Avaliação da assistência odontológica na atenção primária à saúde em uma região de saúde do Distrito Federal e proposta de manual padrão de procedimentos operacionais

Abstract

Primary Health Care (PHC) is considered the main gateway for users of the Unified Health System and care coordinator. The presence and extent of Primary Care attributes reflects a more effective and organized primary care. Oral health in the context of Primary Health Care has been developing in the country, and has been influenced by federal management actions, but also as a result of regionalization in which local actions and sociodemographic characteristics also condition the outcome of the quality of care. The essential attributes of PHC are access to first contact, longitudinality, coordination and comprehensiveness. The concept of attributes guides the assessment and research strategies for health services and systems based on PHC. The presence and extent of these attributes is fundamental to defining a service as truly PHC-oriented. This study aimed to analyze, from the dental surgeon’s perspective, the presence and extent of the essential attributes of Primary Health Care in the Oral Health Teams of the PHC of the Southwest Health Region, in the Federal District. The specific objectives were to describe the accessibility and use of the oral health service in PHC in the Southwest Health Region of the FD, characterize the longitudinality of oral health care in PHC in the Southwest Health Region, report the integration of oral health care in PHC, describe access and availability of PHC information on oral health and understand comprehensiveness in dental care considering the services available and the services provided. This is a cross-sectional descriptive study, with a qualitative and quantitative approach in a sample of 83 dentists. The Primary Care Assessment Tool, oral health version, for professionals, and a sociodemographic characterization instrument were used, which were associated to generate high or low performance. The study was divided into descriptive and association analyses. The scores of the PHC attributes were calculated and scores ≥ 6.6 indicated a high degree of implementation of the attributes. The results of this study made it possible to produce two articles. The article Assessment of dental care in Primary Health Care in a Health Region in the Federal District was based on the study of all essential attributes and the analysis of the association of these attributes with sociodemographic characteristics. The research protocol was approved by CEP/FEPECS. Therefore, an essential score was found with an average of 6.87, that is, the services were considered PHC-oriented. However, the low value of some attributes reflected weaknesses, such as accessibility, longitudinality and coordination (integration of care), while the attributes coordination (information system) and comprehensiveness showed high performance. When comparing sociodemographic characteristics with performance, it was found that younger participants had higher performance. This article was submitted to the Ciência & Saúde Coletiva Journal. The second article was elaborated using the Coordination attribute (Integration of care) and associating it with the sociodemographic characteristics of the participants. The result was an average of 6.40, that is, below the 6.6 cut-off. Therefore, the services are not well oriented towards PHC in relation to the integration of care component. The low performance reflects weaknesses in the Oral Health Care Networks. When comparing the sociodemographic characteristics of the participants with their performance, there were some characteristics with a significant difference in terms of better performance: younger participants, those with a master's/doctorate degrees and those with 6 to 10 years of service. This second article was submitted to the Brazilian Journal in Health Promotion. The technical products developed were the Manual of Standard Operating Procedures for Oral Health in Primary Health Care to adjust the technical side of the dental team and improve the productivity of the dental teams. This technical product, in addition to being prepared, was implemented at the Basic Health Unit (BHU) 11 in Samambaia with the presence of the immediate supervisor and oral health teams. Furthermore, a second technical product was created, the Dental Prenatal Banner. This topic was chosen because dental care for pregnant women is the oral health indicator of Previne Brasil. This banner has also been made available to BHU 11 Samambaia. The products have already been requested for implementation in other BHU. Conclusion: The results reflect dental care under development in Primary Health Care, with attributes that are not fully consolidated in the oral health of this Health Region of the Federal District and an Oral Health Care Network that still has weaknesses.This work sought to collaborate in the diagnosis of this dental care and through the products of this dissertation, qualify the professional actions that works in oral health and inform the patient in dental prenatal care.