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Objectives: Item response theory (IRT) is a method used to design, analyze, and score tests, questionnaires, and similar instruments measuring abilities, attitudes, or other variables. The aim of this study was to assess the psychometric properties of dental care questions in the "Programa Nacional de Melhoria do Acesso e Qualidade da Atenção Básica-PMAQ-AB," Brazil, using IRT.Methods: Dentists in primary health care units in Brazil (n = 12,403) were interviewed face-to-face using a structured questionnaire. The questions were primarily dichotomous, with a no answer/do not know option. The items about dental care from a Brazilian national evaluation survey were analyzed using the IRT model (20 items). Oral health teams (OHTs) received scores that varied from the lowest performance level to the highest performance level. Scores for the Brazilian states and the Federal District were calculated to evaluate the regional distribution of OHT performance.Results: The questions about dental care exhibited higher discrimination power for OHTs with below average performance. In general, the teams, including those with low performance, performed the actions, and procedures included in the questionnaire. Actions such as making prostheses and tracking and monitoring oral cancer cases characterized the high-performing teams. The performance of the teams distributed throughout the Brazilian states indicated that OHTs in the south and southeast performed better than OHTs in the rest of the country.Conclusions: Although the analyzed items are insufficient to determine the performance of OHTs, the items related to prosthesis and oral cancer tend to discriminate high-performing OHTs from other OHTs. [ABSTRACT FROM AUTHOR]

This cross-sectional study evaluated the relationship between primary and secondary oral health care in Brazil. For this purpose, data from the National Program for Improving Access and Quality of Primary Care were used. Dentists from 12,403 oral health teams (OHTs) answered a structured questionnaire in 2012. The data were analyzed descriptively and by cluster analysis. Of the 12,387 (99.9%) OHTs that answered all the questions, 62.2% reported the existence of Dental Specialties Centers (DSCs) to which they could refer patients. The specialties with the highest frequencies were endodontics (68.4%), minor oral surgery (65.8%), periodontics (63.0%), radiology (46.8%), oral medicine (40.2%), orthodontics (20.5%) and implantology (6.2%). In all percentiles, the shortest wait time for secondary care was for radiology, followed by oral medicine and the other specialties. In the 50th percentile, the wait for endodontics, periodontics, minor oral surgery and orthodontics was 30 days, while for implantology, the wait was 60 days. Finally, in the 75th percentile, the wait for endodontics, orthodontics and implantology was 90 days or more. Two clusters, with different frequencies of OHT access to specialties, were identified. Cluster 1 (n = 7,913) included the OHTs with lower frequencies in all specialties except orthodontics and implantology compared with Cluster 2 (n = 4,474). Of the Brazilian regions, the South and Southeast regions had the highest frequencies for Cluster 2, with better rates for the relationship between primary and secondary care. This study suggests certain difficulties in the relationship between primary and secondary care in specific specialties in oral health, with a great number of OHTs with limited access to DSCs, in addition to different performance in terms of OHT access to DSCs across Brazilian regions. [ABSTRACT FROM AUTHOR]

Objective: to analyze service users' perception of health care provided by the teams participating in the National Program for Primary Care Access and Quality Improvement (PMAQ-AB) in Brazil., Methods: this was a cross-sectional study using data from interviews with users of services provided by PMAQ-AB teams in 2012. Multinomial logistic regression was used to analyze the association between perception level (very good/good, regular, poor/very poor) and variables of four primary care attributes: accessibility, integrality, longitudinality and care coordination., Results: out of 65,391 users, 78.9% evaluated care as very good/good, 19.0% as regular and 2.1% as poor/very poor. Associations with care by the same physician (OR 3.21; 95% CI 2.68, 3.83) and physical examination at consultation (OR 3.08; 95% CI 2.50, 3.79) were the most prominent., Conclusion: the majority of users evaluated care positively, however there is perception of care problems within the recommended attributes.

Information and Communication Technologies (ICTs) are means to handle information, streamline communication, and contribute to patient care. This article describes the incorporation of Information and Communication Technologies in primary care and its association with quality, based on the Brazilian National Program for the Improvement of Access and Quality in Primary Care (PMAQ in portuguese). This was a cross-sectional study with 17,053 teams. An Index of Incorporation of ICTs was created, which included: information infrastructure, systems, and utilization. Regression analysis was used to assess associations. Only 13.5% of the teams had a high degree of ICTs. The strongest association was seen in the utilization of information. ICTs can contribute to improving quality of primary care.

Objective: To provide an overview of the distribution of institutional support in primary care in Brazil and to identify associations between the activities of institutional support and the outcome of the certification of the National Programme for Improving Access and Quality in Primary Health Care (PMAQ)., Materials and Methods: A cross-sectional study was conducted through interviews with 16 960 professionals in Brazil in 2012.To examine the relationship between the received support and the quality of health care it was made a multiple binary logistic regression., Results: A positive relationship between high-level support and certification in the sub-dimensions analyzed was observed: women and child care, diabetes mellitus/ hypertension and mental health.The support activities which contributed most were: self-assessment, shared assessment, targeted workshops and training., Conclusion: Institutional support activities have helped to improve the quality and access of the population to healthcare in the country.

Objective: To describe the primary care actions performed by oral health teams (OHTs) that participated in a large national survey led by the Ministry of Health in 2012., Methods: A total of 12,403 dentists from OHTs completed a set of survey questions (response rate = 85.01%) on the organization of care, basic dental procedures and oral health surveillance actions of OHTs. Descriptive and hierarchical cluster analyses were developed., Results: The majority of OHTs (85.2%) reported that they performed "patient welcoming". The delivery of services was based on a patient's identified disease risk (83.1%), and continuity of care was ensured by 85.9% of OHTs. Individual preventive, restorative and surgical procedures were performed by the majority of the teams; however, screening for oral cancer and construction of dental prostheses/dentures occurred less frequently. Cluster 1 was composed of OHTs with the lowest proportion of oral healthcare actions related to oral cancer and dental prostheses/dentures, and the Southeastern and Southern regions had higher proportions of OHTs from cluster 2., Conclusions: OHTs adhere to some of the principles of primary care organizations; however, the teams perform fewer actions related to oral cancer treatment and rehabilitation with complete dentures. The geographical distribution of the clusters was unequal in Brazil.