Friday, 26 May 2017

679. State would spend € 280 million a year on dentistry for all

The state would need 280 million euros annually to give all users access to dental care under a convention with private practices, according to a study by the Universidade Nova de Lisboa.
The study, which the Lusa agency had access to, offered several scenarios to increase Portuguese access to oral health care, and recommends that public coverage be increased through private provision, a scheme agreed on as in other areas (analysis Clinics, for example). The application of this scheme points to a charge of the National Health Service (SNS) of 280 million euros per year, which would give an expense of 28 euros for each Portuguese.
The head of the Order of Dentists, which ordered the study, said that the most reasonable option in terms of costs and equipment already installed would be to take advantage of the approximately 10,000 dentists who are distributed by nearly 7,000 clinics and offices. In an interview with the Lusa agency, Orlando Monteiro da Silva, explained that the annual cost of 280 million euros would allow to include about 90% of health care for all users of the SNS. That is, those costs include the most frequent care and treatment, such as extractions, devitalization or cleaning.
The president recognizes the economic weight of the measure, assuming that it is not carried out suddenly, but rather in a gradual perspective, opening up oral health care to the population successively, starting with, for example, the most disadvantaged or users with chronic pathologies. There is a gradual path that can be traversed. And it must be done, already wasted too much time, with other costs: the cost of doing nothing is much higher than this, the cost of having a population to avoid food, the cost of absenteeism to work, children missing school , The social cost of toothless walking, he said.The study by Alexandre Lourenço and Pedro Pita Barros, from Nova School of Busines & Economics, also outlined the scenario of an entirely public oral health care setting, equipping health centers and hiring dentists. To meet the needs of the country, it would be necessary to hire 6,500 dentists, which would represent an annual cost of 182 million euros, only for the payment of salaries of these professionals.
The study did not carry out other accounts for this scenario, but the OMD estimates that the value would triple if expenses were recorded for dental assistants, adaptation works, equipment and maintenance costs, as well as consumables used in Queries. Forty years later, the NHS landscape changed radically, with almost 7,000 dental offices and clinics. The study recommends not duplicating and looking for a possibility to take advantage of the private investment that is wasted, he summed up.For the president of dentists, the future path does not have to go through a fully public or fully agreed solution, and there may be a combination of both. One of these possibilities of mixed solution could be to have a scheme agreed with a small network of health centers with dentists for some groups of patients, such as oncological or renal insufficiencies or other type of chronic patients.
The study also evaluates the scenario of increasing the private coverage of oral health care through insurance with private provision, and the State has to negotiate with the insurance sector. According to the authors, this hypothesis could allow a reduction of the financial risk of the families and make the existing private provision profitable, but the political and social framework is adverse to the use of the insurance sector to assure functions of the State.
The dentists' leader points out that the country has already waited too long for universal access to oral health care, considering that political decisions should be weighed against the scientific and technical bases and without ideological prejudices as a backdrop.
Porto Canal    

678. Oral health consultations in health centers start as of Saturday

As of Saturday, oral health consultations are beginning to be phased in at the health centers, initially aimed at more vulnerable users and, starting in 2017, all registered users. According to an order published this Friday in the Diário da República, from July 2 pilot experiments are being started in some health centers in Greater Lisbon and Alentejo to expand the National Program for the Promotion of Oral Health ( PNPSO).In the first phase, which runs until 31 December of this year, patients with diabetes, neoplasias, chronic cardiac or respiratory disease, renal failure on hemodialysis or peritoneal dialysis, and transplant patients, enrolled in Centers Groupings (ACES) where the pilot experiences are taking place. In the second phase, as from 1 January 2017, depending on the assessment of unmet needs and waiting times, the project can be extended to all users enrolled in these ACES, in a phased and progressive manner, depending on the referral By the family doctor.
In the area of the Regional Health Administration of Lisbon and Vale do Tejo, the pilot experiences will be held in the ACES of Almada-Seixal (Monte da Caparica Health Center), Arco Ribeirinho (Moita Health Center), Médio Tejo (Health of Fátima), Lezíria (Salvaterra de Magos, Cartaxo and Rio Maior Health Centers), Tejo Estuary (Azambuja, Alenquer and Arruda dos Vinhos Health Centers) and Oeste Oeste (Health Centers of Lourinhã and Mafra -Ericeira).
Within the scope of the Alentejo Regional Health Administration, pilot experiments are carried out at ACES Alentejo Central, namely at the Montemor-o-Novo and Portel Health Centers.

Users enrolled in these health centers may be referred for oral health consultations following a decision of the family doctor, and the doctor who provides the oral health consultation should maintain close articulation with the other professionals of the family health team. The order specifies that the oral health care included in the pilot experiments only includes those treatments considered necessary in clinical terms, leaving interventions of a strictly aesthetic nature.
Currently, under PNPSO, children and young people under the age of 18 are pregnant, undergoing prenatal surveillance at the National Health Service, elderly beneficiaries of the solidarity supplement and users infected with the HIV / AIDS virus. The PNPSO is reviewed by the Directorate-General for Health until July 29, 2016.