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

• Published in: BMJ open Vol. 9; no. 1; p. e023283
• Main Authors: Nascimento, Antonio Carlos, Moysés, Simone Tetü, Werneck, Renata Iani, Gabardo, Marilisa Carneiro Leão, Moysés, Samuel Jorge
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01-01-2019; BMJ Publishing Group
• Subjects: Adult; Brazil; Cross-Sectional Studies; Dental Care - statistics & numerical data; Dentistry; Dentists; Female; Health care policy; Health services; Health Services Accessibility - statistics & numerical data; Humans; Male; Medical personnel; Oral hygiene; Primary care; Primary Health Care - methods; Primary Health Care - statistics & numerical data; Public Health; Quality of Health Care - statistics & numerical data; Self Report; Brazil; oral health; primary health care; public health
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2018-023283

ObjectivesTo 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.DesignCross-sectional.SettingPublic PHC services in Curitiba, the state capital of Paraná.ParticipantsPHC users of the public oral health network (n=900) and dentists active in this municipal network (n=203).Primary and secondary outcome measuresThe 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.ResultsOverall, 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.ConclusionsThe 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.