Advances and weaknesses of the work process of the oral cancer care network in Brazil: A latent class transition analysis.
epidemiologic studies
mouth neoplasms
oral cancer
quality of health care
secondary care centers
Journal
Community dentistry and oral epidemiology
ISSN: 1600-0528
Titre abrégé: Community Dent Oral Epidemiol
Pays: Denmark
ID NLM: 0410263
Informations de publication
Date de publication:
02 2022
02 2022
Historique:
revised:
07
10
2021
received:
13
06
2021
accepted:
23
11
2021
entrez:
30
12
2021
pubmed:
31
12
2021
medline:
3
5
2022
Statut:
ppublish
Résumé
To analyse the provision of oral cancer (OC) care services in the Dental Specialties Centers (Centros de Especialidades Odontológicas-CEO) in Brazil and identify changes over two cycles of external evaluation of the Program for the Improvement of Access and Quality-PMAQ, in 2014 and 2018. This is a nationwide panel ecological study, including 916 CEO. Data from interviews with managers and dentists of the CEO were used, including variables related to training on OC, clinical protocols, biopsies, referral for diagnosis and treatment, and registration of users with OC. We carried out Latent Transition Analysis (LTA) to identify patterns (latent status LS) of service adequacy and work processes' changes between the two assessment cycles. We tested models with three, four, and five LS, selecting the one with the best conceptual interpretability and good model fit parameters. Data from the LS were plotted on choropleth and hotspots maps in Brazil allowing us to identify areas with the better or worse provision of specialized OC services. The model with four LS was chosen. The four LS were named: 1.'Most indicators inadequate for OC care' (the worst); 2. 'Most indicators suitable for OC care' (the best); 3. 'CEO with a poor relation with Primary Health Care (PHC) services'; and 4. 'CEO with a poor relation with tertiary hospital services'. The comparison of the LS transition between the two cycles revealed that 419 (45.7%) CEO remained in the same LS (1→1, 3→4, 2→2); 228 (24.9%) switched to a worse status (2→1, 2→4, 3→1) and 269 (29.4%) switched to a better LS (1→2, 1→4, 3→2). While the majority of the CEO improved, we identified a decline of 17.8% in those who reported performing biopsies and 18.3% in the number of CEO that had hospitals for referring confirmed OC cases. Almost all Brazilian states had CEO that improved the work process. The Southeast and South regions had the highest percentage of CEO with the better work process in both cycles. Hotspots showed areas concentrating improvements in the work process in the Northeast region. However, some hotspots in the North revealed some CEO where the work process deteriorated or remained unsatisfactory. There are regional inequities in the provision of OC care in CEO. Most services improved their work process or remained stable. However, the biopsies and the referral to hospital care for confirmed cases declined, indicating that CEO need to improve planning and care provision to reduce OC morbimortality.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
38-47Informations de copyright
© 2021 The Authors. Community Dentistry and Oral Epidemiology published by John Wiley & Sons Ltd.
Références
Ghantous Y, Abu EI. Global incidence and risk factors of oral cancer. Harefuah. 2017;156(10):645-649.
Miranda-Filho A, Bray F. Global patterns and trends in cancers of the lip, tongue and mouth. Oral Oncol. 2020;102:104551.
Kowalski LP, Oliveira MM, Lopez RVM, Silva DRM, Ikeda MK, Curado MP. Survival trends of patients with oral and oropharyngeal cancer treated at a cancer center in São Paulo, Brazil. Clinics. 2020;75:e1507.
Bonfante GMS, Machado CJ, Souza PEA, Andrade EIG, Acurcio FA, Cherchiglia ML. Specific 5-year oral cancer survival and associated factors in cancer outpatients in the Brazilian Unified National Health System. Cad Saúde Pública. 2014;30(5):983-997.
Thavarool SB, Muttath G, Nayanar S, et al. Improved survival among oral câncer patients: findings from a retrospective study at a tertiary care cancer centre in rural Kerala, India. World J Surg Oncol. 2019;17(1):15.
Seo BY, Lee CO, Kim JW. Changes in the management and survival rates of patients with oral cancer: a 30-year single-institution study. J Korean Assoc Oral Maxillofac Surg. 2016;42:31-37.
Pulte D, Brenner H. Changes in survival in head and neck cancers in the late 20th and early 21st century: a period analysis. Oncologist. 2010;15:994-1001.
Messadi DV, Wilder-Smith P, Wolinsky L. Improving oral cancer survival: the role of dental providers. J Calif Dent Assoc. 2009;37(11):789-798.
Hung M, Park J, Hon ES, Bounsanga J, Moazzami S, Ruiz-Negrón B. Artificial intelligence in dentistry: harnessing big data to predict oral cancer survival. World J Clin Oncol. 2020;11(11):918-934.
Ilhan B, Guneri P, Wilder-Smith P. The contribution of artificial intelligence to reducing the diagnostic delay in oral câncer. Oral Oncol. 2021;116:105254.
de Lima FLT, O’Dwyer G. Policies for prevention and control of oral cancer in the light of giddens’ structuration theory. Cienc E Saude Coletiva. 2020;25(8):3201-3214.
Rocha TAH, Thomaz EBAF, da Silva NC, et al. Oral primary care: an analysis of its impact on the incidence and mortality rates of oral cancer. BMC Cancer. 2017;17(1):1-11.
Freire AR, Freire DEWG, Araújo ECF, de Lucena EHG, Cavalcanti YW. Influence of public oral health services and socioeconomic indicators on the frequency of hospitalization and deaths due to oral cancer in Brazil, between 2002-2017. Int J Environ Res Public Health. 2020;18(1):238.
Moris AJ, Burke FJT. Primary and secondary dental care: the nature of the interface. BDJ. 2001;191(12):660-664.
Pucca GA Jr, Gabriel M, de Araujo MED, Almeida FCS. Ten years of a national oral health policy in Brazil: innovation, boldness, and numerous challenges. J Dent Res. 2015;94(10):1333-1337.
Goes PSAD, Figueiredo N, Neves JCD, et al. Avaliação da atenção secundária em saúde bucal: uma investigação nos centros de especialidades do Brasil. Cad Saude Publica. 2012;28:81-89.
Torres-pereira CC, Angelim-dias A, Melo NS, Lemos CA Jr, Oliveira EMF. Strategies for management of oral cancer in primary and secondary healthcare services. Cad Saude Publica. 2012;28:530-539.
Leal RVS, Emmi DT, Araújo MVA. Access and quality of secondary care and stomatology assistance in Brazil. Physis: Rev Saúde Coletiva. 2021;31(2):1-23.
Macinko J, Harris MJ, Rocha MG. Brazil's National Program for Improving Primary Care Access and Quality (PMAQ): fulfilling the potential of the world's largest payment for performance system in primary care. J Ambul Care Manage. 2017;40(2 Suppl):S4-S11.
Goes PSA, Figueiredo N, de Lima Martelli PJ, et al. Theoretical and methodological aspects of the external evaluation of the improvement, access and quality of centers for dental specialties program. Pesqui Bras Odontopediatria Clín Integr. 2018;18(1):3433.
Donabedian A. Criteria and standards for quality assessment and monitoring. QRB Qual Rev Bull. 1986;12:99-108.
Rodrigues LV, Ribeiro ILA, Protasio APL, Valença AMG, Lima EDA. Oral health actions in the primary health care network of northeastern Brazil in relation to oral cancer. RGO. 2019;67:e20190027.
Ribeiro AGA, Martins RFM, Vissoci JRN, et al. Progress and challenges in potential access to oral health primary care services in Brazil: a population-based panel study with latent transition analysis. PLoS One. 2021;16(3):e0247101.
Hwang WT, Brookmeyer R. Design of panel studies for disease progression with multiple stages. Lifetime Data Anal. 2003;9(3):261-274.
Lanza ST, Patrick ME, Maggs JL. Latent transition analysis: benefits of a latent variable approach to modeling transitions in substance use. J Drug Issues. 2010;40(1):93-120.
Lanza ST, Collins LM, Lemmon DR, Schafer JL. PROC LCA: a SAS procedure for latent class analysis. Struct Equ Model. 2007;14(4):671-694.
Muthén L, Muthén B. Mplus User’s Guide (Version 7) [Internet]. Seventh. Muthén & Muthén; 2012. Available from: http://scholar.google.com/scholar?hl=en&btnG=Search&q=intitle:Mplus+user+guide#8
ESRI. ArcGIS Desktop: Release 10.3. Environmental Systems Research Institute; 2014.
Menezes RG, Barbosa R Jr. Environmental governance under Bolsonaro: dismantling institutions, curtailing participation, delegitimising opposition. Z Vgl Polit Wiss. 2021;2:1-19.
Russo G, Levi ML, Alves MTSSB, et al. How the ‘plates’ of a health system can shift, change and adjust during economic recessions: a qualitative interview study of public and private health providers in Brazil’s São Paulo and Maranhão states. PLoS One. 2020;15(10):e0241017.
Harzheim E, D'Avila OP, DdeC R, et al. New funding for a new Brazilian primary health care. Cien Saude Colet. 2020;25:1361-1374.
Boschiero MN, Palamim CVC, Ortega MM, Mauch RM, Marson FAL. One year of coronavirus disease 2019 (COVID-19) in Brazil: a political and social overview. Ann Glob Health. 2021;87(1):44.
Perea LME, Peres MA, Boing AF, Antunes JLF. Trend of oral and pharyngeal cancer mortality in Brazil in the period of 2002 to 2013. Rev Saude Publica. 2018;52:10.
Cunha AR, Prass TS, Hugo FN. Mortality from oral and oropharyngeal cancer in Brazil, between 2000 and 2013: trends by sociodemographic strata. Cienc E Saude Coletiva. 2020;25(8):3075-3086.
Laronde DM, Williams PM, Hislop TG, et al. Decision-making on detection and triage of oral mucosa lesions in community dental practices: screening decisions and referral. Community Dent Oral Epidemiol. 2014;42(4):375-384.
Wong TJ, Li Q, Dodd V, Wang W, Bian J, Guo Y. Oral cancer knowledge and screening behavior among smokers and non-smokers in rural communities. BMC Cancer. 2021;21:430.
Scherer CI, Scherer MD. Advances and challenges in oral health after a decade of the "Smiling Brazil" program. Rev Saude Publica. 2015;49:98.
Raymundo ML, Freire AR, Gomes-Freire DE, et al. Trend of hospitalized cases of oral cancer in Brazil and its relationship with oral health coverage in public health system between 2009 and 2017. Med Oral Patol Oral Cir Bucal. 2021;26(1):e78-e83.
Casotti E, Monteiro ABF, de Castro Filho EL, dos Santos MP. Organização dos serviços públicos de saúde bucal para diagnóstico precoce de desordens com potencial de malignização do estado do Rio de Janeio. Brasil. Cienc E Saude Coletiva. 2016;21(5):1573-1582.
Cunha AR, Antunes JLF, Martins MD, Petti S, Hugo FN. The impact of the COVID-19 pandemic on oral biopsies in the Brazilian National Health System. Oral Dis. 2020. 10.1111/odi.13620. Online ahead of print.
Almutlaqah MA, Baseer MA, Ingle NA, Assery MK, Al Khadhari MA. Factors affecting access to oral health care among adults in Abha City, Saudi Arabia. J Int Soc Prev Community Dent. 2018;8(5):431-438.
Wang TT, Mathur MR, Schmidt H. Universal health coverage, oral health, equity and personal responsibility. Bull World Health Organ. 2020;98:719-721.
de Mello ALSF, de Andrade SR, Moysés SJ, Erdmann AL. Saúde bucal na rede de atenção e processo de regionalização. Cienc E Saude Coletiva. 2014;19(1):205-214.
Rasella D, Basu S, Hone T, Paes-Sousa R, Ocké-Reis CO, Millett C. Child morbidity and mortality associated with alternative policy responses to the economic crisis in Brazil: a nationwide microsimulation study. PLoS Medicine. 2018;15(5):e1002570.
Chaves SCL, Almeida AMFL, Reis CS, Rossi TRA, Barros SG. Política de Saúde Bucal no Brasil: as transformações no período 2015-2017. Saúde Debate. 2018;42(spe2):76-91.