Management Models of Centers of Dental Specialties: Analysis from PMAQ-CEO

Objective: To identify and understand how management models are being institutionalized in Centers of Dental Specialties, specifically with regard to the publicprivate relationship. Material and Methods: A descriptive and quantitative study using database of the 1st cycle PMAQ/CEO External Evaluation, specific to the question directed to managers or Dentists working at CEO: what is the labor link of CEO professionals? It was considered an alternative model when at least one dentist had nonstatutory labor relationship. Statistical analyses performed were exploratory and descriptive. Results: Data were collected from 930 CEOs distributed throughout Brazil, of which 170 (18.3%) are under alternative management model, especially in the southeastern (37.6%) and northeastern regions (34.7%), distributed in 147 municipalities, 144 (85%) under municipal management, 22 (13%) under state management. Of CEOs with state management, 68% are in Ceará State and 27% in Paraná State. In 78.6% of CEOs, the labor link of dentists is exclusively via direct public administration. Other 10.1% are in direct public administration with new legal arrangements. Only alternative management models were identified in 8.2% of CEOs. Conclusion: A significant number of CEOs are under alternative management model, and its distribution to all regions indicates a consolidation trend.

Centers of Dental Specialties in the Context of Oral Health Attention Regionalization in Brazil: PMAQ-CEO Results

Objective: To describe the distribution of Centers of Dental Specialties by Brazilian health regions and analyze the intermunicipal consortia as an alternative management of provision of oral health in the medium complexity. Material and Methods: The quantitative database of the external evaluation of the first-cycle PMAQ CEO directed to the CEO Manager was explored (Module II - 4.1), which seeks to identify the relationship of professionals and locate the consortium-type management. To obtain data about health regions, the interfederactive department of Strategic and Participative Management of the Health Ministry of Brazil database has been consulted. Results: In national perspective, of the 438 health regions, 78.1% (n = 342) have at least one service implanted. Under federal management, only university services: 02 in Pará and 01 in Santa Catarina. There are 40 services under state management (4.3% of the total in Brazil), half of which are under the model of consortiums between state and municipalities, especially Ceará, with fifteen and Paraná with five. Municipals consortiums are institutional arrangements still incipient: 4.62% of specialized dental clinics in Brazil. Conclusion: There was a rapid expansion of Centers of Dental Specialties after ten years of their implementation, demonstrating a healthy capillarity and a great capacity for the implementation of Health Policies. The incipient supply of medium complexity oral health services via specialized dental clinics of the consortiumtype management model was verified.

Theoretical and Methodological Aspects of the External Evaluation of the Improvement, Access and Quality of Centers for Dental Specialties Program

Objective: To introduce the main theoretical and methodological aspects of the external evaluation of the 1st cycle National Program for Quality Evaluation (AEPMAQ/ CEO). Material and Methods: This is an evaluative and quantitative research carried out in all Centers for Dental Specialties - CEO of Brazil, and macro-geographical regions were taken into account for analysis. The general AE-PMAQ/CEO coordination was from the Collaborative Centre for Oral Health Surveillance of the Ministry of Health - Federal University of Pernambuco and Department for Primary Health Care of the Ministry of Health. A collaborative network was established to offer a scientific and technical support for the Project among different higher education institutions around the country, state oral health coordination and quality researchers of AE-PMAQ/CEO. Data collection was carried out through interviews with managers, dentists and users. In addition, researchers used an observation template to check for infrastructure and a questionnaire to register previously discussed quality standards. Conclusion: The external evaluation of the 1st cycle National Program for Quality Evaluation offered data to demonstrate and give recognition to CEO services and municipalities' managers to assure quality for specialized dental care.