Judicialização do direito à saúde na região Nordeste, Brasil: dimensões e desafios

Nunes, Carlos Francisco Oliveira; Ramos, Alberto Novaes

doi:10.1590/1414-462x201600020070

Cited by 32 publications

(63 citation statements)

References 13 publications

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“…This study is the first of its kind to propose the active monitoring of claims filed in court, compliance, attainment and outcomes, according to plaintiff's knowledge. Said proposal had been formerly suggested, (6) but this is the first work to have a direct follow-up, on a case by case basis, to check the outcomes. (23) Increased efficiency is expected in the proceedings, both due to the monitoring of outcomes in health (24) and also to prevent waste of resources due to negligence, improper use, embezzlement or other means.…”

Section: ❚ Discussionmentioning

confidence: 99%

“…(1) It involves ethical issues, such as the role of the Government in the mediation of individual and collective interests and rights, (2) due to the imbalance created in health planning, (3) negatively affecting the system beneficiaries. (4) Despite the substantial amount of academic data covering medication requests, (5) characteristics of proceedings, (2) mapping of lawsuits in several scenarios, (6) among others, the means to obtain reliable data are decentralized, with variable access to information and lack of standardization, (7) regardless of the efforts made by research groups in specific segments with expressive results. (8) The main item requested in court is medication.…”

Section: ❚ Introductionmentioning

confidence: 99%

“…(11) Conflicts of interests are also discussed, considering the substantial volume of lawsuits filed by the private sector, (15) concentrated in a limited number of physicians and lawyers. (6) In spite of government efforts to mitigate the costs of fraud, corruption and embezzlements, substantial sums are misused. (16) However, these types of cases must be heard by criminal courts.…”

Section: ❚ Introductionmentioning

confidence: 99%

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Economic evaluation of an active search system to monitor the outcomes of health-related claims

Rodrigues¹,

Zaia²,

Viana³

et al. 2019

Einstein (São Paulo)

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Objective: Economic evaluation of a scientific advisory program with the Public Defenders Office to mitigate the impacts of the judicialization on health in the municipality, as well as the implementation of an active follow-up program to monitor health outcomes arising from court demands. Methods: A two-step study, the first documental, retrospective, with data collection of lawsuits in the region of Barbalha (CE), Brazil, from 2013 to 2018, and the second stage, prospective and intervention, through mediation between the citizen and the Public Defenders Office, aiming to reduce the occurrence of the judicialization, and the monitoring of the health outcomes of the processes. The study adopted the Consolidated Health Economic Evaluation Reporting Standards protocol for economic health assessments. The data obtained from the processes were grouped and treated for characterization of the scenario. A comparison of the profile of the lawsuits in the period of 12 months before and after the installation of the program to delimit a complete fiscal cycle was carried out. Results: The advisory service promoted a decrease of 40% (p=0.01) in lawsuits. There was a 31% reduction in court costs (p=0.003), with medicines accounting for 33% of this amount. There was a decrease in inputs outside the Sistema Único de Saúde lists (27%; p=0.003), however there was no statistical difference among several demanding groups, suggesting an equanimous approach. Conclusion: Data from the initial survey were comparable to those reported in Brazil regarding the profile of judicial demands. In view of the scenario, the proposal proved feasible as a means to mitigate the costs of the judicialization through mediation. Finally, the initiative can serve as a model for adoption by municipalities that have characteristics similar to those presented in this study.

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Section: ❚ Discussionmentioning

confidence: 99%

Section: ❚ Introductionmentioning

confidence: 99%

Section: ❚ Introductionmentioning

confidence: 99%

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Economic evaluation of an active search system to monitor the outcomes of health-related claims

Rodrigues¹,

Zaia²,

Viana³

et al. 2019

Einstein (São Paulo)

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“…Given resource scarcity and the need to mobilize management to meet these demands, it is important to know how a municipality manages LitMed. Some studies have already discussed judicialization at the municipal (and state) level, but we still lack information from a standpoint of regionalization, which has not been sufficiently addressed by the literature [19][20][21] . From this premise, we initially proposed an approach according to geographical regions, observing common contexts.…”

Section: Introductionmentioning

confidence: 99%

Falhas na gestão da Assistência Farmacêutica para Medicamentos Judicializados, em 16 municípios da região Sudeste brasileira

et al. 2019

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RESUMO Desde a década de 1990, as solicitações de medicamentos por via judicial vêm se intensificando. Vários estudos têm traçado o panorama destas demandas. Buscou-se descrever a existência de organização própria da gestão da Assistência Farmacêutica (AF) Municipal para o atendimento de medicamentos demandados judicialmente. Um conjunto de 16 municípios incluiu 4 de cada estado da região Sudeste brasileira. Para a descrição do perfil da gestão da AF, foi estruturada uma matriz de indicadores que contemplou suas dimensões de recursos humanos, financeiros e suas atividades. Em nove municípios, a gestão dos medicamentos solicitados por via judicial coube ao gestor local da AF. Os indicadores com os piores desempenhos em todas as respostas foram aqueles que versaram sobre as despesas com Medicamentos Judicializados. Somente seis gestores informaram que realizavam análise técnica das prescrições e contato regular com o judiciário. Em sete municípios, os gestores não souberam especificar a modalidade de aquisição dos medicamentos demandados. A gestão municipal tem papel preponderante sobre a gestão da AF e precisa ser revista, havendo a necessidade de amplo questionamento a respeito do seu papel e de eventuais mudanças pelas quais possa passar.

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“…Uma das ações foi ajuizada pelo Ministério Público (MP) do Pará, por meio de uma Ação Pública 14 . Nela, o MP ordenou ao estado do Pará que fornecesse a somatropina, conhecida como hormônio do crescimento, a todas as crianças e adolescentes com deficiência na produção de somatropina, motivados pela falta de fornecimento do hormônio pelo SUS.4.1.1 Ações para obtenção de medicamentosPercebe-se que há diversos estudos10,[15][16][17][18][19][20][21][22][23][24][25][26][27] que investigam as ações judiciais para obtenção de medicamentos ou tratamentos. Os usuários do SUS estão em maioria como solicitantes.…”

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Iniciativas de Judicialização de Saúde no Brasil: Revisão Integrativa

Silva¹,

Carrara²,

Ventura³

2019

BJFS

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Resumo. Trata-se de revisão integrativa da literatura a respeito da judicialização da saúde no contexto brasileiro. Os objetivos foram identificar, analisar e sintetizar as evidências científicas disponíveis na literatura sobre as iniciativas de judicialização de saúde no Brasil.A busca dos artigos foi realizada nas bases de dados SCOPUS, SCIELO e LILACS, com estudos produzidos entre 2015 e 2018 e que tratassem sobre a judicialização da saúde no Brasil. Foram selecionados 29 artigos, dos quais 15 investigaram ações judiciais de saúde, e em 14 a iniciativa mais presente foi para obtenção de medicamentos. Foi observado que as despesas com essas ações são elevadas, o que leva à discussão sobre os altos gastos para ações individuais em detrimento à saúde coletiva. Foram apontados métodos alternativos às ações, como a mediação. Palavras-chave: Direito à saúde; Judicialização da saúde; Medicamentos; Sistema único de saúde. Abstract. It is an integrative review of the literature on the judicialization of health in the Brazilian context. The objectives were to identify, analyze and synthesize the scientific evidence available in the literature on health judicialization initiatives in Brazil. The search for articles was carried out in the databases SCOPUS, SCIELO and LILACS, with studies produced between 2015 and 2018 and dealing with the judicialization of health in Brazil. A 62 Brazilian Journal of Forensic Sciences, Medical Law and Bioethics 8(2):61-79 (2019) K. F. G. Silva et al.total of 29 articles were selected, of which 15 investigated health judicial actions, and in 14 the most present initiative was to obtain medicines. It was observed that the expenses with these actions are high, which leads to the discussion about the high expenses for individual actions in detriment to the collective health. Alternative methods to actions, such as mediation, were pointed out.

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Judicialização do direito à saúde na região Nordeste, Brasil: dimensões e desafios

Cited by 32 publications

References 13 publications

Economic evaluation of an active search system to monitor the outcomes of health-related claims

Economic evaluation of an active search system to monitor the outcomes of health-related claims

Falhas na gestão da Assistência Farmacêutica para Medicamentos Judicializados, em 16 municípios da região Sudeste brasileira

Iniciativas de Judicialização de Saúde no Brasil: Revisão Integrativa

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