The Role of Organizational Factors and Human Resources in the Provision of Dental Prosthesis in Primary Dental Care in Brazil

Abstract

This study aimed to investigate factors associated with dental prosthesis procedures by oral health teams (OHTs) in the Brazilian primary health care in 2013-2014, who participated in the National Program for Improving Access and Quality of Primary Health Care (PMAQ-AB). This is an analytical cross-sectional study using a questionnaire with dichotomous questions applied in 18,114 OHTs. The dependent variable studied was making any type of prosthesis (removable or fixed). Independent variables involved issues related to human resources and health service management. Data were submitted to simple and multiple binary logistic regression with odds ratio calculation, 95% confidence intervals, and p-values. Most OHTs (57%) do not perform any dental prosthesis. The teams that are more likely to perform dental prostheses have human resources-related characteristics, such as professionals admitted through public examinations (OR 1.25, 95% CI 1.14-1.36) and those involved in permanent education (OR 1.13, 95% CI 1.02-1.26). Moreover, OHTs with a more organized work process and that receive more significant support from municipal management are more likely to perform dental prostheses (p < 0.05). The oral health teams which tended to provide the most dental prostheses to benefit patients were; hired as civil servants, had a municipal career plan, involved all members of the oral health team, and trained undergraduate dental students from outreach programs. Better organizational support and improved work incentives may be needed to get the majority of oral health teams to start providing dental prostheses to their patients.

Keywords: dental prosthesis; primary health care; public health.