Indicators proposed by the Brazilian Ministry of Health for monitoring and evaluating oral health actions in the National Health System: documentary research, 2000-2017

França, Mary Anne de Souza Alves; Freire, Maria do Carmo Matias; Pereira, Edsaura Maria; Marcelo, Vânia Cristina

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Epidemiologia e Serviços de Saúde

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RESEARCH NOTE • Epidemiol. Serv. Saúde 29 (1) • 2020 • https://doi.org/10.5123/S1679-49742020000100002 copy

Indicators proposed by the Brazilian Ministry of Health for monitoring and evaluating oral health actions in the National Health System: documentary research, 2000-2017^* * Article derived from the Master’s Degree thesis entitled ‘Indicators used in oral health in Brazil’, defended by Mary Anne de Souza Alves França at the Public Health Postgraduate Program, Federal University of Goiás Public Health Studies Center, in 2013.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

to present the indicators for monitoring and evaluation of oral health actions in the Brazilian National Health System (SUS), proposed in the period 2000-2017.

Methods:

documental research conducted on the Ministry of Health website regarding government guidelines on oral health monitoring and evaluation systems; the indicators were classified according to the following categories: access to care; resolutive capacity and continuity; and availability of oral health services.

Results:

oral health indicators were identified in the following guidelines: ‘Health Services Performance Evaluation Methodology Project’, ‘SUS Qualification Evaluation Program’, ‘National Program for Improving Primary Care Access and Quality’, and ‘SUS Performance Index’; most of them refer to access to services and resolutive capacity and continuity of care.

Conclusion:

oral health indicators in the four government guidelines identified provide important input for health management, but new indicators are needed for effective monitoring and evaluation of oral health actions.

Keywords:
Indicators of Health Services; Oral Health; Health Management; Government Document

Category	Indicators and sources	Guideline	Calculation formula
Category	Indicators and sources	Guideline	Numerator	Denominator
Access to care	Dental appointment Sources: PNAD and PNS	PROADESS	No. of people who had a dental appointment in the last 12 months x 100	Total resident population
	Percentage of people who never had a dental appointment Sources: PNAD and PNS	PROADESS	No. of people reporting never having had a dental appointment x 100	Total resident population
	Percentage of the population reporting having used health services in the last 15 days, in a given geographical space. Sources: PNAD and PNS	PROADESS	No. of people seeking health services in the last 15 days and who received care x 100	Total resident population
	Coverage of first programmatic dental appointment ^a Sources: SIA/SUS and IBGE	SUS Qualification Evaluation Program	Total number of first programmatic dental appointments ^a attended in a given place and period x 100	Population in the same place and period
Service availability	Number of dental surgeons per 100,000 inhabitants, in a given geographic space, in the year under consideration. Source: CNES	PROADESS	No. of dental surgeons x 100 mil	Total resident population
Service availability	Estimated population coverage of the Family Health Strategy Oral Health teams Sources: FCES and IBGE	SUS Qualification Evaluation Program	No. of Family Health Strategy Oral Health teams implanted (Modalities I and II) x 3,450 people	Population in the same place and period x 100

Category	Indicators	Calculation formula (and sources consulted)		Parameter
Category	Indicators	Numerator ^a	Denominator	Parameter
1^st and 2^nd Cycles
Access to care	Coverage of first programmatic dental appointment	No. of first programmatic dental appointments in a given place and period x 100	Population registered in the same place and period Source: SIAB Form A	Not provided
	Coverage of first dental care appointment for pregnant women	No. of pregnant women having first appointment with Oral Health team dental surgeon in a given place and period x 100	No. of pregnant women registered in the same place and period Source: SIAB SSA2 Report	Not provided
	Average urgent dental care session per inhabitant	No. of urgent dental care sessions performed by the Oral Health team dental surgeon in a given place and period	Population registered in the same place and period Source: SIAB Form A	Not provided
	Oral mucosa alteration incidence rate	No. of diagnoses of oral mucosa alteration in service users care for the by Oral Health team in a given place and period x 1,000	Population registered in the same place and period Source: SIAB Form A	Not provided
Service availability	Average supervised collective dental brushing actions	No. of people taking part in the supervised collective dental brushing action performed in a given place and period x 100	Population registered in the same place and period Source: SIAB Form A	Not provided
Resolutive capacity and continuity	Average dental prosthesis fitted	No. of dental prostheses fitted by the Oral Health team in a given place and period	Population registered in the same place and period x 0.03 Source: SIAB Form A	Not provided
Resolutive capacity and continuity	Ratio between concluded treatments and first programmatic dental appointments	No. of treatments concluded by the Oral Health team dental surgeon in a given place and period	No. of first programmatic dental appointments carried out by the Oral Health team dental surgeon in the same place and period Source: PMA2 Report - SIAB Complement	Not provided
3^rd Cycle
Access to care	Coverage of first programmatic dental appointments	No. of first programmatic dental appointments attended x 100	Population registered	15% first programmatic dental appointment attended/year 1.25% first programmatic dental appointment attended/month
Service availability	Percentage of services made available by the Oral Health team	Quantity of actions and service performed by the Oral Health team x 100	Total actions and services expected by the Oral Health team	70%/month
Resolutive capacity and continuity	Ratio between concluded treatments and first programmatic dental appointments	No. of treatments concluded by the dental surgeon	No. of first programmatic dental appointments	0.5-1.0 treatment concluded/month

Category	Simple indicators and sources	Calculation formula		Parameter
Category	Simple indicators and sources	Numerator	Denominator	Parameter
Service availability	Population coverage estimated by the Oral Health teams Sources: CNES and IBGE	Average monthly number of Family Health Strategy Oral Health teams plus Average monthly number of qualified equivalents per each 60 hours/week of non-Oral Health team dental surgeons x 3,000 inhabitants	Population resident in the municipality	50% coverage taking one Primary Care Oral Health team per each group of 3,000 inhabitants in the year assessed
Service availability	Average supervised collective dental brushing actions Sources: SIA/SUS and IBGE	No. of people taking part in the supervised collective dental brushing action in the 12 month period, in a municipality, divided by 12 x 100	Population in the municipality in the period evaluated	8 participants per 100 inhabitants - average of municipalities covered by Oral Health teams or THD/ACD teams greater than 60%
Resolutive capacity and continuity	Proportion of tooth extraction in relation to dental procedures Sources: SIA/SUS and IBGE	No. of teeth extractions performed in a municipality and year evaluated x 100	Total individual preventive and curative procedures, selected per municipality and year evaluated.	8% (percentage close to the average for the year 2010: 8.6%) of all Brazilian cities that performed dental procedures on the SUS

Secretaria de Vigilância em Saúde e Ambiente - Ministério da Saúde do Brasil SRTVN Quadra 701, Via W5 Norte, Lote D, Edifício P0700, CEP: 70719-040, +55 61 3315-3464, Fax: +55 61 3315-3464 - Brasília - DF - Brazil
E-mail: ress.svs@gmail.com

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[1] Correspondence: Mary Anne de Souza Alves França - Av. Afonso Pena, No. 140, Apto. 802, Bloco A, Edifício Manhathan I, Vila Alpes, Goiânia, GO, Brazil. Postcode: 74310-220. E-mail: maryanne_sa@hotmail.com