Avaliação da atenção secundária em saúde bucal do Centro de Especialidades Odontológicas - CEO Jequitibá - Município de Pelotas, RS

Abstract

The Dental Specialties Centres (DSC) are an initiative of the National Oral Health Policy, created to perform medium complexity procedures with the aim of completing the Brazilian population’s oral health care network and providing a comprehensive service. This study aims to evaluate the structure, the work process and the results of Jequitibá DSC, in the municipality of Pelotas, whilst also estimating the waiting list for the service. To this end the DSC’s structure and service user care process was evaluated in a descriptive manner. Using a cross-sectional design, the production results achieved were studied, as were the characteristics of the demand for the service, including appointment control service information, between July 2012 and June 2013. Jequitibá DSC has 28 dental teams allocated from the Faculty of Dentistry who are distributed between the specialties covered by this study (periodontics, surgery and endodontics). The DSC has capacity to provide 164 hours of care a week. The teams include 45 students, as well as 1 professional responsible for molar endodontics. Care was provided to 940 service users at Jequitibá DSC in the one year period and there was an 18% no-show rate. 1502 procedures were performed (an average of 1.6 per user) and 76% of treatments were concluded. Service user age range was similar in all the specialties and varied between 10 and 87 years of age. The majority of service users were female, except in the case of molar endodontics where 51% were male. Most users had only elementary education. The average waiting time for all specialties at the DSC was 95 days. Average time for concluding treatment was 38 days. Currently, according to information provided by the municipal dental appointment control service, 849 people are on the DSC waiting list. The appointment control service lacks protocols to provide guidance on prioritizing care provision. The DSC did not comply with the parameters required by the Health Ministry and needs to increase production, especially during academic holiday periods. The municipality also needs additional DSCs. It is important that the dental services network be reorganized, so that there is a clearer definition between primary care and specialized services as to which actions should be undertaken by which level of care, optimizing the services and achieving greater interaction between them, whilst respecting the referral and counter-referral system.