Custo direto da judicialização dos sistemas de infusão contínua de insulina no município do Rio de Janeiro
Custo direto da judicialização dos sistemas de infusão contínua de insulina no município do Rio de Janeiro
Data
2019
Autores
Telheiro, Viviane Silva
Journal Title
Journal ISSN
Volume Title
Publisher
Instituto Nacional de Cardiologia
Resumo
O objetivo do presente estudo foi estimar o custo direto anual da judicialização dos Sistemas de Infusão Contínua de Insulina (Sici) e analisar as características dos processos relacionados à referida tecnologia, no município do Rio de Janeiro, entre os anos de 2015 e 2017. Para isso foram analisados os pareceres técnicos sobre os Sici emitidos pelo Núcleo de Assessoria Técnica em Ações de Saúde e os respectivos processos judiciais. As informações relacionadas aos custos foram obtidas a partir dos portais de transparência dos entes governamentais, relatório de solicitação de empenho fornecido pela Central de Atendimento às Demandas Judiciais do Estado do Rio de Janeiro e de orçamentos fornecidos pelos fabricantes/distribuidores contidos nos processos. Foram analisados 189 processos judiciais, no período de 2015 a 2017. A média de idade dos autores dos processos foi de 25,1 anos e 57,1% era do sexo feminino. Em 98 casos (51,9%), o documento utilizado no processo foi proveniente de médicos da rede pública de saúde. A Defensoria Pública foi utilizada por 153 pacientes (80,9%) para dar início ao processo. O juiz deferiu o pleito em 153 processos (80,9%). De um total de 75 médicos prescritores, nove foram responsáveis por 43,9% das prescrições, demonstrando uma concentração das prescrições em determinados profissionais. O valor estimado de custo direto acumulado (2015-2017) decorrente da judicialização dos Sici, no município do Rio de Janeiro, corresponde a R$ 6,9 milhões, o que representa 6,7% dos gastos de judicialização da saúde. Considerando que a tecnologia analisada é recorrentemente judicializada, os dados coletados podem gerar informações úteis para os gestores governamentais da área da saúde, na avaliação da eficiência na alocação dos recursos públicos, para os profissionais que trabalham na assistência judiciária e para os juízes.
The main goal of the present study was to estimate the annual direct cost of the Judicialization of Continuous Insulin Infusion Systems (Sici) and to analyze the characteristics of the processes related to this technology, in the city of Rio de Janeiro, from 2015 to 2017. For that, we analyzed the technical opinions on the Sici issued by the Core of Technical Advice on Health Actions and the respective judicial processes. The information related to the costs was obtained from the transparency portals of government entities, the Report of Request for Compromise provided by the Center of Attendance to the Lawsuits of the state of Rio de Janeiro and budgets of the manufacturer / distributors contained in the processes. In general, 189 lawsuits were analyzed in the period from 2015 to 2017. Regarding the analyzed characteristics, it was identified that the average age of the Authors was 25.1 years and that the majority was female (57.1%). In 98 cases (51.9%) the document used in the process came from doctors of the public health network. The Public Defender's Office was used by 153 patients (80.9%) to start the process. The judge granted the suit in 153 cases (80.9%). Nine physicians were responsible for 43.9% of the prescriptions, out of a total of 75 prescribing physicians, demonstrating a concentration of prescribing physicians. Finally, the estimated value of accumulated direct cost (2015-2017), due to the Sici's judicialization in the city of Rio de Janeiro, corresponds to R$ 6.9 million, which represents 6.7% of health care expenditures. Considering that the technology under review is judicially recurring, the data collected can generate useful information to government health managers, the evaluation of efficiency in the allocation of public resources, and professionals working in legal aid or for the judges themselves.
The main goal of the present study was to estimate the annual direct cost of the Judicialization of Continuous Insulin Infusion Systems (Sici) and to analyze the characteristics of the processes related to this technology, in the city of Rio de Janeiro, from 2015 to 2017. For that, we analyzed the technical opinions on the Sici issued by the Core of Technical Advice on Health Actions and the respective judicial processes. The information related to the costs was obtained from the transparency portals of government entities, the Report of Request for Compromise provided by the Center of Attendance to the Lawsuits of the state of Rio de Janeiro and budgets of the manufacturer / distributors contained in the processes. In general, 189 lawsuits were analyzed in the period from 2015 to 2017. Regarding the analyzed characteristics, it was identified that the average age of the Authors was 25.1 years and that the majority was female (57.1%). In 98 cases (51.9%) the document used in the process came from doctors of the public health network. The Public Defender's Office was used by 153 patients (80.9%) to start the process. The judge granted the suit in 153 cases (80.9%). Nine physicians were responsible for 43.9% of the prescriptions, out of a total of 75 prescribing physicians, demonstrating a concentration of prescribing physicians. Finally, the estimated value of accumulated direct cost (2015-2017), due to the Sici's judicialization in the city of Rio de Janeiro, corresponds to R$ 6.9 million, which represents 6.7% of health care expenditures. Considering that the technology under review is judicially recurring, the data collected can generate useful information to government health managers, the evaluation of efficiency in the allocation of public resources, and professionals working in legal aid or for the judges themselves.
Description
Palavras-chave
Assessment Of Health Technologies, Direct cost, Continuous Insulin Infusion Systems, Health Judiciary, Avaliação de Tecnologias em Saúde, Custo direto, Sistemas de Infusão Contínua de Insulina, Judicialização da Saúde
Citação
Telheiro, VS. Custo direto da judicialização dos sistemas de infusão contínua de insulina no município do Rio de Janeiro. Rio de Janeiro. Dissertação [Mestrado Profissional em Avaliação de Tecnologias em Saúde] - Instituto Nacional de Cardiologia; 2019.