Factors Associated with Avoiding Referrals by Dental Teleconsulting Sessions in Brazil.

Area of Science:

• Oral Health
• Telemedicine
• Public Health

Background:

• Dental referrals between care levels are crucial for patient management.
• The COVID-19 pandemic accelerated the adoption of telehealth solutions in dentistry.
• Understanding factors influencing referral decisions is vital for optimizing care pathways.

Purpose of the Study:

• To determine the frequency of avoided referrals through dental teleconsulting.
• To analyze individual and contextual factors associated with avoided dental referrals.
• To assess the effectiveness of dental teleconsulting in managing patient care levels.

Main Methods:

• Cross-sectional analytical study using asynchronous dental teleconsulting data from 2020.
• Multilevel analysis to examine individual (dentist sex, specialty) and contextual (municipality characteristics) variables.
• Statistical analysis using SPSS and Hierarchical Linear and Nonlinear Modeling software.

Main Results:

• Dental teleconsulting successfully avoided referrals in 65.1% of sessions.
• Contextual variables accounted for 44.23% of the variance in avoided referrals.
• Female dentists (OR=1.74) and increased primary health care coverage (OR=1.01) were associated with higher likelihoods of avoiding referrals.

Conclusions:

• Dental teleconsulting is an effective tool for preventing unnecessary referrals.
• Both individual professional characteristics and broader public health infrastructure influence referral outcomes.
• Teleconsulting optimizes dental care delivery by reducing barriers to accessing appropriate levels of care.