A Odontologia Hospitalar no serviço público do Estado de São Paulo

O projeto Sorria mais Sao Paulo, recentemente lancado pelo Governo do Estado, preve, em uma de suas vertentes, a instituicao da "Odontologia Hospitalar" e, visando a integralidade da atencao a saude, incluiu o Cirurgiao-Dentista (CD) a equipe hospitalar. O objetivo deste estudo foi mapear os atuais servicos de Odontologia na Rede Hospitalar Publica do Estado de Sao Paulo. Para tanto, foi consultado o Cadastro Nacional de Estabelecimentos de Saude (CNES). A rede publica conta com 199 hospitais, sendo apenas 20% dos municipios contemplados. O Departamento Regional de Saude I apresenta a maior concentracao desses estabelecimentos (37). A esfera administrativa da maioria dos hospitais e privada (87,4%) e 66,3% sao de gestao municipal, sendo que 17% atendem exclusivamente ao SUS. Existem 859 CDs contratados, porem mais da metade desses profissionais possuem perfil de atuacao diferente do proposto pelo programa de "Odontologia Hospitalar". Em relacao a jornada de trabalho, 58% trabalham menos de 20 horas semanais e pelo menos metade do tempo desses profissionais e destinado ao atendimento ambulatorial de pacientes. 58,20% dos CDs possuem vinculo de "autonomo", e 40,39% das contratacoes sao intermediadas por entidades filantropicas. Ao avaliar os CDs que possuem o perfil designado no programa "Odontologia Hospitalar", verifica-se que a relacao leito/CD e de 87,57:1. Com CDs com uma carga horaria pequena e dividida entre o atendimento ambulatorial e hospitalar, parece apropriado tanto a estruturacao de novos servicos como o aumento de contratacoes especificas para suprir a demanda crescente desse profissional de saude em hospitais. The Sao Paulo state government recently began a project known as "Sorria Mais Sao Paulo" ("Smile More Sao Paulo"). which, among other measures, instituted a Hospital Dentistry Program within the state's public healthcare system. In an attempt to be more comprehensive, the state government has added dental surgeons (DSs) to hospital staff. The goal of this study was to chart the dentistry services available in Sao Paulo's public healthcare system. To do so, Brazil's National Health Establishment Registry (CNES) was consulted. The state's public healthcare network includes 199 hospitais, though only 20% of the state's cities are covered. The largest concentration of establishments (37) are in the DRS I region. In these hospitais, the administrative sectors are often private (87.4%). 66.3% are under city management, and 17% are exclusively public hospitais. Though 859 DSs have been hired, more than half of them per- form tasks that were not proposed by the Program, 58% work fewer than 20 hours per week, and more than half of their time is spent on ambulatory care services. Of these DSs, 58.20% are considered "independent contractors." and 40.39% of their hirings are initiated by philanthropic entities. When one considers only the DSs that perform the tasks of the Program, the ratio of hospitalized patients to doctors is 87.57:1. With DSs working few hours and dividing their time between surgery and ambulatory care, it seems that the state needs to develop new servicesand increase hirings in order to meet the demand for these healthcare professionals.