Influence of Sociodemographic Factors, and the Coverage and Offer of Health Services on Mortality Due to Oral and Oropharyngeal Cancer in Brazil: A 20-year Analysis

2021 ◽  
Author(s):  
Márcio Vinicius de Gouveia Affonso ◽  
Igor Gonçalves de Souza ◽  
Emerson Souza da Rocha ◽  
Eny Maria Goloni-Bertollo ◽  
Fabiana de Campos Gomes ◽  
...  
Keyword(s):  
Oral Health ◽  
Mortality Rate ◽  
Health Services ◽  
Oropharyngeal Cancer ◽  
Cox Regression ◽  
Survival Rates ◽  
Mortality Rates ◽  
Sociodemographic Factors ◽  
Oral And Oropharyngeal Cancer ◽  
Oral Health Services

Abstract Background: To investigate the influence of sociodemographic factors and variables related to oral health services in oral and oropharyngeal cancer mortality in Brazil. Results: The mortality rate was higher in men than in women; the Southeast and South regions had the highest rates, which increased with age. Regarding APC analysis, men aged 57 years or more and those born from the 1920s to 1955, presented the highest mortality rate, while women born between the 1920s and the 1930s had a higher rate ratio. Kaplan-Meier survival curves and Cox regression showed that black men living in the Midwest region had the lowest survival rate. Considering the correlations, the North and Northeast regions presented mortality rates inversely proportional to FPDC and NSTB, while the Southeast presented it only to FPDC. Conclusions: The sociodemographic variables analyzed exhibited an influence on mortality and survival rates in relation to oral and oropharyngeal cancer. Regarding the oral health services, it was observed that preventive and diagnostic procedures are not being performed, which may be exacerbating the increase in the mortality rates observed.

scholarly journals Mortality from oral and oropharyngeal cancer in Brazil: impact of the National Oral Health Policy

2019 ◽  
Vol 35 (12) ◽  
Author(s):  
Amanda Ramos da Cunha ◽  
Taiane Schaedler Prass ◽  
Fernando Neves Hugo
Keyword(s):  
Health Policy ◽  
Oral Health ◽  
Dental Care ◽  
Oropharyngeal Cancer ◽  
Mortality Rates ◽  
Mortality Data ◽  
Care Services ◽  
Implementation Studies ◽  
Oral And Oropharyngeal Cancer ◽  
Oral Health Policy

Abstract: The objective was to investigate if there is an association between the mortality rates due to oral and oropharyngeal cancer in Brazil and the expansion of access to public primary and specialized dental care services that resulted from the implementation of the National Oral Health Policy, between 2000 and 2013. The mortality data were obtained from the records of the Mortality Information System and the exposure variables were obtained from databases of the Brazilian Ministry of Health and the Brazilian Institute of Geography and Statistics. The main exposures investigated were “coverage of primary dental care” and “number of specialized dental care centers”. Additional covariates included “Gini index of household income”, “average number of years of study”, “proportion of unemployed people” and “proportion of smokers”. For the statistical analysis, a random coefficient model was used. There was a statistically significant association between the mortality rates by oral and oropharyngeal cancer with coverage by primary dental care and the number of specialized dental care centers with males. This study found that the expansion of the coverage of primary dental care and the number of specialized dental care centers are associated with the reduction of mortality rates due to oral and oropharyngeal cancer in Brazil. There is plausibility for the association found, which needs to be confirmed by implementation studies.

scholarly journals 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

2020 ◽  
Vol 18 (1) ◽  
pp. 238
Author(s):  
Aldelany R. Freire ◽  
Deborah E. W. G. Freire ◽  
Elza C. F. de Araújo ◽  
Edson H. G. de Lucena ◽  
Yuri W. Cavalcanti
Keyword(s):  
Primary Care ◽  
Oral Health ◽  
Oral Cancer ◽  
Health Services ◽  
Population Size ◽  
Cox Regression ◽  
Health Coverage ◽  
Socioeconomic Indicators ◽  
Access To Health Services ◽  
Oral Health Services

Background: Oral cancer is a frequent neoplasm worldwide, and socioeconomic factors and access to health services may be associated with its risk. Aim: To analyze effect of socioeconomic variables and the influence of public oral health services availability on the frequency of new hospitalized cases and mortality of oral cancer in Brazil. Materials and Methods: This observational study analyzed all Brazilian cities with at least one hospitalized case of oral cancer in the National Cancer Institute database (2002–2017). For each city were collected: population size, Municipal Human Development Index (MHDI), Gini Coefficient, oral health coverage in primary care, number of Dental Specialized Centers (DSC) and absolute frequency of deaths after one year of the first treatment. The risk ratio was determined by COX regression, and the effect of the predictor variables on the incidence of cases was verified by the Hazard Ratio measure. Poisson regression was used to determine factors associated with higher mortality frequency. Results: Cities above 50,000 inhabitants, with high or very high MHDI, more unequal (Gini > 0.4), with less oral health coverage in primary care (<50%) and without DSC had a greater accumulated risk of having 1 or more cases (p < 0.001). Higher frequency of deaths was also associated with higher population size, higher MHDI, higher Gini and lower oral health coverage in primary care (p < 0.001). Conclusions: The number hospitalization and deaths due to oral cancer in Brazil was influenced by the cities’ population size, the population’s socioeconomic status and the availability of public dental services.

Public Oral Health Services Coverage and Socioeconomic Indicators’ Effect on The Number of Hospitalized Cases of Oral Cancer in Brazil

2020 ◽  
Author(s):  
Aldelany Ramalho Freire ◽  
Deborah Ellen Wanderley Gomes Freire ◽  
Elza Cristina Farias de Araújo ◽  
Edson Hilan Gomes de Lucena ◽  
Yuri Wanderley Cavalcanti
Keyword(s):  
Primary Care ◽  
Oral Health ◽  
Oral Cancer ◽  
Health Services ◽  
Population Size ◽  
Cox Regression ◽  
Predictor Variables ◽  
Health Coverage ◽  
Socioeconomic Indicators ◽  
Oral Health Services

Abstract Background: Oral cancer still representing one of the most frequent neoplasms worldwide, especially in developing countries. Socioeconomic factors and access to health services may be associated with the risk of oral cancer. This study analyzed the frequency of new hospitalized cases of oral cancer in Brazil, according to socioeconomic variables and data on oral health coverage in its public health system. Methods: Observational study, with a retrospective cohort design, whose sampling units was composed of all Brazilian cities that registered at least one hospitalized case of oral cancer in the National Cancer Institute database, between 2002-2017. For each city included, were collected the population size, Municipal Human Development Index (M-HDI), Gini Coefficient, as well as data regarding oral health coverage in primary care and the number of Dental Specialized Center (DSC). The COX regression was used to determine the risk ratio for a city to present a new hospitalized case of oral cancer, and the effect of the predictor variables on the incidence of cases was verified by the Hazard Ratio measure. Accumulated risk curves were obtained for the adjusted model, and for each variable. Results: All predictor variables were considered significant in the regression model (p<0.05). Cities above 50 thousand inhabitants, with high or very high M-HDI, more unequal (Gini>0.4), with less oral health coverage in primary care (<50%) and without the presence of DSC demonstrated a greater accumulated risk of having 1 or more hospitalized cases of oral cancer. Conclusions: The risk of hospitalization for oral cancer in Brazil is greater in cities with a larger population size, more developed, with greater inequality of income distribution and with less availability of public oral health services.

scholarly journals The Impact of Inequalities and Health Expenditure on Mortality Due to Oral and Oropharyngeal Cancer: A 20-Year Trend Analysis

2020 ◽  
Author(s):  
Amanda Cunha ◽  
Alessandro Bigoni ◽  
José Antunes ◽  
Fernando Hugo
Keyword(s):  
Health Services ◽  
Oropharyngeal Cancer ◽  
Government Expenditure ◽  
Health Spending ◽  
Mortality Rates ◽  
Mortality Data ◽  
Mortality Trends ◽  
Oral And Oropharyngeal Cancer ◽  
The Government ◽  
The Impact

Abstract Objectives: To assess the magnitude and trend of mortality rates due to oral (OC) and oropharyngeal cancer (OPC) in the 133 Intermediate Geographic Regions (IGR) of Brazil between 1996 and 2018 and to analyze its association with sociodemographic variables and provision of health services. It also aims to compare the trend of mortality from neoplasms that have been reported as associated with HPV (OPC) with the trend of neoplasms that have been reported as not associated with HPV (OC). Methods: We obtained mortality data from the Mortality Information System in Brazil and analyzed the trends using the Prais-Winsten method. Then, we assessed the relationship between mortality trends and socioeconomic, health spending, and health services provision variables. Results: The median of the APC of the country’s mortality rates was 0.63% for OC and 0.83% for OPC. Trends in mortality in the IGRs correlated significantly with the Human Development Index and government expenditure on ambulatory health care and hospitalizations. Conclusions: Mortality from both types of cancer decreased in those IGR in which the government spent more on health and in the more socioeconomically developed ones. This study found no epidemiological evidence that HPV plays the leading etiological factor in OPC in Brazil.

scholarly journals Does the implementation of a national oral health policy reduce inequalities in oral health services utilization? The Brazilian experience

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Maria Helena Rodrigues Galvão ◽  
Angelo Giuseppe Roncalli
Keyword(s):  
Health Policy ◽  
Oral Health ◽  
Health Services ◽  
Health Services Utilization ◽  
Age Groups ◽  
Public Access ◽  
Services Utilization ◽  
Index Of Inequality ◽  
Oral Health Services ◽  
Oral Health Policy

Abstract Background This study aimed to assess the trend in income-related inequalities in oral health services utilization by the Brazilian population from 1998 to 2013. This period represents a timeline that includes different stages of implementation of the National Oral Health Policy. Methods The design was based on repeated cross-sectional surveys using secondary data from household-based studies carried out in Brazil in 1998, 2003, 2008, and 2013. The dependent variable was “having access to a dentist appointment at least once in a lifetime (yes/no).” Monthly household per capita income, based on Brazil’s minimum wage, was included as the main independent variable. To measure the inequalities in oral health access related to economic position, the following complex indexes based on regression were used: (a) the slope index of inequality (SII) and (b) the relative index of inequality (RII). Results There was a reduction in the percentage of individuals who never had a dentist appointment for all age groups and income classifications. In general, there was a reduction trend in absolute inequality for all age groups (p < 0.001). The relative inequality and reduction trend were different between the age groups studied. Conclusions The National Oral Health Policy was very important for expanding free of charge, public access to dental appointment. However, despite policy implementation, there continues to be high levels of inequality in access to dental consultation. Assessing which strategies are necessary to overcome this challenge is discussed.

scholarly journals Accuracy of the need for dental prosthesis and associated factors between elderly in Recife, Brazil

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L F R Santos ◽  
E P Carvalho ◽  
S R A Oliveira ◽  
R S Moreira
Keyword(s):  
Oral Health ◽  
Health Services ◽  
Associated Factors ◽  
Family Income ◽  
Dental Prosthesis ◽  
The Self ◽  
Metropolitan Region ◽  
Self Perception ◽  
Epidemiological Surveys ◽  
Oral Health Services

Abstract Background The latest national oral health survey showed a high prevalence of the need for dental prostheses between the Brazilian elderly. To classify this need, normative (clinical) and subjective (self-reported) criteria must be considered since patients' self-perception takes into account social and functional issues that arise with oral health problems. Few studies investigate the agreement between these criteria, as well as its determinants. Thus, this study aimed to investigate the accuracy of the need for the use of total dental prosthesis and factors associated with the agreement between criteria. Methods Cross-sectional study, carried out in three municipalities in the Metropolitan Region of Recife, with a random sample of 816 elderly people from 65 to 74 years old. The dependent variable was the accuracy, calculated by the agreement between the self-reported and the normative need for a total dental prosthesis, and the independents were assembled in three blocks (socioeconomic/demographic, access to oral health services and self-perceived oral health). Hierarchical logistic models were conducted for total upper prosthesis (TUP) and total lower prosthesis (TLP). Results The self-perception of the need for prosthetic use presented an accuracy of 75.9% (95% CI = 72.8-78.7%) for TUP and 78.6% (95% CI = 75.6-81.3%) for TLP. In the multiple analysis, the accuracy for TUP and TLP needs holds an association with the variables: family income, age and time since the last dental appointment. Conclusions In conclusion, the self-perception of need for dental prosthesis demonstrates potential applicability for the elderly, presenting notable accuracy values. It suggests that studies based on patients' self-reports should be stimulated, aiming for the evaluation and validation of self-reported criteria in different contexts and cultures. Furthermore, the identification of accuracy associated factors can help to build more meaningful questions to be used in future surveys. Key messages The use of the self-reported need for total dental prosthesis may be feasible when considering lower cost, reduced time of execution and ease of use in population epidemiological surveys. Application of self-reporting as an epidemiological tool for planning and monitoring oral health services, incorporating it in the form of indicators for oral health surveillance.

scholarly journals Reopening Oral Health Services during the COVID-19 Pandemic through a Knowledge Exchange Coalition

2021 ◽  
pp. 238008442110119
Author(s):  
M. McNally ◽  
L. Rock ◽  
M. Gillis ◽  
S. Bryan ◽  
C. Boyd ◽  
...  
Keyword(s):  
Health Care ◽  
Oral Health ◽  
Health Services ◽  
Return To Work ◽  
Health Care Providers ◽  
Online Survey ◽  
Knowledge Exchange ◽  
Oral Health Care ◽  
Care Providers ◽  
Oral Health Services

Background: The COVID-19 novel coronavirus closed oral health care in Nova Scotia (NS) Canada in March 2020. Preparing for a phased reopening, a knowledge exchange coalition (representing government, academia, hospitals, oral health professions, and regulators) developed return-to-work (RTW) guidelines detailing the augmentation of standard practices to ensure safety for patients, oral health care providers (OHPs), and the community. Using online surveys, this study explored the influence of the RTW guidelines and related education on registered NS OHPs during a phased return to work. Methods: Dissemination of R2W guidelines included website or email communiques and interdisciplinary education webinars that coincided with 2 RTW phases approved by the government. Aligned with each phase, all registered dentists, dental hygienists, and dental assistants were invited to complete an online survey to gauge the influence of the coalition-sponsored education and RTW guidelines, confidence, preparedness, and personal protective equipment use before and after the pandemic. Results: Three coalition-sponsored multidisciplinary webinars hosted 3541 attendees prior to RTW. The response to survey 1 was 41% (881/2156) and to survey 2 was 26% (571/2177) of registrants. Survey 1 (82%) and survey 2 (89%) respondents “agreed/strongly agreed” that R2W guidelines were a primary source for guiding return to practice, and most were confident with education received and had the skills needed to effectively treat patients during the COVID-19 pandemic. Confidence and preparedness improved in survey 2. Gowns/lab coat use for aerosol-generating procedures increased from 26% to 93%, and the use of full face shields rose from 6% to 93% during the pandemic. Conclusions: A multistakeholder coalition was effective in establishing and communicating comprehensive guidelines and web-based education to ensure unified reintegration of oral health services in NS during a pandemic. This multiorganizational cooperation lay the foundation for responses to subsequent waves of COVID-19 and may serve as an example for collaboratively responding to future public health threats in other settings. Knowledge Transfer Statement: The return-to-work strategy that was developed, disseminated, and assessed through this COVID-19 knowledge exchange coalition will benefit oral health practitioners, professional regulators, government policy makers, and researchers in future pandemic planning.

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