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1.
Preprint em Inglês | SciELO Preprints | ID: pps-781

RESUMO

COVID-19 pandemic implied new biosafety recommendations to avoid dissemination of SARS-CoV-2 virus within healthcare centers. Changes on recommended personal protective equipment (PPE), decontamination protocols and organization of patient demand resulted may result in cost variation. Based on this, the present study aimed to evaluate the economic impact of new biosafety recommendations for oral healthcare assistance during COVID-19. An Activity Based Costing evaluation was used to calculate the acquisition of PPE and decontamination solutions recommended for dental practice during COVID-19 pandemic in Brazil. PPE and decontamination solutions quantity and frequency of use were based on the newly COVID-19 recommendations. Costs (in Brazilian Real ­ R$) for biosafety recommendations pre- and post-COVID-19 were outlined and calculated for each patient, service shift and year. A sensitivity analysis considered 20% to 50% variation of direct costs. Previously to COVID-19 pandemic, direct costs of biosafety recommendations consisted of R$0.84 per patient, R$6.69 per service shift and R$3,413.94 per year. Post-COVID-19 costs of biosafety recommendations resulted in R$16.01 per patient, R$128.07 per service shift, and R$32,657.96 per year. Yearly costs can vary between R$26,126.37 and R$39,189.56. The annual budget increase necessary to adopt post-COVID biosafety recommendations was R$29,244.02. Newly biosafety recommendations increased significantly the costs of oral healthcare assistance during COVID-19 pandemic. Decision making of healthcare managers must consider rational and equity allocation of financial resources.


A pandemia da COVID-19 implicou novas recomendações de biossegurança para evitar a disseminação do vírus SARS-CoV-2 nos centros de saúde. Alterações nos equipamentos de proteção individual (EPI) recomendados, protocolos de descontaminação e organização da demanda de pacientes resultaram em variações de custos. Com base nisso, o presente estudo teve como objetivo avaliar o impacto econômico de novas recomendações de biossegurança para assistência à saúde bucal durante a COVID-19. Uma avaliação do Custeio Baseado em Atividade foi usada para calcular a aquisição de EPI e soluções de descontaminação recomendadas para a prática odontológica durante a pandemia da COVID-19 no Brasil. A quantidade e a frequência de uso de EPI e das soluções de descontaminação foram baseadas nas novas recomendações da COVID-19. Os custos (em Reais Brasileiros ­ R$) das recomendações de biossegurança pré- e pós-COVID-19 foram delineados e calculados para cada paciente, turno de serviço e ano. Uma análise de sensibilidade considerou uma variação de 20% a 50% dos custos diretos. Anteriormente à pandemia da COVID-19, os custos diretos das recomendações de biossegurança consistiam em R$0,84 por paciente, R$6,69 por turno de serviço e R$3.413,94 por ano. Os custos pós-COVID-19 das recomendações de biossegurança resultaram em R$16,01 por paciente, R$128,07 por turno de serviço e R$32.657,96 por ano. Os custos anuais podem variar entre R$26.126,37 e R$39.189,56. O aumento do orçamento anual necessário para adotar as recomendações de biossegurança pós-COVID foi de R$29.244,02. As novas recomendações de biossegurança aumentaram significativamente os custos da assistência à saúde bucal durante a pandemia da COVID-19. A tomada de decisão dos gerentes de saúde deve considerar a alocação racional e equitativa dos recursos financeiros.

2.
Braz Oral Res ; 34: e040, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32520075

RESUMO

This study aimed to identify factors associated with the need for complete dentures in one dental arch or both, among the elderly population. The cross-sectional household study was conducted with a representative sample of elderly people (65 years or older) in the state of São Paulo, Brazil, in 2015. The dependent variable was the need for complete dentures (in one arch or both), and independent variables were socioeconomic and demographic conditions, social capital, self-perception of oral health and access to dental services. Simple and multinomial logistic regression models tested effect measures (p < 0.05). A total of 5,948 elderly people participated. Results indicated that those with greater chances of needing a complete denture in one arch were male (OR = 1.54; CI95%:1.04-2.29), with fewer household goods (OR = 2.25; CI95%:1.50-3.38), lower monthly household income: R$501-1500 (OR = 3.44; CI95%:1.27-9.35), R$1501-2500 (OR = 4.11; CI95%:1.50-11.27), R$2501-4500 (OR = 2.76; CI95%:1.10-6.95), self-reported need for a complete denture (OR = 4.75; CI95%:3.08-7.35), ≥3 years since last dental appointment (OR = 1.80; CI95%:1.06-3.05), and dissatisfaction with last dental appointment (OR = 1.80; CI95%:1.06-3.05). There were more chances of the need for complete dentures in both arches among older elders (OR = 1.44; CI95%:1.06-1.88), with lower monthly household income: R$ < 501 (OR = 4.45; CI95%:1.71-11.60), R$501-1500 (OR = 4.01; CI95%:2.14-7.51), R$1501-2500 (OR = 2.95; CI95%:1.64-5.32), < 3 years of education (OR = 1.45; CI95%:1.13-1.85), feeling unhappy (OR = 2.74; CI95%:1.35-5.57), self-reported need for a complete denture (OR = 8.48; CI95%:5.75-12.50), dissatisfaction with their mouth (OR = 2.38; CI95%:1.64-3.46), ≥3 years since last dental appointment (OR = 4.28; CI95%:2.85-6.43), and dissatisfaction with last dental appointment (OR = 4.28; CI95%:2.85-6.43). The several dimensions of the determinants of the need for a complete denture reflect the influence of both demographic and socioeconomic aspects, social capital, self-perception of oral health and access to dental services.


Assuntos
Prótese Total/estatística & dados numéricos , Determinação de Necessidades de Cuidados de Saúde/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Brasil , Estudos Transversais , Arco Dental , Feminino , Acesso aos Serviços de Saúde/estatística & dados numéricos , Humanos , Modelos Logísticos , Masculino , Saúde Bucal/estatística & dados numéricos , Autoimagem , Fatores Socioeconômicos , Inquéritos e Questionários
4.
Ciênc. Saúde Colet ; 25(1): 365-374, jan. 2020. tab
Artigo em Português | LILACS-Express | LILACS | ID: biblio-1055776

RESUMO

Resumo O objetivo deste artigo é analisar os fatores associados ao uso dos serviços odontológicos públicos por adultos. Estudo transversal com amostra representativa de adultos de 35 a 44 anos, com dados do Levantamento Epidemiológico das Condições de Saúde Bucal da População do Estado de São Paulo (SBSP-2015). Utilizou-se análise de regressão logística multivariada, baseada em modelo proposto por Andersen para predizer o acesso aos serviços odontológicos públicos. Visitaram o serviço privado 3.421 (59,9%) adultos e 2.288 (40,1%), o público. Os serviços odontológicos públicos foram mais acessados por mulheres (41,8%) e menos escolarizados (50,2%). Indivíduos não brancos (OR = 1,32; IC95%:1,16; 1,50), menor renda familiar (OR = 2,37; IC95%:2,11; 2,65), histórico de dor de dente (OR = 1,60; IC95%:1,39; 1,83) e necessidade de tratamento endodôntico (OR = 1,44; IC95%:1,12; 1,85) foram associados ao uso dos serviços odontológicos públicos. Fatores contextuais, individuais e necessidade de tratamento foram associados à utilização dos serviços odontológicos públicos por adultos residentes no estado de São Paulo, em 2015.


Abstract The aim of this study was to investigate the factors associated with public dental care use by adults in the State of São Paulo, Brazil. A cross-sectional study was conducted with a representative sample of adults aged 35 to 44 years using data from the 2015 Epidemiological Survey of the Oral Health Status of the Population of the State of São Paulo (SBSP-2015). Multivariate logistic regression was performed using variables based on a model proposed by Andersen for predicting access to public dental services. Results: 3,421 (59.9%) adults visited private services and 2,288 (40.1%) visited public services. Prevalence of the use of public dental services was greatest among women (41.8%) and adults with a lower education level (50.2%). Being non-white (OR = 1.32, 95% CI: 1.16, 1.50), lower household income (OR = 2.37, 95% CI: 2.11, 2.65), having had toothache (OR = 1.60, 95% CI: 1.39, 1.83), and need for endodontic treatment (OR = 1.44, 95% CI: 1.12, 1.85) were associated with public dental service use. Predisposing, enabling, and need factors were associated with public dental care use.

5.
Cien Saude Colet ; 25(1): 365-374, 2020 Jan.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31859883

RESUMO

The aim of this study was to investigate the factors associated with public dental care use by adults in the State of São Paulo, Brazil. A cross-sectional study was conducted with a representative sample of adults aged 35 to 44 years using data from the 2015 Epidemiological Survey of the Oral Health Status of the Population of the State of São Paulo (SBSP-2015). Multivariate logistic regression was performed using variables based on a model proposed by Andersen for predicting access to public dental services. Results: 3,421 (59.9%) adults visited private services and 2,288 (40.1%) visited public services. Prevalence of the use of public dental services was greatest among women (41.8%) and adults with a lower education level (50.2%). Being non-white (OR = 1.32, 95% CI: 1.16, 1.50), lower household income (OR = 2.37, 95% CI: 2.11, 2.65), having had toothache (OR = 1.60, 95% CI: 1.39, 1.83), and need for endodontic treatment (OR = 1.44, 95% CI: 1.12, 1.85) were associated with public dental service use. Predisposing, enabling, and need factors were associated with public dental care use.


Assuntos
Serviços de Saúde Bucal/estatística & dados numéricos , Utilização de Instalações e Serviços/estatística & dados numéricos , Adulto , Brasil , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
6.
Braz. j. oral sci ; 19: e206621, jan.-dez. 2020. ilus
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1116009

RESUMO

Aim: The aim of this study was to explore the impact of oral health-related quality of life (OHRQoL) on the child's family structure. Methods: A representative sample of 613 children from public preschools, in a city in southeastern Brazil, were enrolled in this cross-sectional study. The sample was determined through probabilistic sampling in two stages (preschools and children). The outcome variable (Early Childhood Oral Health Impact Scale [ECOHIS]) was multi-categorized in children and family. Independent individual variables were sex, race, family income, parents'/caregivers' level of education, family income, dental caries, and malocclusion. Initially, individual analyses were performed, relating the study variables to the outcome variables, estimating the raw odds ratio with the respective confidence intervals of 95%. The variables with p < 0.20 in the individual analyses were tested in the multiple logistic regression models, and those with p < 0.10 remained in the model. Results: Impact on OHRQoL was reported by 40.9% of the children and 17% of their families. Children with low family income and caries experience had, respectively, 1.53 (95% CI: 1.00-2.32) (p = 0.0465) and 2.96 (95% CI: 1.81-4.84) (p < 0.0001) more chance of presenting negative impact on OHRQoL. Conclusions: The aspects that most affected the OHRQoL of child's family structure were low income and dental caries experience


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Qualidade de Vida , Pré-Escolar , Saúde Bucal , Cárie Dentária , Má Oclusão
7.
Braz. j. oral sci ; 19: e206537, jan.-dez. 2020. tab
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1116566

RESUMO

Aim: To evaluate the influence of social capital on self-perception related to orthodontic treatment need. Methods: A cross-sectional study was conducted with a sample of 578 11-16 years-old adolescents from a city in southern Brazil. Social capital was evaluated using the Social Capital Questionnaire for Adolescent Students (SCQ-AS). Index of Orthodontic Treatment Need (IOTN) assessed malocclusion and self-perception related to orthodontic treatment need. Sociodemographic aspects of adolescents were also evaluated. Individual analyses were performed, relating the study variables to the outcome, estimating the odds ratio with the respective confidence intervals of 95%. The variables with p<0.20 in the individual analyses were tested in the multiple logistic regression models, and those with p<0.10 remained in the model. Results: Social capital did not influence the self-perception related to orthodontic treatment need. Adolescents with high orthodontic needs were 5.35 (CI 95%: 2.68 to 10.65) times more likely to perceived orthodontic treatment need (p <0.05). Crowding and dental absence were associated with self-perception related to orthodontic treatment need (p <0.05). Conclusions: Social capital did not influence the self-perception related to orthodontic treatment need


Assuntos
Humanos , Masculino , Feminino , Adolescente , Ortodontia , Autoimagem , Índice de Necessidade de Tratamento Ortodôntico , Capital Social , Má Oclusão
8.
Rev Saude Publica ; 53: 108, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31826175

RESUMO

OBJECTIVE: To evaluate the association of school failure among Brazilian adolescents with social conditions and aspects of oral health through hierarchical analysis. METHODS: A state-wide survey of 5,558 adolescents from the state of São Paulo, Brazil, inquired about the sociodemographic and social capital of participants by using a structured questionnaire. Trained and calibrated professionals performed intraoral examinations and interviews in the households. Questions about the access to dentist, reason for and frequency of using dental services, toothache episodes and impact of oral conditions on daily activities (OIDP) were applied. Oral examinations evaluated caries experience, tooth losses, periodontal problems, presence of open bite, and maxillary and mandibular overjet. School failure was estimated according to the teenagers' years of schooling. The independent variables were grouped into three blocks: sociodemographic and economic characteristics, social capital and oral health aspects. The multiple hierarchical logistic regression model was used to identify the factors associated with school failure. RESULTS: Of the total sample, information about schooling of 5,162 adolescents was obtained, of whom 29.6% presented school failure. We found that adolescents over the age of 16 years who did not declare themselves as white, female, with feelings of insecurity, unhappiness, with toothache, caries, tooth losses, affected by dentofacial and/or periodontal changes, were more likely to fail at school. CONCLUSION: Oral disorders and social factors were associated with school failure in adolescents. A successful school trajectory was a strong determinant of health, therefore actions between the educational and health sectors must be developed for adolescents, especially those with this profile.


Assuntos
Fracasso Acadêmico , Avaliação Educacional , Saúde Bucal/estatística & dados numéricos , Adolescente , Adulto , Brasil/epidemiologia , Estudos Transversais , Cárie Dentária , Inquéritos de Saúde Bucal , Feminino , Humanos , Masculino , Fatores de Risco , Fatores Socioeconômicos , Inquéritos e Questionários , Perda de Dente , Adulto Jovem
9.
Cien Saude Colet ; 24(8): 3057-3066, 2019 Aug 05.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31389552

RESUMO

School performance is a key aspect for future professional and social success. The objective of the present study was to investigate factors associated with adolescents' school performance including sense of coherence (SOC) and oral health status. Three hundred eighty one schoolchildren between 15 and 18 years of age from the city of Campo Grande, Mato Grosso do Sul, Brazil, participated in the study. The outcome variable was school performance, assessed through the final grades of the Portuguese and Mathematics disciplines in 2013. Independent variables were sociodemographic data, self-perception of oral health, use of dental services and sense of coherence, obtained through a self-applied questionnaire. In addition, in a clinical assessment, the number of decayed, missing and filled teeth (DMFT index) was evaluated. Logistic regression analyses were performed, based on a hierarchical model. The mean age of students was 16 years; mean DMFT value 4.1, and SOC 44.5. In the final adjustment, the male subjects (p = 0.0021); those with the largest number of people residing at home (p = 0.0021) and weak SOC (p = 0.0005) showed an association with poorer school performance. In conclusion, school performance is a complex phenomenon associated with SOC and oral characteristics.


Assuntos
Saúde Bucal/estatística & dados numéricos , Autoimagem , Senso de Coerência , Estudantes/estatística & dados numéricos , Adolescente , Brasil , Estudos Transversais , Índice CPO , Serviços de Saúde Bucal/estatística & dados numéricos , Feminino , Humanos , Masculino , Inquéritos e Questionários
10.
Ciênc. Saúde Colet ; 24(8): 3057-3066, ago. 2019. tab
Artigo em Português | LILACS-Express | LILACS | ID: biblio-1011864

RESUMO

Resumo O desempenho escolar é um aspecto fundamental para o futuro sucesso profissional e social. O objetivo do presente estudo foi investigar os fatores associados ao desempenho escolar dos adolescentes, incluindo o Senso de Coerência (SOC) e o estado de saúde bucal. Foram incluídos, no estudo, 381 escolares entre 15 e 18 anos de idade da cidade de Campo Grande, Mato Grosso do Sul, Brasil. O desfecho foi o desempenho escolar avaliado por meio das notas finais das disciplinas de Português e Matemática em 2013. As variáveis independentes foram dados sociodemográficos, autopercepção de saúde bucal, uso de serviços odontológicos e Senso de Coerência, obtidos por um questionário autoaplicado. Além disso, avaliou-se o número de dentes cariados, perdidos e obturados (índice de CPO-D). Análises de regressão logística foram realizadas, com base em um modelo hierárquico. A idade média dos alunos foi de 16 anos; valor médio do CPO-D 4,1 e SOC 44,5. No ajuste final, os indivíduos do sexo masculino (p = 0,0021); aqueles com o maior número de pessoas que moravam em casa (p = 0,0021) e o SOC fraco (p = 0,0005) mostraram associação com o menor desempenho escolar. Em conclusão, o desempenho escolar é um fenômeno complexo, associado ao SOC e às características bucais.


Abstract School performance is a key aspect for future professional and social success. The objective of the present study was to investigate factors associated with adolescents' school performance including sense of coherence (SOC) and oral health status. Three hundred eighty one schoolchildren between 15 and 18 years of age from the city of Campo Grande, Mato Grosso do Sul, Brazil, participated in the study. The outcome variable was school performance, assessed through the final grades of the Portuguese and Mathematics disciplines in 2013. Independent variables were sociodemographic data, self-perception of oral health, use of dental services and sense of coherence, obtained through a self-applied questionnaire. In addition, in a clinical assessment, the number of decayed, missing and filled teeth (DMFT index) was evaluated. Logistic regression analyses were performed, based on a hierarchical model. The mean age of students was 16 years; mean DMFT value 4.1, and SOC 44.5. In the final adjustment, the male subjects (p = 0.0021); those with the largest number of people residing at home (p = 0.0021) and weak SOC (p = 0.0005) showed an association with poorer school performance. In conclusion, school performance is a complex phenomenon associated with SOC and oral characteristics.

11.
PLoS One ; 14(5): e0216640, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31067270

RESUMO

The aim of this study was to analyze the value and meanings that dental surgeons attribute to the Primary Health Care setting, where health promotion is encouraged over a mechanistic performance of procedures. A qualitative study, involving ten Brazilian dental surgeons working in Primary Care in 2016, was designed. In-depth semi-structured interviews were performed, with all interviews recorded, transcribed and subsequently submitted to Qualitative Content Analysis. Despite the Healthcare Promotion model proposed by the Brazilian oral health policy, dental surgeons demonstrated preferences for private and traditional dental practices. These characteristics are counterproductive in public oral health services, which aim to achieve collective health benefits. Traditional practice is based upon a specific and restricted focus, as opposed to overall patient care, hence maintaining the original professional identity, ruled by manual procedures, while demonstrating scientifically fragile understanding of disease processes. Despite the implementation of public service models that aim at change, counterproductive characteristics associated with the deeply rooted traditional management strategies were evidenced.


Assuntos
Assistência Odontológica/organização & administração , Padrões de Prática Odontológica/tendências , Adulto , Atitude do Pessoal de Saúde , Brasil , Redes Comunitárias/tendências , Odontólogos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Saúde Bucal , Atenção Primária à Saúde , Pesquisa Qualitativa
12.
Value Health Reg Issues ; 20: 73-78, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31048261

RESUMO

OBJECTIVE: To develop a budgetary impact analysis regarding the possibility of offering complete upper and lower dentures to an eligible population of elderly people (above 65 years) in the São Paulo state, Brazil. METHODS: The proportion of eligible population was calculated by assessing the prevalence of edentulous (upper and lower arch) and by defining the eligible group (public health system users). The budgetary impact analysis was designed under the following scenario: 5-year time horizon (2018-2022), prospect of municipal expenses with prostheses, and additional progressive incorporation of technology (upper and lower dentures) at an annual rate of 10%, 15%, 20%, 25%, and 30%. Sensibility analysis was performed in 3 different situations (reference, more pessimistic, and more optimistic) based on the calculation of spending through assessed demand and epidemiological demand. RESULTS: The municipal cost for each denture, already discounted the value transferred by the union for this procedure, was R$50.97. The incremental impact on the budget measured by the epidemiological demand relative to assessed demand was approximately R$59 141 510 over 5 years, meaning an impact of 0.08% (0.01% more optimistic; 0.13% more pessimistic) of the "medium and high complexity care" budget and 0.09% (0.03%-0.14%) of the primary care budget. CONCLUSION: The budgetary impact of increasing the oral rehabilitation with complete dentures for elderly population in the São Paulo state is low relative to the expenses with primary or specialized care budgets. In addition, incorporation of denture rehabilitation would be feasible, according to the financial availability and priorities of each municipality.

13.
Physis (Rio J.) ; 29(1): e290111, 2019. tab
Artigo em Português | LILACS | ID: biblio-1012766

RESUMO

Resumo Objetivou-se compreender com maior grau de aproximação aspectos da relação entre a odontologia e a sociedade por meio da observação direta do cotidiano e do discurso de dentistas membros de equipes da Estratégia Saúde da Família, que discorreram sobre sua terapêutica na área da saúde bucal num novo cenário normativo. Estudo desenvolvido utilizando o Método Clínico-Qualitativo durante o ano de 2016, que partiu do tema "terapêutica da cárie dentária" como assunto disparador para o desenvolvimento das entrevistas, realizadas por meio de roteiro semidirigido de questões abertas em profundidade, nas próprias unidades de saúde. O material obtido foi analisado por meio de Análise Qualitativa de Conteúdo. Os resultados evidenciaram configurações de poder provenientes de um modelo odontológico conservador, desfavoráveis ao propósito da Promoção da Saúde, mas apontaram também potencialidades trazidas pelo modelo de Saúde da Família, reveladas por meio da criatividade e reflexividade sobre ações educativas e desafios que puderam estimular o profissional. Considerou-se, entretanto, que o trabalho do dentista nesse contexto conservou, predominantemente, um modus operandi hegemônico, caracterizado por relações desequilibradas de poder.


Abstract The aim was to better understand aspects of the relationship between dentistry and society through the direct observation of the daily service and the discourse of dentists members of the Family Health Strategy (Primary Care) teams, who discussed their oral health therapy in a new regulatory scenario. A study developed using the Clinical-Qualitative Method during the year 2016, starting from the theme "dental caries therapy" as a triggering subject for the development of the interviews, carried out by a semi-structured questionnaire of in-depth open questions in the units of health. The material obtained was analyzed through Qualitative Content Analysis. The results showed power settings descended from a conservative dental point of view, unfavorable to the purposes of Health Promotion paradigm, but also pointed to potential brought by the Family Health model, revealed through creativity and reflexivity about educational actions and challenges that could stimulate the professional. It was considered, however, that the work of the dentist in this context retained predominantly a hegemonic modus operandi, characterized by unbalanced relations of power.


Assuntos
Humanos , Atenção Primária à Saúde , Sistema Único de Saúde , Brasil , Saúde Bucal/tendências , Estratégia Saúde da Família , Pesquisa Qualitativa , Odontólogos
14.
PLoS One ; 13(9): e0203777, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30212507

RESUMO

OBJECTIVE: This study aimed to assess the oral impact on daily performance and its association with sociodemographic characteristics, tooth pain, need for prosthesis, and periodontal disease of adults in the state of São Paulo, Brazil. METHODS: This was a cross-sectional epidemiological study with secondary data obtained from the Oral Health Conditions Project- 2015 conducted in 163 municipalities in the state of São Paulo with the participation of 17,560 individuals. This study evaluated adults in the age-range between 35-44 years (n = 5,855), selected by means of probabilistic cluster sampling in two stages. The outcome variable was the OIDP (Oral Impacts on Daily Performances), obtained by using this instrument to assess daily activities (eating, speaking, oral hygiene, relaxation, sports practice, smile, study/work, social contact, and sleep). The independent variables were collected and grouped into three blocks: Block 1 (sex, age group, and ethnic group); Block 2 (household income and education); and Block 3 (tooth pain, need for prosthesis, bleeding, calculus, and periodontal pockets). A hierarchical multiple logistic regression analysis was performed considering the complex cluster sampling plan. Each observation was assigned a specific weight, depending on the location, which resulted in weighted frequencies adjusted for the effect of outlining. RESULTS: the female sex (p<0.0001), ethnic group black/mulatto (p<0.0001), low household income (p = 0.0112), up to 8 years of education (p<0.0001), tooth pain (p<0.0001), presence of bleeding (p<0.0001), and presence of periodontal pockets (p<0.0001) had greater oral impact on daily performance. CONCLUSION: sociodemographic characteristics, tooth pain, and presence of periodontal disease were associated with oral impact on daily performance of the adult population in the state of São Paulo, Brazil.


Assuntos
Atividades Cotidianas , Saúde Bucal/estatística & dados numéricos , Doenças Periodontais/patologia , Adulto , Brasil/epidemiologia , Estudos Transversais , Demografia , Escolaridade , Feminino , Hemorragia/complicações , Hemorragia/diagnóstico , Hemorragia/epidemiologia , Hemorragia/patologia , Humanos , Renda , Modelos Logísticos , Masculino , Razão de Chances , Saúde Bucal/etnologia , Dor/diagnóstico , Dor/etiologia , Doenças Periodontais/epidemiologia , Doenças Periodontais/etnologia , Bolsa Periodontal/complicações , Bolsa Periodontal/diagnóstico , Bolsa Periodontal/epidemiologia , Próteses e Implantes/estatística & dados numéricos , Qualidade de Vida , Fatores Sexuais
15.
PLoS One ; 13(6): e0198428, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29944665

RESUMO

INTRODUCTION: The objective was to analyze whether socioeconomic factors related to the context and those related to the model of care-specifically the coverage of primary care by the Family Health Strategy (ESF)-had an impact on hospitalizations due to heart failure (HF) and stroke, in the State of São Paulo/Brazil between 1998 and 2013. METHODS: A longitudinal ecological study involving 645 municipalities was conducted in the state of São Paulo/Brazil from 1998 to 2013, using the Hospital Information System (SIH-DataSUS database). The hospitalizations for primary care sensitive conditions: Stroke and heart failure (HF) that correspond to the International Classification of Diseases (ICD 10): I50, I63 to I67; I69, G45 to G46 were analyzed longitudinally during the period indicated regarding the percentage of people covered by the Family Health Program (PSF) adjusted for confounders (population size, gross domestic product -GDP and human development index- HDI). RESULTS: There was a significant decrease in the number of hospitalizations for heart failure and stroke per 10000 (inhabitants) in the period (p <0.0001), with a significant relationship with increased proportion of ESF (p <0.0001), and this remained significant even when possible confounders (population size, GDP and HDI) were included in the model (p <0.0001). CONCLUSIONS: GDP per capita was close to or higher than that if many European countries, which shows the relevance of the study. The health care model based on the Family Health Strategy positively impacted hospitalization indicators for heart failure and stroke, indicating that this model is effective in the prevention of primary care sensitive conditions.


Assuntos
Saúde da Família , Insuficiência Cardíaca/epidemiologia , Hospitalização/estatística & dados numéricos , Acidente Vascular Cerebral/epidemiologia , Brasil/epidemiologia , Feminino , Produto Interno Bruto , Humanos , Estudos Longitudinais , Masculino , Fatores Socioeconômicos
16.
Rev Saude Publica ; 52: 32, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29723389

RESUMO

OBJECTIVE To identify and analyze factors associated with preventable child deaths. METHODS This analytical cross-sectional study had preventable child mortality as dependent variable. From a population of 34,284 live births, we have selected a systematic sample of 4,402 children who did not die compared to 272 children who died from preventable causes during the period studied. The independent variables were analyzed in four hierarchical blocks: sociodemographic factors, the characteristics of the mother, prenatal and delivery care, and health conditions of the patient and neonatal care. We performed a descriptive statistical analysis and estimated multiple hierarchical logistic regression models. RESULTS Approximatelly 35.3% of the deaths could have been prevented with the early diagnosis and treatment of diseases during pregnancy and 26.8% of them could have been prevented with better care conditions for pregnant women. CONCLUSIONS The following characteristics of the mother are determinant for the higher mortality of children before the first year of life: living in neighborhoods with an average family income lower than four minimum wages, being aged ≤ 19 years, having one or more alive children, having a child with low APGAR level at the fifth minute of life, and having a child with low birth weight.


Assuntos
Mortalidade da Criança , Serviços de Saúde/estatística & dados numéricos , Mortalidade Infantil , Modelos Logísticos , Prevenção Primária , Adolescente , Adulto , Brasil/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Idade Gestacional , Humanos , Lactente , Recém-Nascido , Gravidez , Cuidado Pré-Natal , Fatores de Risco , Fatores Socioeconômicos , Adulto Jovem
17.
Rev Saude Publica ; 52: 44, 2018.
Artigo em Português, Inglês | MEDLINE | ID: mdl-29668813

RESUMO

OBJECTIVE: Analyze if clinical, sociodemographic and access to dental services variables influence the impact of oral health on the daily activities of adolescents, adults and older adults. METHODS: A cross-sectional study with secondary data from the State Oral Health Survey (SB São Paulo 2015) conducted in 163 cities of São Paulo. A total of 17,560 individuals from three age groups: 15-19-year-old (n = 5,558), 35-44-year-old (n = 6,051), and older people of 65 years or more (n = 5,951) participated in the survey. The selection was made by probabilistic sample by conglomerates in two stages. The endpoint variable was the impact of oral health on daily activities, evaluated by the Oral Impacts on Daily Performances questionnaire, containing questions about eating, talking, oral hygiene, relaxation, sports practice, smile, study or work, social contact, and sleep. Oral Impacts on Daily Performances was dichotomized with and without impact. The independent variables were sociodemographic, clinical and access variables, divided into three blocks. A hierarchical multiple logistic regression analysis was performed considering the complex sampling plan of clusters. Each observation received a specific weight, depending on the location that resulted in weighted frequencies and adjusted for the design effect. RESULTS: The presence of oral health impact was observed in 27.9% of the individuals. In block 1, female gender and black/brown ethnic group had a greater chance of impact of oral health on quality of life, as well as the adults and the older adults in relation to adolescents. In block 2, family income up to R$1,500 was associated with the presence of impact. In block 3, individuals who reported toothache, used the public service and sought dental treatment had a greater chance of impact. CONCLUSIONS: Sociodemographic, clinical and access to health services variables influence the impact of oral health on the daily activities of adolescents, adults and older adults.


Assuntos
Atividades Cotidianas , Saúde Bucal/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Idoso , Brasil/etnologia , Estudos Transversais , Inquéritos de Saúde Bucal , Feminino , Acesso aos Serviços de Saúde , Humanos , Masculino , Saúde Bucal/etnologia , Qualidade de Vida , Fatores Sexuais , Fatores Socioeconômicos , Adulto Jovem
18.
Ciênc. Saúde Colet ; 23(1): 287-294, Jan. 2018. tab, graf
Artigo em Português | LILACS-Express | LILACS | ID: biblio-890478

RESUMO

Resumo O objetivo deste estudo foi identificar os fatores associados ao não comparecimento dos usuários ao tratamento ortodôntico, em três centros de especialidades odontológicas regionais (CEO-R) localizados no estado do Ceará. Metodologia: Os dados foram extraídos de prontuários de pacientes que concluíram o tratamento ortodôntico. Foi calculada a taxa de ausências, com o objetivo de estabelecer um coeficiente de faltas entre os municípios. A fim de descrever o padrão geográfico da ocorrência, foram construídos mapas temáticos baseados nas distribuições. Para as associações entre a variável desfecho (falta ao tratamento) e as independentes (sexo, idade, quebra de aparelho, mudança de profissional, renda e local de residência do usuário), utilizou-se a análise de regressão logística múltipla com p ≤ 0,05. Resultados: Foram examinados 237 prontuários em 20 municípios, com 8.283 consultas ortodônticas realizadas e 2.665 (32,17%) faltas. Apresentou diferença estatisticamente significativa a variável mudança de profissional. Conclusão: O maior número de faltas foi associado à mudança de profissional.


Abstract The aim of this study was to identify the factors associated with the users failing to keep orthodontic treatment appointments (absences), in three regional dental specialty centers (CEO-R) located in the State of Ceará. Methodology: This was a cross-sectional epidemiological study with secondary data source of 3 CEO-R, from which 237 medical records of complete orthodontic treatments were examined, with 8.283 appointments and 2.665 (32.17%) missing appointments. Data collection was standardized by an electronic questionnaire.. Factors associated with users missing appointments were calculated by means of absence rates and thematic maps were constructed based on distributions of the geographical pattern of occurrence. To evaluate the association between the outcome variable (absence from treatment) and the independent variables (sex, age, breakage of appliance, change of professional, income and place of user's residence) multiple logistic regression analysis was used with p ≤ 0.05. Results: There were high absence rates for both city headquarters and non-headquarter CEO-Rs. The variable change of professional showed statistical significance, in relation to the number of absences. Conclusion: The highest number of absences was associated with change of professional.

19.
Ciênc. Saúde Colet ; 23(1): 153-160, Jan. 2018. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-890485

RESUMO

Abstract The objective of this study was to determine of oral and oropharynx cancer mortality rate and the results were analyzed by applying the Spatial Analysis of Empirical Bayesian Model. To this end, we used the information contained in the International Classification of Diseases (ICD-10), Chapter II, Category C00 to C14 and Brazilian Mortality Information System (SIM) of Minas Gerais State. Descriptive statistics were observed and the gross rate of mortality was calculated for each municipality. Then Empirical Bayesian estimators were applied. The results showed that, in 2012, in the state of Minas Gerais, were registered 769 deaths of patients with cancer of oral and oropharynx, with 607 (78.96%) men and 162 (21.04%) women. There was a wide variation in spatial distribution of crude mortality rate and were identified agglomeration in the South, Central and North more accurately by Bayesian Estimator Global and Local Model. Through Bayesian models was possible to map the spatial clustering of deaths from oral cancer more accurately, and with the application of the method of spatial epidemiology, it was possible to obtain more accurate results and provide subsidies to reduce the number of deaths from this type of cancer.


Resumo O objetivo deste estudo foi determinar a taxa de mortalidade por câncer de boca e aplicar o Modelo Bayesiano Empírico e a Análise Espacial para suavizar a taxa bruta de mortalidade por câncer de boca e orofaringe. Foi usado o Capítulo II da Classificação Internacional de Doenças (CID-10) para Categorias C00 a C14. Os dados foram extraídos do Sistema de Informações sobre Mortalidade do Brasil (SIM) do Estado de Minas Gerais. As estatísticas descritivas e as taxas brutas de mortalidade foram calculadas para cada município. Posteriormente, foram aplicados os estimadores Bayesianos Empíricos. Em 2012, em Minas Gerais, foram registradas 769 mortes para o câncer de boca e orofaringe, dos quais 607 (78,96%) eram homens e 162 (21,04%) mulheres. Houve uma grande variação na distribuição espacial da taxa de mortalidade bruta. Foi possível identificar aglomeração nas regiões Sul, Central e Norte com maior precisão pelo Estimador Bayesiano Modelo Global e Local. Através dos Modelos Bayesian foi possível mapear aglomeração espacial de mortes por câncer de boca e orofaringe com maior precisão. Assim, pela epidemiologia espacial foi possível obter resultados mais precisos e fornecer subsídios para ações para reduzir a mortalidade por este tipo de câncer.

20.
Cien Saude Colet ; 23(1): 153-160, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29267820

RESUMO

The objective of this study was to determine of oral and oropharynx cancer mortality rate and the results were analyzed by applying the Spatial Analysis of Empirical Bayesian Model. To this end, we used the information contained in the International Classification of Diseases (ICD-10), Chapter II, Category C00 to C14 and Brazilian Mortality Information System (SIM) of Minas Gerais State. Descriptive statistics were observed and the gross rate of mortality was calculated for each municipality. Then Empirical Bayesian estimators were applied. The results showed that, in 2012, in the state of Minas Gerais, were registered 769 deaths of patients with cancer of oral and oropharynx, with 607 (78.96%) men and 162 (21.04%) women. There was a wide variation in spatial distribution of crude mortality rate and were identified agglomeration in the South, Central and North more accurately by Bayesian Estimator Global and Local Model. Through Bayesian models was possible to map the spatial clustering of deaths from oral cancer more accurately, and with the application of the method of spatial epidemiology, it was possible to obtain more accurate results and provide subsidies to reduce the number of deaths from this type of cancer.


Assuntos
Teorema de Bayes , Neoplasias Bucais/mortalidade , Neoplasias Orofaríngeas/mortalidade , Brasil/epidemiologia , Cidades , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/epidemiologia , Neoplasias Orofaríngeas/epidemiologia , Distribuição por Sexo , Análise Espacial , Taxa de Sobrevida
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