scholarly journals The impact of the COVID-19 pandemic on the provision of dental procedures performed by the Brazilian Unified Health System: a syndemic perspective

2021 ◽  
Vol 24 ◽  
Author(s):  
Amanda Ramos da Cunha ◽  
Sofia Rafaela Maito Velasco ◽  
Fernando Neves Hugo ◽  
José Leopoldo Ferreira Antunes

ABSTRACT: Objectives: This study investigated the impact of the COVID-19 pandemic on the provision of dental care procedures performed by the Brazilian Unified Health System (SUS) nationally and by regions. Considering that the most underprivileged population disproportionately suffers with the reduction in dental care provision, the study hypothesis suggests the presence of a syndemic nature. Methodology: The SUS Outpatient Information System (SIA-SUS) was assessed to gather data on dental care activities and procedures performed between April and July 2018, 2019, and 2020 by dentists registered in the SUS. The 30 most frequent activities and procedures performed by dentists were selected and classified into three categories (urgent dental care, nonemergency dental care, and case-dependent urgency procedures), based on the guidance for dental care during the pandemic published by the American Dental Association. Results: Results demonstrated a reduction in the provision of dental care of all categories during the pandemic. Urgency dental consultations and procedures in primary and specialized dental care services decreased by 42.5 and 44.1%, respectively, between 2020 and 2019. Non-urgent procedures decreased by 92.3%. Although decreases in dental care activities and procedures were reported in all Brazilian regions, the largest relative decreases in urgent procedures – that should have been maintained during the pandemic – occurred in the North and Northeast regions, which are the poorest regions of the country. Conclusions: These results suggest that the COVID-19 pandemic has a syndemic behavior. Further investigation into the pandemic-syndemic impacts on oral disease burden is necessary.

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
B L O Luizeti ◽  
E M M Massuda ◽  
L F G Garcia

Abstract In view of the national scenario of scarcity of material and human resources in public health in Brazil, the survey verified the demographics of doctors who attend the Unified Health System (SUS) in municipalities of extreme poverty. An observational, analytical and cross-sectional study was carried out, based on secondary quantitative data from the Department of Informatics of the SUS using the TABNET of December 2019. The care networks variable was restricted to infer the number of physicians who attend the SUS in extreme poverty municipalities in Brazil. Municipalities of extreme poverty are those that at least 20% of the population have a household income of up to 145 reais per capita monthly. In Brazil, there are 1526 municipalities in extreme poverty, 27.4% of the country's total municipalities. 14,907 doctors linked to SUS work in this condition, 3.19% of the total of these professionals in Brazil. There is still disproportion between regions: North concentrates 11.2% of the municipalities in extreme poverty and 8.61% of the total number of doctors; Northeast, with 61.33% of these municipalities, for 61.5% of doctors; Southeast, with 15.46% of the municipalities in this condition, has 20.6% of doctors; South concentrates 10.87% of the municipalities under discussion with 5.61% of doctors and the Midwest, with 4.87% of these municipalities, has 3.54% of doctors. Between 2009 and 2018, there was a 39% increase in the number of doctors in these locations, however, for 2019, there was a decrease of 3.89%. The medical demographic distribution in Brazil is uneven, especially in the North. There is also the vulnerability of this population in view of the observed reduction in the number of professionals between 2018 and 2019 in municipalities of extreme poverty, for political reasons. It is evident the need to restructure the health system to guarantee access to health for this population, through the attraction and fixation of doctors in needy regions in Brazil. Key messages Shortage of doctors in extreme poverty municipalities reinforces the health vulnerability of the population in Brazil. The uneven medical demography in Brazil requires restructuring in the public health system.


2020 ◽  
Vol 7 ◽  
Author(s):  
Feiyang Guo ◽  
Bojun Tang ◽  
Danchen Qin ◽  
Tingting Zhao ◽  
Yu-xiong Su ◽  
...  

Background: During the COVID-19 pandemic, many dental care services including orthodontic practice were suspended. Orthodontic patients turned to social media platforms to communicate, share experiences, and look for solutions. Our study aimed to investigate the attitudes and perspectives of orthodontic patients during the COVID-19 epidemic in China by analyzing orthodontics-related posts on Sina Weibo (a Chinese counterpart of Twitter).Materials and Methods: Potentially eligible posts on Sina Weibo platform were collected between December 30, 2019, and April 18, 2020. Posts related to both orthodontics and COVID-19 were included and then coded and classified into specific appliances and themes. Geographic and temporal distributions of the included posts were analyzed. In addition, time-lagged cross correlation was performed to explore the association between the number of daily posts and daily new COVID-19 cases/deaths in China. Chi-square tests were employed to compare the differences between fixed appliances and aligners in problems/difficulties and feelings during the epidemic.Results: Of the 28,911 posts identified, 4,484 were included in the analysis. The most frequently mentioned themes were appointments (n = 2,621, 58.5%), negative feelings (n = 2,189, 48.8%), and problems/difficulties (n = 1,155, 25.8%). A majority of posts were tweeted in regions with high levels of economic development and population density in eastern China and from February to March. The number of daily posts had a significantly positive correlation with daily new COVID-19 cases/deaths in China (P < 0.05). Compared with clear aligners, patients with fixed appliances reported more problems/difficulties (P < 0.001) and negative feelings (P < 0.001), but fewer positive feelings (P < 0.001).Conclusions: The analysis of Weibo posts provided a timely understanding of the impact of COVID-19 on orthodontic patients. Delayed appointments were their greatest concern, and negative feelings and untreated orthodontic problems increased during the suspension of dental care services. However, patients with clear aligners reported fewer negative feelings and problems than those with fixed appliances. The findings highlighted the need to consider both treatment- and psychology-related issues of orthodontic patients and how to handle them appropriately during the epidemic.


2002 ◽  
Vol os9 (4) ◽  
pp. 153-156 ◽  
Author(s):  
John Morris ◽  
Rachel Harrison ◽  
Martin Caswell ◽  
Howard Lunn

Introduction With the problems of access to NHS primary dental care services in the last few years attention has focused on manpower considerations for dentistry. Materials and Method This paper presents the results of a simple survey of general dental practitioners in South Staffordshire. Results The response rate was 88%. Most dentists (76%) reported working over 30 hours a week. A small number reported working more than 50 hours a week. Woman dentists were more likely to report working fewer than 31 hours a week. Younger male dentists tended to work longer hours than older male dentists, whereas younger women dentists tended to work fewer hours than older women. The reported retirement plans suggested that around 16% of dentists in their 40s and 50s were planning to retire before 60. Conclusion The findings add weight to the view that woman dentists tend to work fewer hours but studies of cohorts are required to examine the impact of premature retirement and the reasons behind this apparent gender difference.


2017 ◽  
pp. fmw098
Author(s):  
Mudita Gosain ◽  
Akhil D. Goel ◽  
Pradeep Kharya ◽  
Ramesh Agarwal ◽  
Ritvik Amarchand ◽  
...  

2020 ◽  
Vol 14 (3) ◽  
pp. 283-289
Author(s):  
Randhall Bruce Carteri ◽  
Jean Pierre Oses ◽  
Taiane de Azevedo Cardoso ◽  
Fernanda Pedrotti Moreira ◽  
Karen Jansen ◽  
...  

ABSTRACT. Schizophrenia and common mental disorders are noteworthy social and economic concern worldwide. Epidemiologic studies on the impact of specific mental disorders in emerging countries are scarce. Objectives: We aimed to characterize the demographic, social, and economic burden of schizophrenia and common mental disorders patients in the health system in Brazil. Methods: Data on these conditions in Brazil between 2008 and 2019 were collected through the website of the Departamento de Informática do Sistema Único de Saúde (Information Technology Department of the Unified Health System - DATASUS) maintained by the Brazilian Ministry of Health. Mean annual hospital admissions were 154,009.67, and cumulative incidence of 77.44 admissions per 100,000 inhabitants. Results: Average annual hospital expenses were US$ 67,216,056.04, with an average admission cost of US$ 432.58. The most affected age groups were older adults albeit younger individuals showed a trend towards increase of occurrences in recent years. There were a higher number of admissions in men compared to women. Conclusions: We consider the results obtained important to assist in evaluating and guiding public policies regarding the prevention and treatment in health systems.


Author(s):  
Nazanin Pilevari ◽  
Mahyar Valeh Shiva

Background: The outbreak of the COVID-19 virus has had many destructive impacts on socio-economic and health systems. The health systems of countries could be supportive in crisis management, but they also are affected by the impact of the crisis, consequently, their operational level has declined. This study pursued resilience in an overall national health system under pandemic stress. Methods: Based on WHO building blocks, by interviewing informants of the Ministry of Health and Medical Education, in Tehran-Iran, early 2021 a rich picture of the current situation depicted, the resilience model was extracted via a mixed method of Soft System Methodology (SSM) and total interpretive structural modeling (TISM). Dynamic capabilities were applied for the orchestration of the Iranian health system. Results: Particular functional and structural suggestions applicable for designing a ubiquitous resilience model for the country-wide health system are presented in this study. The variables of crisis sensing, opportunity seizing, and reconfiguration are the cornerstones of health system resilience. Conclusion: Well-suited health technology assessment (HTA) and health information system (HIS) play significant roles in the overall strengthening of the health system. All reforms for resilience will have a lasting result when the capabilities created by the resilience model are learned and reused in a dynamic cycle.


2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
D Zota ◽  
P Karnaki ◽  
A Gil-Salmerón ◽  
J Garcés-Ferrer ◽  
E Riza ◽  
...  

Abstract Based on the multiple levels of research conducted within the project the consortium developed a roadmap & toolbox which includes the following categories: Continuity of information, Language Culture & Communication, Mental Health, Vaccinations, Maternal/child health, Health promotion, Oral health/Dental Care and NCDs while the Toolbox contains tools on these categories in different languages. The roadmap & toolbox is accessible through the project website. In addition, different scenarios, giving a comprehensive picture of the foreseen situation and the evidence-based policies and actions needed to maximize the effective delivery and sensitivity in the service of care to culturally diverse population groups were developed focusing on mental health, chronic disease management and oral health. Refugees and migrants tend to have a higher prevalence of mental distress compared to non-refugees. For the challenge of lack of recording mental health of migrants/refugees, improving the collaboration between ‘migrant-specific’ organizations is needed. Health care systems in Europe will have to accommodate the high demand for health care services for chronic conditions among migrants/refugees in the coming years. Implications such as the impact of poverty, level of health literacy and/or the cultural adaption of the measures need to be considered when planning to address future trends related to non-communicable diseases including diabetes among migrants/refugees. The provision of oral care presents great variability across the European countries, but in most cases, it is characterized by high cost and restricted range of services if offered within the state health systems. Migrants /refugees will not be able to meet the high cost of private dental care. Local community interventions have been proven very effective.


2020 ◽  
Vol 128 (S2) ◽  
pp. S237-S288
Author(s):  
Victoria Castro ◽  
Julio Castro

Since March 13, 2020, the COVID-19 virus has been detected in Venezuela. The country had a situation before the pandemic, where the notorious thing was a very important weakness of the health system, a compromised situation of hyperinflation and economic precariousness in the last four years, and a tense political situation. Although the growth of cases in the first wave was not as intense as in other countries in the region (probably related to their economic precariousness), the impact it has had on hospitals and national life has been very important. What is striking about the State’s management has been a few policies that are not very transparent, not very cohesive, and very dispersed, which has made it difficult to interpret and analyze the real impact on the epidemic. It is likely that the difficulty in obtaining gasoline and an extremely reduced economy in recent years have been a negative incentive for the transmission of the virus in the population as has been seen in the African continent at this time. Despite this, vulnerability persists, the capacity for improvement and the preparation of hospitals has not been substantially modified yet. It is estimated that the number of cases may increase significantly and that consecutive waves may be repeated and increase the impact that the virus has had in other latitudes.


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