :Los objetivos de este trabajo fueron: (1) describir el proceso de trabajo de los equipos de salud bucal (ESB) en Brasil, conforme los atributos esenciales de la atención primaria a la salud, según regiones, tipo de equipo y características socioeconómicas de los municipios; además de (2) verificar si los datos del proceso de trabajo de las ESB en el Programa Nacional de Mejora del Acceso y Calidad de la Atención Básica (PMAQ-AB) fueron capaces de evaluar tales atributos. Es un estudio ecológico, de cobertura nacional, con datos del ciclo I del PMAQ-AB. Se realizaron análisis descriptivos, factoriales exploratorios y confirmatorios (α = 5%). Los constructos creados se analizaron a la luz de los atributos esenciales de la atención primaria a la salud (primer contacto, coordinación del cuidado, integralidad y longitudinalidad). Se generaron los tres primeros constructos, y un cuarto factor, denominado acciones en prótesis dental. No obstante, el atributo longitudinalidad no se configuró. Las medidas de ajuste de los modelos fueron satisfactorias. Las cargas factoriales fueron mayores que 0,5, excepto en dos variables del factor 3. Las acciones más realizadas por las ESB (> 60%) fueron las de primer contacto, y las menos comunes fueron las de integralidad, destacándose contar con referencias para especialidades (7,6%). Hubo diferencias en el proceso de trabajo de las ESB entre las regiones, tipo de equipo y extracto de certificación (p < 0,05). Se concluye que los datos del proceso de trabajo de las ESB del ciclo I del PMAQ-AB fueron capaces de discriminar tres de los cuatro atributos esenciales de la atención primaria a la salud en la rutina de los servicios. Se sugiere profundizar en la evaluación de la longitudinalidad. Además, las ESB participantes del ciclo I del PMAQ-AB necesitan avanzar en acciones relacionadas con la integralidad y coordinación del cuidado.
journal_name
Cad Saude Publicajournal_title
Cadernos de saude publicaauthors
Fagundes DM,Thomaz EBAF,Queiroz RCS,Rocha TAH,Silva NCD,Vissoci JRN,Calvo MCM,Facchini LAdoi
10.1590/0102-311X00049817subject
Has Abstractpub_date
2018-09-06 00:00:00pages
e00049817issue
9eissn
0102-311Xissn
1678-4464pii
S0102-311X2018000905005journal_volume
34pub_type
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