Accessibility for people with motor disabilities at CEOs in Brazil: an ecological study

The objective was to compare physical accessibility indicators for people with motor disabilities (PwMD) at dental specialty centers (acronym in Portuguese - CEO) across Brazil during the two evaluation cycles of the Access and Quality Improvement Program (acronym in Portuguese - PMAQ) for CEOs. This ecological study utilized secondary data from the external evaluation of PMAQ-CEO in Cycle I (C1), conducted in 2014, and Cycle II (C2), conducted in 2018, including all CEOs that participated in both cycles (n = 889). The structural items analyzed included corridors and doors adapted for wheelchairs, functional wheelchairs, access ramps with handrails, and bathrooms adapted for PwMD. Latent class transition analysis was applied to identify patterns in physical accessibility among CEOs, selecting the latent status (LS) model based on conceptual interpretability and goodness of fit. The final model identified five LS, labeled as follows: LS1 (most accessible); LS2 (inappropriate doors and bathrooms); LS3 (inappropriate ramps and bathrooms); LS4 (wheelchair unavailability); and LS5 (least accessible). In C1, 33.9% of the CEOs were highly accessible, while 17% were minimally accessible. In C2, these proportions shifted to 69.7% for highly accessible and 6% for minimally accessible. When analyzing the two PMAQ-CEO cycles, improvements in physical accessibility indicators were observed across Brazilian CEOs: corridors (9.7% increase) and doors (4.9%) adapted for wheelchairs; functional wheelchairs (15.7%); access ramps with handrails (38.7%); and bathrooms adapted for PwMD (19.6%). It may be concluded that physical barriers to PwMD in Brazilian CEOs were significantly reduced between 2014 and 2018, improving physical accessibility.