The Regulation of Services in Secondary Oral Health Care in Brazil

Paulo Sávio Angeiras de Goes, Ronald Pereira Cavalcanti, Danilson Ferreira da Cruz, Leopoldina de Fátima Dantas de Almeida, Wilton Wilney Nascimento Padilha


Objective: To analyze the regulation of access to Centers for Dental Specialties (CEO) in the 1st cycle of Program for Improving Access and Quality of Centers for Dental Specialties (PMAQ-CEO), specifically the waiting time for the first consultation in association with socioeconomic and demographic factors of users and the characteristics of services. Material and Methods: The quantitative database of the 1st cycle PMAQ-CEO external evaluation was used, with question directed to the CEO user (Module III - 3.1 and 3.2), which sought to identify user characteristics and access to CEO. To obtain data, a field phase was carried out between months of February to June 2014 in 930 CEOs in all Brazilian states. Results: Users who obtained the first appointment within thirty days of waiting were those who had family incomes above 10 minimum wages; which showed higher schooling; appointment scheduling by telephone made directly to the CEO; and that the consultation was accomplished by "squeeze in" option. Conclusion: It was observed that aspects related to schooling, family income and primary health care coverage influence the waiting time to obtain the first consultation in CEO. There were several ways of referencing of users, and those who performed better were those who shared accountability for the appointments between service and user.


Health Services Administration; Oral Health; Quality of Health Care

Full Text:



Pan American Health Organization. A política de regulação do Brasil. Mendonça CS, Reis AT, Moraes JC (Orgs.). Brasília: Organização Pan-Americana da Saúde, 2006. 116 p.

Baduy RS, Feuerwerker LCM, Zucoli M, Borian JT. Healthcare regulation and healthcare management as tools to assure comprehensiveness and equity in health. Cad Saúde Pública 2011; 27(2):295-304. doi: 10.1590/S0102-311X2011000200011.

Brasil. Ministério da Saúde. Secretaria de Atenção à Saúde. Departamento de Atenção Básica. Manual de especialidades em saúde bucal. Brasília: Ministério da Saúde; 2008.

Souza GC, Lopes MLDS, Roncalli, AG, Medeiros-Júnior A, Clara-Costa IC. Reference and counter-reference in oral health: Regulation of access to specialized dental care centers. Rev Salud Pública 2015; 17(3):416-28. doi: 10.15446/rsap.v17n3.44305.

Machado AT, Werneck MAF, Lucas SD, Abreu MHNG. Who did not appear? First dental visit absences in secondary care in a major Brazilian city: A cross-sectional study. Ciênc Saúde Coletiva 2015; 20(1):289-98. doi: 10.1590/1413-81232014201.01012014.

Laroque MB, Fassa AG, Castilhos ED. Evaluation of secondary dental health care at the dental specialties centre, Pelotas, Rio Grande do Sul, Brazil, 2012-2013. Epidemiol Serv Saúde 2015; 24(3):421-30. doi: 10.5123/S1679-49742015000300008.

Vilarins GCM, Shimizui HE, Gutierrez MMU. Health regulation: conceptual and operational aspects. Saúde Debate 2012; 36(95):640-7. doi: 10.1590/S0103-11042012000400016.

Machado FCA, Silva JV, Ferreira, MAF. Factors related to the performance of Specialized Dental Care Centers. Ciênc Saúde Coletiva 2015; 20(4):1149-63. doi: 10.1590/1413-81232015204.00532014.

Cavalcanti RP, Cavalcanti JCM, Serrano RMSM, Santana PR. Absenteeism of specialized consultations in the public health system: Relationship between causes and the work process of family health teams, João Pessoa - PB, Brazil. Tempus - Actas Saúde Coletiva 2013; 7(2)63-84.

Almeida PF, Gervas J, Freira J, Giovanella L. Strategies for integrating primary health care with specialized care: parallels between Brazil and Spain. Saúde Debate 2013; 37(98)400-15. doi: 10.1590/S0103-11042013000300004.

Albuquerque MSV, Lima LP, Costa AM, Filho DAM. Assistance Regulatory in Recife: possibilities and limits in promoting access. Saúde Soc 2013; 22(1):223-36. doi: 10.1590/S0104-12902013000100020.

Brasil. Ministério da Saúde. Portaria nº 2.488/2011, de 21 de outubro de 2011. Aprova a Política Nacional de Atenção Básica, estabelecendo a revisão de diretrizes e normas para a organização da Atenção Básica, para a Estratégia Saúde da Família (ESF) e o Programa de Agentes Comunitários de Saúde (PACS). Brasília: DF, 2011.

Berg B, Murr M, Chermak D, Woodall J, Pignone M, Sandler RS, Denton B. Estimating the cost of no-shows and evaluating the effects of mitigation strategies. Med Decis Making 2013; 33(8):976-85. doi: 10.1177/0272989X13478194.

Oleskovicz M, Oliva FL, Hildebrand E, Grisi CC, Lima AC, Custódio I. Overbooking in an outpatient healthcare facility in the Brazilian Unified National Health System. Cad Saúde Pública 2014; 30(5):1009-17.

Herkrath FJ, Herkrath APCQ, Costa LNBS, Gonçalves MJF. Performance of Specialized Dental Care Centers considering the sociodemographic context of municipalities of the Amazonas State (Brazil, 2009). Saúde Debate 2013; 37(96):148-58. doi: 10.1590/S0103-11042013000100017.

Figueiredo N, Goes PSA. Development of secondary dental care: a study on specialized dental clinics in Pernambuco State, Brazil. Cad Saúde Pública 2009; 25(2):259-67. doi: 10.1590/S0102-311X2009000200004.

Fernandes LS, Peres MA. Association between primary dental care and municipal socioeconomic indicators. Rev Saúde Pública 2015; 39(6)930-6. doi: 10.1590/S0034-89102005000600010.

Matos DM, Giatti L, Lima-Costa MF. Socio-demographic factors associated with dental services among Brazilian older adults: A study based on the National Household Sample Survey. Cad Saúde Pública 2004; 20(5)1290-7. doi: 10.1590/S0102-311X2004000500023.

Barbato PR, Nagano HCM, Zanchet FN, Boing AF. Tooth loss and associated socioeconomic, demographic, and dental-care factors in Brazilian adults: An analysis of the Brazilian Oral Health Survey, 2002-2003. Cad Saúde Pública 2007; 23(8)1803-14. doi: 10.1590/S0102-311X2007000800007.

Antunes JLF. Socioeconomic status and health: A discussion of two paradigms. Rev Saúde Pública 2008; 42(3):562-7. doi: 10.1590/S0034-89102008005000017.

, Chaves SCL, Barros SG, Cruz DN, Figueiredo ACL, Moura BLA, Cangussu MCT. Brazilian Oral Health Policy: Factors associated with comprehensiveness in health care. Rev Saúde Pública 2010; 44(6):1005-13. doi: 10.1590/S0034-89102010005000041.

Donabedian A. An introduction to quality assurance in health care. New York: Oxford University, 2003. 240p.

Cecílio LCO. Technical health care models: From the pyramid to the circle, a possibility to be explored. Cad Saúde Pública 1997; 13(3):469-78. doi: 10.1590/S0102-311X1997000300022.


PBOCI is a member of CrossRef and all the content of its journals are linked by DOIs through CrossRef.