Lawsuits in health: an integrative review

Healthcare judicialization: an analysis of indicators and official data on medications

OBJECTIVES

to analyze judicial demands for medications in Campo Grande, Brazil, between July 2018 and June 2020.

METHODS

the four dimensions of the Manual of Indicators for Evaluation and Monitoring of Judicial Demands for Medications were examined.

RESULTS

676 judicial processes were identified, corresponding to 1006 requests for 284 different medications. In 92.74% of the processes, access to medications was granted, with 88.80% granted on an urgent basis. The median time between the decision and delivery of the medication was 146 days. The average monthly cost of acquiring medications was R$ 2,183.68 Brazilian reais. Among the identified medications, 90.22% had at least one therapeutic alternative available in the public healthcare system.

CONCLUSIONS

characterizing and analyzing judicial demands related to medications can support discussions on updating medication lists and clinical protocols, organizing healthcare services, allocating resources, and implementing actions to reduce judicialization.

Judicialization of nursing malpractice in perioperative care, and delivery and birth assistance

OBJECTIVES

to analyze the legal outcomes of malpractices in perioperative care, and delivery and birth assistance related to nursing, from the perspective of legal support for malpractice prevention.

METHODS

an exploratory, documentary, qualitative study, based on the cases tried by the Court of Justice of the State of Paraná, available online until April 2018. For the data analysis, we codified the processes and summarized the judicial outcome by the severity of the malpractice. Then, we recommended practices for the prevention of each case we presented.

RESULTS

among the thirteen processes analyzed, eight corresponded to the perioperative period (mainly electrocautery burn), and five to nursing care for delivery and birth. The severity of the cases was high (n=7). The judicial outcome of most cases (n=11) was the conviction of the institution.

CONCLUSIONS

despite the multifactorial nature of the malpractices, the identified ones are preventable since there is a description of good practices.

Judicialization of health: lawsuits for access to medicines in Uruguaiana-RS

Introduction: In Brazil, the right to health has a constitutional and universal provision. However, the judicial route has been widely used to access health goods and services. Objective: To analyze the lawsuits of medicines filed by citizens of a Brazilian municipality. Methods: Quantitative and retrospective study evaluating 652 lawsuits filed in 2016 conducted in Uruguaiana, state of Rio Grande do Sul. The information was made available by the State Department of Health. Results: 55.5% of lawsuits filed were related to drugs provided by the public health system Sistema Único de Saúde (SUS). 44.5% did not fit into the guidelines of the Brazilian Policy for Pharmaceutical Services. Most of the lawsuits were filed by women over 60 years old. Regarding the therapeutic classification, the most requested drugs were for the nervous system. The most described pathological condition according to the ICD-10 (International Classification of Diseases) was Diabetes Mellitus. Conclusion: These data corroborate the situation found in other parts of the country, demonstrating the need to reorganize the Pharmaceutical Service Policy to ensure universal and equitable access to medicines, as described in the Federal Constitution.

Back to the future: five forgotten lessons for the healthcare managers of today

Nowadays, political, economic and technological upheavals require the rediscovery of some elapsed soft skills by healthcare managers. These abilities are values grounded in the past and somewhat nebulous in the present. We suggest five forgotten lessons highlighting the importance of a stronger human and self-conscious approach in today’s and tomorrow’s healthcare managers.