Publications by authors named "Otavio P D'Avila"

Objective: This cross-sectional study aimed to evaluate the psychometric properties of the reduced version of the Primary Care Assessment Tool (PCATool) for adult patients in the Brazilian National Health Survey 2019, a nationally representative population-based study.

Methods: The reduced version of PCATool-adults measures the presence and extent of the following attributes: degree of affiliation; first-contact access; longitudinality; care coordination; comprehensiveness; family orientation; and community orientation. Exploratory and Confirmatory Factor Analysis were performed.

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Article Synopsis
  • The study examined inequalities in specialized public dental care (SPDC) in Brazil from 2015 to 2017, using data from 954 SPDC units across 893 municipalities.
  • It found that 62.9% of municipalities had low SPDC production, with larger municipalities and those with high human development index (HDI) producing more dental services.
  • The findings indicated significant gaps in SPDC production linked to social factors, showing that higher social indicators lead to better dental care performance in these areas.
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Objective: To investigate the perception of parents or caregivers regarding the need for dental appointments for adolescents aged 12-13 years and associated factors.

Methods: Data from the Pelotas 2004 Birth Cohort were used. The outcome variable was the need for dental appointments for young adolescents perceived by parents or caregivers.

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Background: Screening for undiagnosed diabetes using glucose testing is recommended globally to allow preventive action among those detected. Our aim was to evaluate the access to glucose testing to screen for diabetes in Brazil using self-reported information on recent testing and medical consultation from national surveys of Brazilian adults.

Methods: The PNS) was conducted in 2013 and 2019 drawing probabilistic samples of Brazilians aged 18 years and above.

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Oral cancer represents a public health issue because of its high mortality rate, resulting mainly from diagnostic delays. Insufficient training in oral diagnosis is usually perceived by dentists. Distance learning could be used as an auxiliary tool to bridge that gap.

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Since 1994, Brazil has been offering Primary Health Care (PHC) services based on the Family Health Strategy. The ESF has achieved important results. During this period, the PHC financing model did not undergo major methodological changes.

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In 2019, unprecedentedly among the official statistical institutes worldwide, the IBGE included a particular module on evaluating primary health care in its central population-based population survey, the National Health Survey (PNS-2019). The survey considered the reduced version of the Primary Care Assessment Tool (PCAT), developed and disseminated by Starfield and Shi, to assess the existence and extent of the structure and process characteristics of PHC services. It is the most significant probabilistic sample using this instrument ever conducted in a single country in the world that interviewed users aged 18 or over (n=9,677).

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The objective of this study is to describe the profile of use of primary health care services, estimated by the PNS, of the population living in households registered and not registered with the Famly Health Strategy - FHS, in the years 2013 and 2019. Cross-sectional study carried out using microdata from national health surveys 2013 and 2019. The sample originated from a master sample, consisting of a set of units from selected areas in a register.

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The present study aimed to estimate the impact of the COVID-19 pandemic on dental care procedures in the Public Health System in Brazil. A retrospective, ecological study was carried out, comprising 5,564 Brazilian municipalities. The number of dental procedures (per 100,000 inhabitants) performed in the Brazilian Public Health System (SUS) was the outcome.

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This study verified the internal consistency and reliability of an instrument to evaluate dental services in Primary Health Care (PHC). In order to verify the factor validity, a factor analysis with principal component extraction and varimax orthogonal rotation method was used. Factors with three or more items with factor loadings greater than 0,35 were selected.

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Objectives: The purpose of this study was to describe the impact of the COVID-19 pandemic on Primary Health Care in Brazil.

Methodology: This retrospective ecological study was carried out using Brazilian municipality data obtained from the information systems of the National Public Health System. The outcomes were medical appointments, prenatal procedures and diabetes care.

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Background: Several middle and upper income countries carry out household surveys that seek to trace the profile of access and use of health services. Probably one of the most ambitious examples is Brazil, with its National Health Survey (PNS-2019). We evaluated PNS-2019, presenting in an unprecedented way, one of its innovations, which refer to Starfield and Shi's adult Primary Care Assessment Tool (PCAT).

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In this study, we describe a method for reaching a target population (i.e., dentists practicing in Brazil) to engage in survey research using traditional e-mail invites and recruitment campaigns created on Instagram.

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Article Synopsis
  • - The study investigated the perceptions of 192 dentists in Rio Grande do Sul about their training and practices related to diagnosing and preventing oral cancer, including their attitudes towards performing biopsies.
  • - Results showed that while nearly all dentists perform thorough mouth exams and provide tobacco cessation counseling, only a small fraction regularly perform biopsies, mostly due to a lack of experience.
  • - Many dentists felt that their clinical and theoretical training in oral medicine was inadequate, indicating a need for ongoing education and practical training to improve their skills in diagnosing oral lesions and cancer prevention.
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A nationwide survey of dentists was carried out in Brazil, a new pandemic epicenter, to analyze how dental care coverage has been affected in public versus private networks, changes in routine and burdens, and how local prevalence of COVID-19 affects dental professionals. Dentists were recruited via email and Instagram®. Responses to a pre-tested questionnaire were collected May 15-24, 2020.

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The Ministry of Health, through the Primary Health Care Secretariat and in partnership with the Secretariat of Health Surveillance, built and implemented Primary Health Care (PHC) strategies within the scope of support to local managers and in partnership with the National Health Secretaries Council (CONASS) and the National Municipal Health Secretariats Council (CONASEMS) to combat COVID-19. These actions have PHC as the main responsible for several areas and physical, human, and financial resources, as well as allow boosting national progress towards the use of information and communication technologies and new partnerships for conducting research.

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EstomatoNet was created in the south of Brazil to provides specialist support over a web-based platform to primary care dentists for diagnosis of oral lesions. To evaluate the usability of EstomatoNet and to identify user perceptions regarding their expectations and difficulties with the system; and to compare the perceptions of regular users of the service to those of first-time users. Sixteen dentists were selected for the study: 8 were frequent users of EstomatoNet and 8 were residents who had never used the Platform.

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Background: The aim of the present study was to assess the level of satisfaction of dentists working in primary healthcare (PHC) with a Distance learning (DL) course in pediatric dentistry offered by the TeleHealthRS center, and to the investigate possible associations between the variables indicative of their satisfaction and their performance on the questionnaires applied before and after the course.

Methods: The course was offered in 2015 by the Federal University of Rio Grande do Sul (UFRGS) together with the TeleHealthRS center in Brazil. Data were collected on the participants' personal and professional profile, their pre- and post-course knowledge about pediatric dentistry, and their satisfaction with the course.

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Five new challenges were brought to the federal management of SUS from the establishment of the Primary Health Care Secretariat (SAPS) in May 2019, as follows: a) to expand people's access to health facilities; b) to define a new financing model from health outcomes and efficiency; c) to define a new model of provision and training of family and community doctors for remote areas; d) to strengthen clinic and multi-professional teamwork; e) to expand computerization of health facilities and use of electronic medical records. This essay discusses these elements in light of a new evaluation model that also guides a new process of financing the Brazilian Primary Health Care (PHC). It builds on the correction of distributive distortions, and also seeks to guide greater effectiveness and efficiency in public investment and quality of service provided to the population.

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This paper aims to present a debate on the new Brazilian Primary Health Care (PHC) funding policy. We consulted the national and international literature, and we involved municipal, state, and federal PHC managers to develop the payment method. The proposed final model is based on weighted capitation, payment-for-performance, and incentive for strategic actions.

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More than 30 years into the anniversary of the Unified Health System (SUS), 40 years after Alma-Ata, and soon after the Astana Conference, the Brazilian Ministry of Health proposes several strategies to strengthen PHC with the creation of the Primary Health Care Secretariat (SAPS). This paper presents the process of developing the national PHC service portfolio, one of the strategies developed by SAPS to strengthen the PHC clinic, and the challenges for the expansion of comprehensive care in the actions developed by the Family Health and Oral Health teams. After the public consultation, from a total of 209 initially listed actions and procedures, including incorporations and exclusions, 210 items were defined, including the actions planned for the integration between primary care and health surveillance.

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Background: South Africa started to lead the cross-culturally validation and use of the Primary Care Assessment Tool (PCAT) in Africa, when Professor Bresick filled a gap, as this continent was until then the only one that had never used it in evaluation of primary health care facilities until 2015.

Aim: The authors aim to demonstrate that after the consolidation of Bresick's team to an African version of PCAT, it had been adapted to household survey in Brazil.

Methods: In this letter, authors reflect on how Brazil had adapted PCAT to a national random household survey with Brazilian National Institute of Geography and Statistics (IBGE) - the Brazilian Census Bureau.

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