Abstract:El trabajo analiza los problemas de los afiliados a las empresas de medicina prepaga en Argentina cuando las mismas incumplen con la Ley de Defensa del Consumidor. El universo de estudio se conformó por las denuncias de los afiliados durante los años 2000-2008, ante la Subsecretaría de Defensa del Consumidor de la Nación, y por las disposiciones y laudos emitidos por la misma. Un aspecto conclusivo es la recurrencia de los incumplimientos en las prestaciones del Programa Médico Obligatorio y los argumentos exp… Show more
“…The search strategy resulted in 117 scientific productions (according to Figure 1), which made it possible to have as product 14 tracked studies, assessed for readability and included in the research, which comprise 100% of the sample, as shown in Chart 1, named "articles included in the study". Such chart brings the variables: item; year; title of the scientific productions identified by PC 1 (12) , PC 2 (13) , PC 3 (14) and so on until PC15 (26) , with the proviso that the PC 2 (13) , Luzuriaga (13) (2014), was excluded for showing an international character in its objects; author and origin, distinguished by superscript number from 12 to 26 (with emphasis on the fact that the number 13 corresponded to PC 2); journal; objective; and type of study or methodological approach. Thus, the data confirm the information of the sample.…”
Section: Resultsmentioning
confidence: 99%
“…In health services, N is 8, totaling 100%, considering eight items considered in Figure 2, subdivided in: medications; hospital beds for hospitalization in a ward or ICU; diagnostic and surgical procedures; general and specialized consultations; food formulas; and diapers. The other Ns, equal to 1, represent 100% and refer to resource allocation, function and interconnection between the three powers (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26) .…”
Objective: To analyze publications regarding judicial demands related to the violation of the rights of the client who uses private health insurance in Brazil. Method: Integrative review, from September to October 2017, of national character, with complete texts online, in Portuguese and English, published between 2012 and 2017 in the Virtual Health Library portal, excluding studies that were duplicated or with indiscriminate methodology. Results: The judicial demands were for: medication (32%); ward hospitalization (11%); surgical procedures (9%); orthosis, prothesis and special materials (9%); others (9%); and diagnostic procedures, outpatient service, hospitalization in Intensive Care Units, food formulas and disposable diapers (30%). Conclusion: The prevalence of legal disputes arising from the failure in providing health service by private health insurances was observed, which makes it easier for the administrators to identify the sought health products and services in order to reorganize the administrative sphere and provide quality care.
“…The search strategy resulted in 117 scientific productions (according to Figure 1), which made it possible to have as product 14 tracked studies, assessed for readability and included in the research, which comprise 100% of the sample, as shown in Chart 1, named "articles included in the study". Such chart brings the variables: item; year; title of the scientific productions identified by PC 1 (12) , PC 2 (13) , PC 3 (14) and so on until PC15 (26) , with the proviso that the PC 2 (13) , Luzuriaga (13) (2014), was excluded for showing an international character in its objects; author and origin, distinguished by superscript number from 12 to 26 (with emphasis on the fact that the number 13 corresponded to PC 2); journal; objective; and type of study or methodological approach. Thus, the data confirm the information of the sample.…”
Section: Resultsmentioning
confidence: 99%
“…In health services, N is 8, totaling 100%, considering eight items considered in Figure 2, subdivided in: medications; hospital beds for hospitalization in a ward or ICU; diagnostic and surgical procedures; general and specialized consultations; food formulas; and diapers. The other Ns, equal to 1, represent 100% and refer to resource allocation, function and interconnection between the three powers (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26) .…”
Objective: To analyze publications regarding judicial demands related to the violation of the rights of the client who uses private health insurance in Brazil. Method: Integrative review, from September to October 2017, of national character, with complete texts online, in Portuguese and English, published between 2012 and 2017 in the Virtual Health Library portal, excluding studies that were duplicated or with indiscriminate methodology. Results: The judicial demands were for: medication (32%); ward hospitalization (11%); surgical procedures (9%); orthosis, prothesis and special materials (9%); others (9%); and diagnostic procedures, outpatient service, hospitalization in Intensive Care Units, food formulas and disposable diapers (30%). Conclusion: The prevalence of legal disputes arising from the failure in providing health service by private health insurances was observed, which makes it easier for the administrators to identify the sought health products and services in order to reorganize the administrative sphere and provide quality care.
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