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2.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 58(10): 1034-1040, 2023 Oct 09.
Artigo em Chinês | MEDLINE | ID: mdl-37818539

RESUMO

Objective: To investigate and analyze the allocation status of oral health resources in Yunnan Province at the end of the 13th Five-Year Plan, providing a scientific basis for the rational resource allocation and formulation regional oral health plan for government health administrative departments. Methods: With the method of general survey, a cross-sectional study was conducted to investigate the allocation of material and human resources of all kinds of stomatological medical institutions registered in the health administrative departments in Yunnan before January 1, 2020. The general situation of oral health resources was analyzed by descriptive statistical analysis. Results: There were 2 712 stomatological medical institutions in Yunnan, 634 public and 2 078 non-public included. The largest number was in Kunming (1 167) and the least in Diqing (19). There were 9 018 dental chairs in total, among which 2 584 in public and 6 434 in non-public. Kunming had the largest number of chairs (3 612) and Nujiang had the least (57). There were 702 oral and maxillofacial surgical beds, all of which were distributed in public. There were 15 148 stomatological personnel, including 3 667 in public and 11 481 in non-public. The average ratio of stomatologist to population was 1∶6 615. Dehong (1∶6 620) was close to this average level, while Kunming (1∶2 283) and Yuxi (1∶4 936) were lower than the average and the other 13 states (cities) were higher. The population ratio of licensed stomatologist was only 1∶9 110. The average ratio of stomatologist to nurses was 1∶0.94. Honghe (1∶1.05), Kunming (1∶1.00), Yuxi (1∶1.18) and Qujing (1∶0.94) was better than or reached the average level, while the other 13 states (cities) were lower than this average. And this ratio in public comprehensive medical institutions was only 1∶0.38. Conclusions: The distribution of oral health resources in Yunnan was unbalanced between public and non-public institutions and among states (cities), mainly distributed in economically developed states (cities) and non-public institutions. For the oral health in Yunnan Province, the workforce was insufficient and the structure was unreasonable, and the proportion of nurses was seriously insufficient in public comprehensive medical institutions.


Assuntos
Saúde Bucal , Medicina Bucal , Humanos , Estudos Transversais , China/epidemiologia , Alocação de Recursos
3.
Artigo em Russo | MEDLINE | ID: mdl-36801880

RESUMO

At the actual stage of becoming of Russian stomatology, the problem of sustainable development of rural stomatological care, as system of local formations of complex medical social nature belongs to national priorities and is considered as one of most important directions of public social policy. The stomatological health of rural population is to be considered as indicator of national stomatological health. This is confirmed by spatial structure: rural territories (inhabited territories outside cities) cover 2/3 of territory of the Russian Federation with population of 37.3 million or 1/4 of total population. The spatial structure of the Belgorod Oblast is reliably similar to the all-Russian one. The number of national and foreign studies proved that accessibility, quality and timeliness of insurance (state) stomatology is lower for rural residents that can be considered as one of signs of social inequality. Depending on the social economic status of region, signs of social inequality in the stomatology field are conditioned by broad spectrum of factors. Some of them are discussed in the article.


Assuntos
Medicina Bucal , População Rural , Humanos , Federação Russa/epidemiologia , Cidades
4.
Rev. cuba. inform. méd ; 14(2): e563, jul.-dic. 2022. tab
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1408544

RESUMO

Introducción: Al elaborar una metodología resulta importante obtener los criterios de expertos antes de su aplicación. En un periodo precedente a esta investigación se elaboró una metodología con etapas y procedimientos para el desarrollo de software educativo. Objetivo: Valorar la pertinencia de la metodología para la integración de software educativo en el proceso de enseñanza-aprendizaje de las asignaturas Rehabilitación I y II de Estomatología. Método: Se realizó una investigación pedagógica en la Universidad de Ciencias Médicas de Holguín. Para valorar la pertinencia de la metodología se aplicó el método Delphi, a partir del cual, mediante una encuesta aplicada a 17 expertos seleccionados por su alto coeficiente de competencia en la temática, se pudo llegar a un consenso sobre el tema explorado. Resultados: La aplicación del cuestionario reveló que la mayoría de los expertos consideró cada indicador de la dimensión validez como muy adecuado, solo uno evaluó el indicador etapas de la metodología como adecuado y los procedimientos de la etapa dos como bastante adecuados. Para la dimensión viabilidad casi la totalidad consideró muy adecuados los indicadores factibilidad de aplicación y posibilidad de generalización; esta última fue evaluada por un experto como adecuada. Al comparar los resultados de los siete indicadores con los puntos de corte se aprecia que los expertos en su conjunto los definen como muy adecuados. Conclusiones: La pertinencia de la metodología se constató con el criterio consensuado de los expertos, quienes consideraron muy adecuados los aspectos valorados, y realizaron aportes que permitieron perfeccionarla antes de su implementación. Sobre estas bases no fue necesaria una segunda etapa de aplicación del método(AU)


Introduction: When developing a methodology, it is important to obtain the criteria of experts before its application. In a period preceding this research, a methodology with stages and procedures was defined for the development of educational software. Objective: To assess the relevance of the methodology for the integration of educational software in the teaching-learning process of the subjects Rehabilitation I and II of Stomatology. Method: A pedagogical research was carried out at the University Of Medical Sciences Of Holguín. To assess the relevance of the methodology, the Delphi method was applied, from which, through a survey applied to 17 experts selected for their high coefficient of competence in the subject, a consensus could be reached on the explored topic. Results: The application of the questionnaire revealed that most of the experts considered each indicator of the validity dimension as very adequate; only one evaluated the indicator stages of the methodology as adequate and the procedures of stage two as quite adequate. For the feasibility dimension, almost all considered the feasibility of application and possibility of generalization indicators to be very adequate; the latter was evaluated by an expert as adequate. When comparing the results of the seven indicators with the cut-off points, it can be seen that the experts as a whole define them as very adequate. Conclusions: The relevance of the methodology was verified with the agreed criteria of the experts, who considered the aspects evaluated to be very adequate, and made contributions that allowed it to be perfected before its implementation. On these bases, a second stage of application of the method was not necessary(AU)


Assuntos
Humanos , Aplicações da Informática Médica , Técnica Delphi , Revisão da Pesquisa por Pares , Medicina Bucal , Multimídia , Tecnologia da Informação/normas , Tecnologia/métodos
5.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 57(11): 1156-1162, 2022 Nov 09.
Artigo em Chinês | MEDLINE | ID: mdl-36379895

RESUMO

Objective: To study the quantity, structure and allocation equity of stomatologists, in order to provide bases and advices for improving the allocation of stomatologists in China. Methods: On the basis of data from China Health Statistics Yearbooks and Brief Book of Administrative Divisions of the People's Republic of China, the general situation of stomatologists was analyzed by descriptive analysis. Gini coefficient was used to evaluate the allocation equity in 2010 and 2020. Results: The total number of stomatologists reached 2 780 hundred in 2020, which increased by 150.5% compared with that in 2010. The overall quality structure of stomatologists had improved. The gender proportion was balanced and the age distribution was reasonable. The team was mainly composed by the young people, in which the numbers under 44 years old accounted for 71.6% (1 991 hundred/2 780 hundred). The proportion of personnel with senior professional titles decreased to 7.9% (220 hundred/2 780 hundred) while the total number increased to 220 thousand. The distribution of stomatologists by population was fair. Gini coefficients of the whole country as well as the eastern, central and western regions were less than 0.3. Conclusions: The quantity, quality and allocation equity of stomatologists were still insufficient in China. It is necessary to optimize the human resources allocation for stomatologists. It is suggested to increase the talents supply through supply-side reform, medicine-education collaboration and multi-agent participation. And it is suggested to optimize criterions to improve the quality of stomatologists.


Assuntos
Alocação de Recursos , Adolescente , Adulto , Humanos , China , Medicina Bucal , Odontólogos/provisão & distribuição
6.
Artigo em Russo | MEDLINE | ID: mdl-36282665

RESUMO

The paper highlights the issues of monitoring and assessing the state of infection control conducted over four years of research in order to prevent infections associated with the provision of medical dental care to the population of the republic. The results are presented at baseline and periodically in order to predict and scientifically substantiate preventive measures. The studies were carried out in dental organizations using the "Evaluation sheet of the state of infection control in dentistry" which included 31 criteria for seven functional and organizational blocks by the method of direct observation of existing practices, interviewing medical staff, discussion of causal relationships between processes and phenomena (qualitative assessment) and the method calculating a numerical expression of the percentage between existing and expected compliance with infection control requirements (quantification). As a result of the fourth Monitoring and Evaluation, indicators of compliance with infection control requirements showed a significant increase, both in general - by 37.2% (2.4 times compared to the baseline monitoring and evaluation), and in the functional blocks of the infection control system. The growth rate was 116.5%, the rate of increase was 16.5% (p<0.05). However, the indicators remain low, which requires further improvement of the system of measures for the prevention of infections associated with the provision of dental care to the population.


Assuntos
Controle de Infecções , Medicina Bucal , Humanos , Quirguistão , Organizações , Serviços de Saúde
7.
Lima; IETSI; sept. 2022.
Não convencional em Espanhol | BRISA/RedTESA | ID: biblio-1551701

RESUMO

ANTECEDENTES: El presente documento expone la evaluación de la eficacia y seguridad del equipo de aspiración de vacío extraoral en comparación con el eyector de saliva o el aspirador de secreción con flujo de succión no menor a 50 L/min (actualmente disponibles en la institución), para prevenir la infección por SARS-CoV-2 en personal sanitario expuesto durante procedimientos estomatológicos. ASPECTOS GENERALES: La pandemia por la enfermedad por coronavirus (COVID-19) ha tenido un impacto significativo en la atención odontológica (Abdelrahman et al. 2021; Cagetti et al. 2021). En diversos países, la atención odontológica ambulatoria fue interrumpida al inicio de la pandemia, a excepción de la atención de emergencia y urgencia dental (Abdelrahman et al. 2021; Cagetti et al. 2021). Esta interrupción de las atenciones odontológicas se debió a que 14,tc. 1 el cuidado dental implica un contacto cercano con el paciente durante periodos de tiempo "or prolongados, lo que genera preocupación sobre la transmisión del SARS-CoV-2 a través de la generación de aerosoles durante los procedimientos estomatológicos (Meng, Hua, and Bian 2020; Peng et al. 2020). De acuerdo con los Centers for Disease Control and Prevention (CDC), los dispositivos dentales que generan aerosoles y contaminan el aire incluyen al raspador ultrasónico, la pieza de mano dental de alta velocidad, jeringa de aire o agua, pulido y abrasión por aire (Centers for Disease Control and Prevention 2022). Estos procedimientos generan una mezcla de aerosoles y gotitas (miden 0.001 a 50 pm de diámetro) que contienen sangre y saliva con diversos patógenos (T. S. Singh and Mabe 2009), lo que genera un ambiente con alto potencial de transmisión de enfermedades como la COVID-19 (Peng et al. 2020). En base a este aumento del riesgo de transmisión de SARS-CoV-2 en los trabajadores de salud, los responsables de formular políticas y los equipos clínicos han optado por reevaluar y adaptar la atención odontológica en respuesta a los desafíos de la pandemia por COVID-19 (World Health Organization 2020b). METODOLOGÍA: La búsqueda sistemática se realizó en las bases de datos bibliográficas PubMed, The Cochrane Library, Web of Science y LILACS (Literatura Latinoamericana y del Caribe en Ciencias de la Salud). Asimismo, se realizó una búsqueda en las páginas web de grupos o instituciones que realizan revisiones sistemáticas (RS), evaluación de tecnologías sanitarias (ETS) y guías de práctica clínica (GPC), tales como el National Institute for Health and Care Excellence (NICE), la Canadian Agency for Drugs and Technologies in Health (CADTH), el Scottish Medicines Consortium (SMC), la Haute Authorité de Santé (HAS), el Institute for Quality and Efficiency in HealthCare (IQWiG), el Institute for Clinical and Economic Review (ICER) yen la Base Regional de Informes de Evaluación de Tecnologías en Salud de las Américas (BRISA), y en las principales instituciones o sociedades especializadas en odontología: la American Dental Association y la British Dental Association. Adicionalmente, se llevó a cabo una búsqueda manual en el motor de búsqueda Google utilizando los términos: (("extra-oral" OR extraoral) AND (vacuum OR aspirator OR suction) AND (COVID-19 OR SARS-CoV-2)) y (("extra-oral" OR extraoral) AND (vacuum OR aspirator OR suction) AND (virus OR viral)); revisando en las diez primeras páginas de resultados, a fin de poder identificar otras publicaciones de relevancia que pudiesen haber sido omitidas por la estrategia de búsqueda o que no hayan sido publicadas en las bases de datos bibliográficas consideradas. Finalmente, se realizó una búsqueda manual de las referencias de los estudios que ingresaron a la fase de texto completo, así como una búsqueda manual en la plataforma ClinicalTrials.gov para identificar ensayos clínicos aleatorizados (ECA) en curso o que no hayan sido publicados aún. RESULTADOS: GPC: gula de práctica clínica; ETS: evaluación de tecnologías sanitarias; RS: revisión sistemática; ECA: ensayo clínico aleatorizado; EO: estudio observacional; LILACS: Literatura Latinoamericana y del Caribe en Ciencias de la Salud; BRISA: Base Regional de Informes de Evaluación de Tecnologías en Salud de las Américas; JDA: Japan Dental Association, NHS: National Health Service. Flujograma adaptado de: Page MJ, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021;372:n71. CONCLUSIONES: El presente dictamen preliminar tuvo por objetivo realizar una evaluación sobre la eficacia y seguridad del equipo de aspiración de vacío extraoral en comparación con el eyector de saliva y el aspirador de secreción con flujo de succión no menor a 50 L/min (actualmente disponibles en la institución), para prevenir la infección por SARS-CoV-2 en personal sanitario expuesto durante procedimientos estomatológicos. Se identificaron una GPC (Hoshi et al.) y cinco documentos de recomendación realizados por Centers for Disease Control and Prevention, World Health Organization, Dental Council of India, Federal Ministry of Health of Nigeria y Government of Canada relevantes para el tema. La GPC emite una recomendación sobre la tecnología de interés; sin embargo, esta recomendación tuvo un muy bajo nivel de evidencia y recomendación débil debido a que se basó en un único estudio de simulación, lo cual no permite extrapolar los resultados a un entorno clínico de la vida real con pacientes o personal de salud. Ninguno de los documentos de recomendación incluidos emite recomendaciones sobre la intervención de interés (equipo de aspiración de vacío extraoral), sino que hacen referencia a los dispositivos evacuadores de alto volumen que son de uso intraoral, diferentes a lo solicitado. Asimismo, recomiendan otras medidas que se deben tomar en cuenta para mitigar la transmisión de enfermedades durante procedimientos generadores de aerosoles, donde destacan el uso de diques dentales, uso de equipo de protección personal adecuado, odontología a cuatro manos, y enjuagues bucales con clorhexidina. En el documento del MINSA, destacan una serie de disposiciones que deben instaurarse al momento de realizar una atención odontológica. Dentro de estas disposiciones destacan las medidas que debe utilizar el personal de salud dental antes, durante y después de la atención (principalmente, el uso del equipo de protección personal), en los establecimientos odontológicos (como una ventilación adecuada) y el esquema de vacunación completo del personal de salud. Las acciones combinadas tendrían un impacto positivo en la prevención de la infección por SARS-CoV-2. Por lo expuesto, el !ETS' no aprueba el uso del equipo de aspiración de vacío extraoral para prevenir la infección por SARS-CoV-2 en personal sanitario expuesto durante procedimientos estomatológicos.


Assuntos
Humanos , Sucção/normas , Pessoal de Saúde/normas , Medicina Bucal/instrumentação , Técnicas e Procedimentos Diagnósticos/normas , COVID-19/prevenção & controle , Eficácia , Análise Custo-Benefício
8.
Artigo em Russo | MEDLINE | ID: mdl-35439391

RESUMO

To improve quality and efficiency of primary health care and to strengthen its preventive directivity is possible through health care modernization including implementation of management technologies, development of database for evaluation and control. The purpose of the study is to develop method of evaluating activity of stomatologic clinic. The methodology was based on concepts of "functional systems" and "decision making". The listing of informative criteria was based on data analysis of functioning of stomatologic service of the Chechen Republic in 2002-2016 and results of sociological survey of stomatologists (n=181), health care administrators in stomatology (n=45), paramedics (n=220) and patients (n=359). The experts (n=13) developed required number of criteria and their gradation. The algorithm of evaluating activity of stomatologic clinic was developed using systematic approach. The listing of 52 criteria and their 10 blocks were established. The experts established coefficients of significance of criteria (0.0084-0.0781; ≥0.0224 - more significant, <0.0224 - less significant). Three levels were determined for each criterion (according principle of minimization) that became a basis for calculation of integrated indicator of efficiency of functioning of stomatologic polyclinic. The expanded methodological approaches ensure comparartivity of estimates of stomatologic polyclinic in various time periods. The health care authorities have opportunity to objectify analysis of functioning of a number of polyclinics in different periods.


Assuntos
Medicina Bucal , Medicina Preventiva/normas , Atenção Primária à Saúde/normas , Pessoal Técnico de Saúde , Instituições de Assistência Ambulatorial , Tomada de Decisões , Serviços de Saúde , Humanos , Medicina Bucal/normas , Federação Russa , Inquéritos e Questionários
9.
Educ. med. super ; 35(2): e2953, 2021. tab
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1286227

RESUMO

Introducción: Contar con un instrumento de calidad que contribuya a unificar criterios y a elevar el grado de preparación del personal en la atención de las urgencias médicas durante la práctica estomatológica, es una necesidad para los docentes de esta especialidad. Objetivo: Evaluar los protocolos de atención para urgencias y emergencias médicas durante la práctica estomatológica. Métodos: Se realizó un estudio descriptivo y transversal, combinado con enfoques cualitativos en el marco de la protocolización de la atención médica entre mayo y junio de 2019. Se efectuó una búsqueda en internet de protocolos de atención para urgencias y emergencias médicas durante la práctica estomatológica en español, inglés y portugués; y, a nivel nacional, mediante correo electrónico y teléfono. Se empleó el instrumento evaluativo de Morales Navarro y se creó un grupo evaluador. Se trabajó con números enteros, índices y medias. Resultados: El protocolo que alcanzó mayor calificación fue el de la Universidad Andrés Bello de Chile, con 860 puntos (76,4 por ciento) del total y con ID menor de 0,66. Mientras que el de menor puntuación resultó el de la Universidad Nacional de Colombia con 528 puntos (46,9 por ciento), con relación a la mínima puntuación alcanzable de 225; este también presentó el mayor ID (0,2). Conclusiones: Los protocolos analizados presentaron una calidad desigual y predominantemente baja en su elaboración. No se encontraron evidencias de que existiera un instrumento de este tipo, diseñado para las características de los servicios estomatológicos en el país, que pudiera contribuir a elevar el grado de preparación del personal y la calidad de la atención(AU)


Introduction: Having a quality instrument that contributes to unifying criteria and raising the degree of preparation of personnel in the care of medical emergencies during dental practice is a necessity for professors of this specialty. Objective: To assess the care protocols for medical urgencies and emergencies during dental practice. Methods: A descriptive and cross-sectional study was carried out, between May and June 2019, combined with qualitative approaches within the framework of medical care protocolization. An internet search was carried out for care protocols in medical urgencies and emergencies during dental practice, in Spanish, English and Portuguese; and, at the national level, by email and telephone. The assessment instrument of Morales-Navarro was used and an assessment group was created. We worked with whole numbers, indexes and means. Results: The protocol that achieved the highest rating was that of Andrés Bello University, of Chile, with 860 points (76.4 percent) of the total and with an ID under 0.66; while the lowest score was that of the National University of Colombia, with 528 points (46.9 percent), in relation to the minimum achievable score, of 225. The latter also presented the highest ID, of 0.2. Conclusions: The protocols analyzed presented uneven and predominantly low quality regarding their elaboration. No evidence was found that there was an instrument of this type, with a design based on the characteristics of dental services in the country and that could contribute to raising the level of preparation of personnel and the quality of care(AU)


Assuntos
Humanos , Emergências , Docentes/educação , Epidemiologia Descritiva , Estudos Transversais , Medicina Bucal
10.
Br J Oral Maxillofac Surg ; 59(5): 605-608, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33863593

RESUMO

During the COVID-19 pandemic, NHS services had to convert face-to-face consultations to remote consultations to facilitate the ongoing provision of healthcare. Many specialties including Oral and Maxillofacial Surgery and Rheumatology have found such virtual clinics effective and appreciated by both patients and clinicians. In Oral Medicine, whilst responses to virtual clinics have been positive, we have recognised that they are not sufficient. In this reflective piece, we describe our experiences and our approach to their use in the management of Oral Medicine and Behçet's disease patients, which has developed iteratively during the lockdown period. We also consider the role of virtual clinics in Oral Medicine in the post-COVID-19 era.


Assuntos
COVID-19 , Medicina Bucal , Controle de Doenças Transmissíveis , Humanos , Pandemias , SARS-CoV-2 , Telefone
12.
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1351213

RESUMO

ABSTRACT Objective To evaluate the effect of the COVID-19 impacts on the activities of researchers in the field of Oral Medicine (OM) and Oral Pathology (OP). To assess the research activities and training of human resources by Brazilian productivity fellows in research (BPFR) in OM and OP in the COVID-19 Era. Material and Methods Thirty-six BPFR in OM and OP areas, funded by National Council for Scientific and Technological Development (CNPq), received a virtual structured questionnaire by e-mail, on the Google Forms (Google®) platform, with questions regarding research activities and training of human resources (supervision of undergraduate and postgraduate students), during the COVID-19 pandemic. From the thirty-six BPFR in OM and OP, twenty-seven (75.0%) answered the questionnaire. Results Most of them were males (n=20; 74.1%) and were distributed in four Brazilian regions and ten states of the federation, including the Federal District. Twenty-four (88.9%) BPFR reported having suspended clinical activities, while sixteen (59.3%) answered that histopathology practices are suspended. Twenty-five (92.6%) BPFR mentioned difficulties in conducting research projects and 55.5% stated having no difficulties in the supervision of undergraduates, master's and PhD students. Conclusion The current scenario may significantly impact the diagnosis of oral diseases in Brazil. Moreover, a decrease in the scientific production of BPFR in OM and OP in the coming years is also considered.


Assuntos
Humanos , Masculino , Feminino , Patologia Bucal , Apoio à Pesquisa como Assunto , Apoio ao Desenvolvimento de Recursos Humanos , Brasil/epidemiologia , Medicina Bucal , COVID-19 , Pesquisa , Desenvolvimento Tecnológico , Inquéritos e Questionários , Interpretação Estatística de Dados , Recursos Humanos , Tutoria
14.
Wiad Lek ; 73(8): 1650-1654, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33055327

RESUMO

OBJECTIVE: The aim: to substantiate conceptual approaches to organizing the model of university stomatological clinic based on the public-private partnership principles (PPP). PATIENTS AND METHODS: Materials and methods: To achieve the aim the author used general scientific methods of analysis, synthesis, generalization, interpreting scientific data as well as systemic and structural-functional approaches. The conceptual approaches comply with the Constitution of Ukraine, laws and other legislative standards of Ukraine, generally accepted standards and principles of world law in the healthcare, considering the Ukrainian and foreign experience. RESULTS: Results: The article represents conceptual approaches to organizing university clinic, based on the public-private partnership principles, in order to provide development of theoretical and practical stomatology, training professionals as well as to providing accessible and affordable high-quality stomatological service to population. Introduction of the conceptual approaches will provide for development of a modern model of the university clinic, creating public-private healthcare institution which will provide affordable and high-quality stomatological service corresponding to modern requirements and approaches ( last advances of science and technology). Implementation of the public-private partnership mechanisms will be a guarantee of steady long-lasting social-economic development of the clinic. CONCLUSION: Conclusions: The priority way of development of the university clinics under new economic conditions is basing their economic mechanisms on the PPP principles. To realize this, the conceptual approaches to organizing university stomatological clinic model based on the public-private partnership principles were introduced (with the example of university stomatological clinic).


Assuntos
Medicina Bucal , Parcerias Público-Privadas , Atenção à Saúde , Ucrânia , Universidades
15.
BMJ Open Qual ; 9(3)2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32611597

RESUMO

Histological, haematological and microbiological investigations are essential in the field of oral medicine and are a crucial adjunct to clinical findings, often being relied on to obtain a definitive diagnosis. Importantly, in some cases, these investigations can help exclude or confirm the presence of malignancy. This project highlighted some problems regarding labelling and recording of specimens in an oral medicine department and a lack of clear specimen management processes. It aimed to improve specimen management by reducing reported incidents surrounding diagnostic tests. Quality improvement methods such as process mapping were key to understanding the journey of specimens and the departments involved at each stage of the system. Initiatives included a recording log book, staff training, information signage around the clinic and delegation of responsibilities, all of which were implemented over multiple plan, do, study, act (PDSA) cycles. The project was extremely successful and since implementation there has been a clear and sustained reduction in reported incidents. The small number of incidents which did occur all involved transportation of specimens and none involved labelling or recording. One can conclude that the change in test management systems in terms of recording and labelling of specimens in the department has been sustained. Ongoing engagement with stakeholders and senior leaders is the priority to ensure further reduction in incidents in the future and that the improvements are maintained. This project demonstrates how simple, realistic, cost-effective, quality improvement initiatives can have a significant positive impact on patient care and hospital management systems.


Assuntos
Técnicas e Procedimentos Diagnósticos/instrumentação , Medicina Bucal/estatística & dados numéricos , Manejo de Espécimes/normas , Técnicas e Procedimentos Diagnósticos/normas , Técnicas e Procedimentos Diagnósticos/estatística & dados numéricos , Humanos , Medicina Bucal/organização & administração , Melhoria de Qualidade , Gestão de Riscos/métodos , Manejo de Espécimes/métodos , Manejo de Espécimes/estatística & dados numéricos
16.
J Med Syst ; 44(4): 89, 2020 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-32172426

RESUMO

Oral health is a critical component to overall quality of life. Recommendations and guidelines for oral health continue to evolve while remaining underutilized worldwide. Still, oral healthcare parity and equity are achievable. This public health priority must be supported with stronger research, service delivery must be equitable and transparent, and the impact of oral healthcare must be fully understood. Data, surveillance, evidence and translation must be improved for oral health specialties as well as for greater global governance. Further, interdisciplinary coordination between orthodontic, dentistry, medical, biotechnology and research organizations must be prioritized. With dedication and consistent approach, oral healthcare can achieve the best outcomes for quality of life and cost effective public health.


Assuntos
Disparidades em Assistência à Saúde , Saúde Bucal , Saúde Global , Humanos , Saúde Bucal/tendências , Medicina Bucal , Qualidade de Vida
17.
Artigo em Inglês | MEDLINE | ID: mdl-33396190

RESUMO

Background: Oral cancer is a frequent neoplasm worldwide, and socioeconomic factors and access to health services may be associated with its risk. Aim: To analyze effect of socioeconomic variables and the influence of public oral health services availability on the frequency of new hospitalized cases and mortality of oral cancer in Brazil. Materials and Methods: This observational study analyzed all Brazilian cities with at least one hospitalized case of oral cancer in the National Cancer Institute database (2002-2017). For each city were collected: population size, Municipal Human Development Index (MHDI), Gini Coefficient, oral health coverage in primary care, number of Dental Specialized Centers (DSC) and absolute frequency of deaths after one year of the first treatment. The risk ratio was determined by COX regression, and the effect of the predictor variables on the incidence of cases was verified by the Hazard Ratio measure. Poisson regression was used to determine factors associated with higher mortality frequency. Results: Cities above 50,000 inhabitants, with high or very high MHDI, more unequal (Gini > 0.4), with less oral health coverage in primary care (<50%) and without DSC had a greater accumulated risk of having 1 or more cases (p < 0.001). Higher frequency of deaths was also associated with higher population size, higher MHDI, higher Gini and lower oral health coverage in primary care (p < 0.001). Conclusions: The number hospitalization and deaths due to oral cancer in Brazil was influenced by the cities' population size, the population's socioeconomic status and the availability of public dental services.


Assuntos
Acessibilidade aos Serviços de Saúde , Hospitalização/estatística & dados numéricos , Neoplasias Bucais/mortalidade , Medicina Bucal , Fatores Socioeconômicos , Brasil/epidemiologia , Cidades , Humanos , Saúde Pública
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