A Judicialização da saúde nos sistemas público e privado de saúde: uma revisão sistemática

Freitas, Beatriz Cristina de; Fonseca, E.; Queluz, Dagmar de Paula

doi:10.1590/interface.190345

Cited by 25 publications

(23 citation statements)

References 33 publications

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“…Considering the context, how to plan and develop strategies to mitigate the threats imposed by lawsuits? The present characterization of litigation is similar to the previous studies conducted in Brazil (Oliveira et al, 2020), while others diverge, for example, by demanding mainly incorporated medicines (Freitas et al, 2020). The lack of a national database of lawsuits hinders a comprehensive overview of the phenomenon and, consequently, the generalization of the results.…”

Section: Discussionsupporting

confidence: 80%

“…From the legislative branch, the Federal Law 12.401/2011 (Brasil, 2011a) clarifies the definition of the right to health in the Constitution stating that integral access to medicines in the public health system encompasses the provision of treatments according to the funded lists and the clinical protocols and therapeutic guidelines issued by the Ministry of Health. However, previous studies suggest that part of the lawsuits could be prevented if the regulations of the public health system were adhered to (Carvalho and Leite, 2014;Lopes et al, 2014;Catanheide et al, 2016;Freitas et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

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Strategies to Approach Medicines Litigation: An Action Research Study in Brazil

2021

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Background: In the last decades, litigation has been increasingly used to access medicines in Brazil. This phenomenon has led to the development of diverse strategies to reduce its negative impact on the organization of pharmaceutical services. In spite of that, managers still face difficulties dealing with lawsuits.Objective: This study aims to report the planning and implementation of strategies to approach medicines litigation in a municipality located in the southeast region of Brazil.Methods: Mixed methods were employed through an action research cycle. A network coordination team included researchers from university and municipal managers. The scenario analysis comprised the characterization of pharmaceutical services and the profile of medicines lawsuits. Afterward, strategies were planned to deal with the central problem identified. The action plan involved educational outreach visits and distribution of printed materials for health professionals, evaluated through opinion survey. Group conversations were conducted with the users of the public health system, followed by thematic analysis of reports.Results: The characterization of pharmaceutical services in the municipality revealed that treatments supplied were in accordance with the National Medicines Policy. In addition, a sector was implemented to attend demands for non-incorporated medicines. In spite of the services available, the characterization of lawsuits indicated that the main claimants were users of the public health system, requiring non-incorporated medicines, with therapeutic alternatives available. Thus, educational outreach visits were held in 14 health units (23 physicians in total). Everyone who answered the evaluation declared that they were very satisfied with the approach. Group conversations with the users of the health system reached 227 participants in total. In regard to users’ perception about pharmaceutical services, thematic analysis of reports identified three main categories including aspects related to medicines provided, users assisted, and quality of service.Conclusion: The study described the first cycle of an action research project to develop strategies to approach medicines litigation at the municipal level. The application of educational outreach visits for health professionals and group conversations with health system users is a promising approach to improve access to information about pharmaceutical services in Brazil.

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Section: Discussionsupporting

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Strategies to Approach Medicines Litigation: An Action Research Study in Brazil

2021

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“…In Brazil and around the world, health systems and their managers are facing challenges to offer quality health care to the population considering the available resources (Brazil, 2009;Zechmeister-Koss et al, 2019). These challenges can be described as growing technological innovation, proportional arise of spending, restriction of budget resources, industry, media and population impositions and the process of health judicialization (Brazil, 2009;Freitas et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

Health evaluation of three types of baths in patients with severe heart diseases

Santos

Lôbo

Reis

et al. 2022

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Aim: To analyze the cost of three bed bath technologies in critically ill cardiac patients. Study design: Non-participant, prospective, observational, and cost assessment study. Data were collected between February and August 2017, at the cardiac intensive care (ICU) of a university hospital. The convenience sample corresponded to 18 patients in the immediate postoperative period of cardiac surgery. Data were collected within 72 h after cardiac surgery, with 24-hour washout between baths. Project was approved under the number: 1.823.316. Results: The mean time for bed bath was 39.00±15.00 min (traditional bath), 33.00±12.24 min (distilled water bath) and 25.28±7.35 min (disposable bath). The average final costs identified were R$ 45.47 (US$ 8.80), R$ 40.78 (US$ 7.89) and R$ 48.36 (US$ 9.36). Conclusion: The bath with the lowest total average cost was the distilled water bath. The cost category that most burdens the bed baths is human capital, which represents more than 2/3 of the procedures total cost. There are few studies exploring the costs associated to nursing procedures, and this analysis can contribute to discussions about materials purchase and support managers to make better decisions about nursing care.

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“…As ações judiciais permitem aos gestores traçarem os perfis e problemas de saúde mais judicializados, gerando informações que podem auxiliar gestores locais na compreensão dos problemas relacionados à gestão, ao gerenciamento do cuidado, e às possíveis reorientações das práticas de saúde 63 .…”

Section: Direito à Saúde E O Contexto Brasileirounclassified

“…resultados mostraram baixa aderência da norma, pouco mencionada nos julgados mesmo após quatro anos de sua vigência. Reajuste por alteração de faixa etária -RN nº63/2003 O tema do reajuste por alteração de faixa etária foi identificado por Robba 2 , em 2017 como um dos mais debatidos no TJSP. Contudo, aplicando os critérios metodológicos para a presente pesquisa, especialmente na limitação temporal da pesquisa, não foram obtidos resultados no período.…”

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Judicialização da saúde suplementar e regulação: efeitos das normas da ANS nas decisões judiciais

Mazzoni¹

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Mazzoni L. Supplementary health judicialization and regulation: effects of ANS rules on judicial decisions [dissertation]. São Paulo: "Faculdade de Medicina, Universidade de São Paulo"; 2020. The numbers on the judicialization of health are growing, as are the criticisms of the National Regulatory Agency for Private Health Insurance and Plans (ANS), responsible for regulating the sector. The Health Plans Law came to discipline an consolidated sector, ten years after the promulgation of the 1988 Constitution. The creation of ANS is part of a moment of activities' privatization, which are now also exercised by the private entity. Competent to issue rules, ANS creates rules for health plan operators, in a scenario where rules of consumer law prevailed. These new rules issued specifically for the segment, but whose validity is often questioned, either by consumers or by the Judiciary itself. The present work seeks to analyze the relationship between judicialization of supplementary health and ANS regulation, through the study of individual lawsuits filed by the São Paulo State Court of Justice, as well as prominent collective actions in the supplementary health sector. The study seeks to verify whether the publication of ANS regulations changes the content of judicial decisions in any sense, as well as analyzes whether the issues addressed by the Judiciary are considered by ANS in the preparation of its regulations that create the sector's rules.

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A Judicialização da saúde nos sistemas público e privado de saúde: uma revisão sistemática

Cited by 25 publications

References 33 publications

Strategies to Approach Medicines Litigation: An Action Research Study in Brazil

Strategies to Approach Medicines Litigation: An Action Research Study in Brazil

Health evaluation of three types of baths in patients with severe heart diseases

Judicialização da saúde suplementar e regulação: efeitos das normas da ANS nas decisões judiciais

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