Avaliação do desempenho da atenção secundária em saúde bucal no Brasil: uma revisão integrativa

Abstract

Introduction: The comprehensiveness of care is a fundamental principle of the Brazilian Unified Health System (SUS). For this reason, the perspective of working in networks of care is essential to ensuring this right. In this context, the oral health care network (RSB) is integrated with primary health care (APS) and supported by secondary and tertiary care. Mediumcomplexity dental services are offered within SUS by the Centers for Dental Specialties (CEOs). The incentive for the expansion and improvement of CEOs came after the creation of the National Oral Health Policy (PNSB) and was further promoted by the Access and Quality Improvement Program (PMAQ). Thus, the strengthening of the RSB directly influenced the increase in demand for specialized procedures by users, and despite its exponential growth, secondary dental care still faces challenges in meeting its production targets. Objective: To review the literature on the analysis of the quality of secondary dental care services in Brazil, considering the context of political changes in resource management over the years. Methodology: This study is qualitative in nature and is characterized as a literature review. The search strategy using DeCs and MeSH terms was applied across three databases: PubMed, Embase, and BVS, with a publication date filter from 2010 to 2024. The articles selected based on inclusion criteria had their data extracted and tabulated in a spreadsheet. Results and Discussion: A total of 535 articles were retrieved, with 202 duplicates excluded. After reading 333 titles and abstracts and excluding those that did not meet the inclusion criteria, 16 articles were selected for full reading. Of these, 2 articles were excluded, leaving 14 studies selected for data extraction. The literature shows that studies assessing secondary oral health care are analytical in nature and use secondary data for their analysis. The main finding of the study was the shift in the profile of the indicators analyzed with the policy that established PMAQ-CEO, moving from merely meeting targets to analyzing process, structure, and outcome variables of the services. Conclusions: The study reinforces the importance of establishing performance evaluation and concludes that the performance of secondary oral health care within SUS is an issue that deserves more visibility, particularly in the context of changes in health financing policies in Brazil.