ACESSO E IMPACTOS FINANCEIROS DA PROVISÃO ORTODÔNTICA PÚBLICA NOS SISTEMAS DE SAÚDE MUNDIAIS: REVISÃO INTEGRATIVA

Abstract

Introduction: The supply of public orthodontic services is still unable to meet the demand for treatment of malocclusions. The resources available are sometimes mismanaged and significant financial impacts contribute to limited access to the services. Objective: To carry out an integrative review regarding the access and financial impacts of public orthodontic service among the various health systems worldwide, considering social inequalities and the referral and counter-referral systems for services. Methodology: A survey was conducted using the BVS (Biblioteca Virtual em Saúde / Virtual Health Library), PubMed, and Cochrane databases, including articles available from 1970 to 2019, which elucidated the guiding question “How does access work and what are the financial impacts of the provision of orthodontic services in different public health systems worldwide?”. Results: 204 articles were found, of which 19 were analyzed. The chronological distribution was relatively uniform. The topic ‘access to orthodontic services’ was most frequently reported and there was a predominance of studies addressing the provision of treatment for children and adolescents. Conclusions: There are significant financial impacts and demographics have a strong influence on access to services. The provision of orthodontic treatments by the private sector predominates, preventive approaches are scarce, and an optimization in the use of available resources is necessary. Primary Care has much to contribute in increasing access, reducing costs, and making the referral / counter-referral system effective.