Dataset Information

Assessment of public oral healthcare services in Curitiba, Brazil: a cross-sectional study using the Primary Care Assessment Tool (PCATool).

ABSTRACT:

Objectives

To compare two different models of public oral health in primary care services, a so-called family health strategy (FHS), as opposed to non-FHS services designated as 'conventional' healthcare (CHC), regarding the presence and extent of the attributes of 'good' primary healthcare (PHC). The null hypothesis of this study is that the attributes do not differ between the FHS and CHC.

Design

Cross-sectional.

Setting

Public PHC services in Curitiba, the state capital of Paraná.

Participants

PHC users of the public oral health network (n=900) and dentists active in this municipal network (n=203).

Primary and secondary outcome measures

The Primary Care Assessment Tool (PCATool)-Dentists and PCATool-Users were used to analyse the primary outcomes ('essential' attributes) and secondary outcomes ('derived' attributes) in the PHC.

Results

Overall, the primary care services in oral health were well evaluated, both by users and by dentists, with mean scores ascribed to PHC attributes mostly above the cut-off point (6.6). The exception for users were affiliation (6.36; 95%?CI 6.11 to 6.60) and accessibility (5.83; 95%?CI 5.78 to 5.89); and for dentists the accessibility (5.80; 95%?CI 5.63 to 5.96). When comparing FHS and CHC, there was a superiority of the FHS model, which reached a general mean score of 7.53 (95% CI 7.48 to 7.58) among users and 7.56 (95% CI 7.45 to 7.67) among dentists; on the other hand, the CHC general mean score was of 6.61 (95% CI 6.49 to 6.73) and 6.68 (95% CI 6.56 to 6.80) respectively for users and dentists.

Conclusions

The results reveal a reasonable level of attainment of PHC attributes in the services investigated. Nevertheless, public health managers should make efforts to reduce the difficulties faced by users in accessing dental care. The more positive results achieved by FHS services indicate that the provision of oral healthcare under this strategy should be expanded.

SUBMITTER: Nascimento AC

PROVIDER: S-EPMC6340483 | biostudies-literature | 2019 Jan

REPOSITORIES: biostudies-literature

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Publications

Assessment of public oral healthcare services in Curitiba, Brazil: a cross-sectional study using the Primary Care Assessment Tool (PCATool).

Nascimento Antonio Carlos AC Moysés Simone Tetü ST Werneck Renata Iani RI Gabardo Marilisa Carneiro Leão MCL Moysés Samuel Jorge SJ

BMJ open 20190117 1

<h4>Objectives</h4>To compare two different models of public oral health in primary care services, a so-called family health strategy (FHS), as opposed to non-FHS services designated as 'conventional' healthcare (CHC), regarding the presence and extent of the attributes of 'good' primary healthcare (PHC). The null hypothesis of this study is that the attributes do not differ between the FHS and CHC.<h4>Design</h4>Cross-sectional.<h4>Setting</h4>Public PHC services in Curitiba, the state capital ...[more]

PMID: 30659038

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Project description:ObjectivesQuantify the risk of mental health (MH)-related emergency department visits (EDVs) due to heat, in the city of Curitiba, Brazil.DesignDaily time series analysis, using quasi-Poisson combined with distributed lag non-linear model on EDV for MH disorders, from 2017 to 2021.SettingAll nine emergency centres from the public health system, in Curitiba.Participants101 452 EDVs for MH disorders and suicide attempts over 5 years, from patients residing inside the territory of Curitiba.Main outcome measureRelative risk of EDV (RREDV) due to extreme mean temperature (24.5°C, 99th percentile) relative to the median (18.02°C), controlling for long-term trends, air pollution and humidity, and measuring effects delayed up to 10 days.ResultsExtreme heat was associated with higher single-lag EDV risk of RREDV 1.03(95% CI 1.01 to 1.05-single-lag 2), and cumulatively of RREDV 1.15 (95% CI 1.05 to 1.26-lag-cumulative 0-6). Strong risk was observed for patients with suicide attempts (RREDV 1.85, 95% CI 1.08 to 3.16) and neurotic disorders (RREDV 1.18, 95% CI 1.06 to 1.31). As to demographic subgroups, females (RREDV 1.20, 95% CI 1.08 to 1.34) and patients aged 18-64 (RREDV 1.18, 95% CI 1.07 to 1.30) were significantly endangered. Extreme heat resulted in lower risks of EDV for patients with organic disorders (RREDV 0.60, 95% CI 0.40 to 0.89), personality disorders (RREDV 0.48, 95% CI 0.26 to 0.91) and MH in general in the elderly ≥65 (RREDV 0.77, 95% CI 0.60 to 0.98). We found no significant RREDV among males and patients aged 0-17.ConclusionThe risk of MH-related EDV due to heat is elevated for the entire study population, but very differentiated by subgroups. This opens avenue for adaptation policies in healthcare: such as monitoring populations at risk and establishing an early warning systems to prevent exacerbation of MH episodes and to reduce suicide attempts. Further studies are welcome, why the reported risk differences occur and what, if any, role healthcare seeking barriers might play.

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Dataset Information

Assessment of public oral healthcare services in Curitiba, Brazil: a cross-sectional study using the Primary Care Assessment Tool (PCATool).

Objectives

Design

Setting

Participants

Primary and secondary outcome measures

Results

Conclusions

Publications

Assessment of public oral healthcare services in Curitiba, Brazil: a cross-sectional study using the Primary Care Assessment Tool (PCATool).

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