Factors associated with dental service use in Brazil according to Andersen's Behavioral Model: analysis of the 2023 Brazilian National Oral Health Survey.

چکیده اصلی

OBJECTIVE: To analyze factors associated with the time since the last dental visit among Brazilians aged 15-19, 35-44, and 65-74 years, according to Andersen's Behavioral Model. METHODS: This cross-sectional analytical study used microdata from a nationally representative oral health survey. Data from 21,385 individuals were analyzed. The outcome was the time since the last dental visit (≤1 year vs. >1 year). The independent variables were grouped into predisposing, facilitating, and perceived need factors according to Andersen's Behavioral Model. Analyses accounted for the complex sampling design and were performed using multilevel logistic regression with random intercepts at the municipality level, estimating odds ratios (OR) and 95% confidence intervals (95%CI). RESULTS: Older adults (OR 1.436; 95%CI 1.242-1.660), Black (OR 1.161; 95%CI 1.011-1.334) and Brown individuals (OR 1.096; 95%CI 1.005-1.196) were more likely to report a dental visit more than one year prior. Higher education was strongly associated with lower odds of delayed visits (OR 0.383; 95%CI 0.318-0.461). Poor self-rated oral health (OR 2.486; 95%CI 2.041-3.028) increased the likelihood of delayed visits, whereas dental pain was associated with more recent use (OR 0.413; 95%CI 0.382-0.448). Use of private services was associated with lower odds of delayed visits (OR 0.820; 95%CI 0.732-0.919). Municipal coverage and the presence of specialized centers were not significantly associated. CONCLUSION: Sociodemographic characteristics and perceived need factors remain central determinants of recent dental service utilization patterns in Brazil.

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