Profile of The Judicialization In Pharmaceutical Assistance And Expenses With Antineoplastics: A Cross-Sectional, Descriptive Study Based On A Set of All The Lawsuits Filed Between The Years 2016 To 2018 In of A State In Northeastern Brazil

2021 ◽  
Author(s):  
Fábio Henrique Cavalcanti Oliveira ◽  
José Eudes de Lorena Sobrinho ◽  
Antônio da Cruz Gouveia Mendes ◽  
Haynne Magalhães Santos Gutman ◽  
Geraldo Jorge Filho ◽  
...  
Keyword(s):  
Health System ◽  
Latin American ◽  
Descriptive Study ◽  
The State ◽  
Unit Price ◽  
Northeastern Brazil ◽  
Metropolitan Region ◽  
Antineoplastic Drugs ◽  
Cross Sectional ◽  
Unified Health System

Abstract Background: The judicialization of healthcare for acquiring medication is not an isolated occurrence in Brazil, it may also be observed in other Latin American countries, regardless of the existence of a universal health system, in Brazil, the Unified Health System. The search for justice, in terms of medications, has existed ever since the high demand for treating the Acquired Immunodeficiency Syndrome, while currently, the protagonist is cancer. Since pharmaceutical assistance is the area within Unified Health System, which is responsible for maintaining access to medications, the aim of this article is to describe the profile of judicialization in the pharmaceutical assistance of a state in Northeastern Brazil of economic significance, according to the characteristics of the lawsuits, regarding: the plaintiff filing the lawsuit; the medical and health information; the expenditure on acquiring the requested medications; and the relevance of spending on antineoplastic drugs. Methods: This was a cross-sectional, descriptive study based on a set of lawsuits filed between 2016-2018 at the Litigation Center in the State Health Department of Pernambuco.Results: A total of 2,947 lawsuits were analyzed that contained at least one requested medication, with a predominance of males (51.7%); and in which 49.8% of the requests originated in the Unified Health System, and were primarily from patients in the Metropolitan region of the state capital. The most frequent ICDs for cancer were C61, C71 and C50. The median overall expense of the lawsuits was U$1,734.94. Considering only antineoplastic drugs, expenditure exceeded U$7,500 per lawsuit over the three years, given that the median unit price of antineoplastic drugs is approximately U$65.00 compared to U$4.00 for non-antineoplastic drugs. Conclusion: The present study is of relevance as a matter of public health, and how the profile of judicialization behaves as a tool for managing and improving decision-making in times of economic austerity.

scholarly journals Incidence of human visceral leishmaniasis: the importance of municipal socio-economic indicators in the state of Pernambuco, Brazil

2020 ◽  
Vol 9 (12) ◽  
pp. e47091211368
Author(s):  
Cicero Emanoel Alves Leite ◽  
Ocilma Barros de Quental ◽  
Patrícia Lopes Oliveira ◽  
Ramiro Moreira Tavares
Keyword(s):  
Socioeconomic Factors ◽  
Cross Sectional Study ◽  
Incidence Rates ◽  
Study Data ◽  
The State ◽  
Northeastern Brazil ◽  
Metropolitan Region ◽  
Cross Sectional ◽  
Development Index ◽  
Municipal Development

Objective: To analyze the main municipal socioeconomic factors associated with the incidence of HVL in the state of Pernambuco, northeastern Brazil. Methods: It is a analytical cross-sectional study. Data on the incidence of HVL and socioeconomic factors were collected from 954 cases notified by the SINAN (National System of Notifiable Diseases) and SIM (Mortality Information System). The cases considered were reported by municipalities in the state of Pernambuco, Brazil, from 2005 to 2014. Statistical differences were analyzed by Pearson's correlation test, followed by multiple regression analysis. Significant differences were considered when p <0.05. Results: The FIRJAN Municipal Development Index was the variable that showed the most remarkable statistical robustness and strong negative association with the incidence of HVL. The municipal spending on health and residing in the metropolitan region also influenced its mean incidence rates. Conclusion: The indicators that had an influence on the performance of the incidence of LVH were the FIRJAN Municipal Development Index, health expenditure and residing in the metropolitan region.

Spatiotemporal clustering, social inequities and the risk of leptospirosis in an endemic area of Brazil: a retrospective spatial modelling

2020 ◽  
Author(s):  
Katyucia O C de Souza ◽  
José Augusto P Góes ◽  
Matheus S Melo ◽  
Paula M G Leite ◽  
Lucas A Andrade ◽  
...  
Keyword(s):  
Urban Areas ◽  
Spatial Regression ◽  
Temporal Trends ◽  
Spatial Dynamics ◽  
Secondary Data ◽  
The State ◽  
Scan Statistics ◽  
Northeastern Brazil ◽  
Metropolitan Region ◽  
Social Inequities

Abstract Background Leptospirosis is an endemic disease in Brazil of social and economic relevance related to behavioural and socioenvironmental factors. This study aimed to analyse the spatiotemporal distribution of the incidence of leptospirosis and its association with social determinants in health in a state of northeastern Brazil. Methods An ecological study of temporal series with techniques of spatial analysis using secondary data of the cases of leptospirosis notified in the Information System of Notifiable Diseases of the state of Sergipe (2008–2017) was conducted. The analysis of temporal trends was performed using Poisson regression. Spatial analyses were performed using the Moran index, the local empirical Bayesian model, scan statistics and spatial regression. Results The incidence rate decreased from 3.66 to 1.44 cases per 100 000 inhabitants in 2008 and 2017, respectively. Leptospirosis was associated with social inequities, mostly affecting males aged 20–49 y living in urban areas. The space-time scan indicated the formation of a risk cluster in municipalities in the metropolitan region of the state. Conclusions The data indicated the persistence of leptospirosis transmission, maintaining a pattern of high endemicity in some municipalities associated with social inequities. The study showed the temporal and spatial dynamics of the disease to better target specific actions for prevention and control.

scholarly journals Retrospective study of the distribution of doctors in municipalities of extreme poverty in Brazil

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
B L O Luizeti ◽  
E M M Massuda ◽  
L F G Garcia
Keyword(s):  
Public Health ◽  
Health System ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Extreme Poverty ◽  
The Public ◽  
The North ◽  
Unified Health System ◽  
Shortage Of Doctors ◽  
Demographic Distribution

Abstract In view of the national scenario of scarcity of material and human resources in public health in Brazil, the survey verified the demographics of doctors who attend the Unified Health System (SUS) in municipalities of extreme poverty. An observational, analytical and cross-sectional study was carried out, based on secondary quantitative data from the Department of Informatics of the SUS using the TABNET of December 2019. The care networks variable was restricted to infer the number of physicians who attend the SUS in extreme poverty municipalities in Brazil. Municipalities of extreme poverty are those that at least 20% of the population have a household income of up to 145 reais per capita monthly. In Brazil, there are 1526 municipalities in extreme poverty, 27.4% of the country's total municipalities. 14,907 doctors linked to SUS work in this condition, 3.19% of the total of these professionals in Brazil. There is still disproportion between regions: North concentrates 11.2% of the municipalities in extreme poverty and 8.61% of the total number of doctors; Northeast, with 61.33% of these municipalities, for 61.5% of doctors; Southeast, with 15.46% of the municipalities in this condition, has 20.6% of doctors; South concentrates 10.87% of the municipalities under discussion with 5.61% of doctors and the Midwest, with 4.87% of these municipalities, has 3.54% of doctors. Between 2009 and 2018, there was a 39% increase in the number of doctors in these locations, however, for 2019, there was a decrease of 3.89%. The medical demographic distribution in Brazil is uneven, especially in the North. There is also the vulnerability of this population in view of the observed reduction in the number of professionals between 2018 and 2019 in municipalities of extreme poverty, for political reasons. It is evident the need to restructure the health system to guarantee access to health for this population, through the attraction and fixation of doctors in needy regions in Brazil. Key messages Shortage of doctors in extreme poverty municipalities reinforces the health vulnerability of the population in Brazil. The uneven medical demography in Brazil requires restructuring in the public health system.

scholarly journals Changes in contraception use among Brazilian women after childbirth, 2006-2013

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Felisbino-Mendes ◽  
B Barrozo Siqueira
Keyword(s):  
Health System ◽  
Secondary Data ◽  
Reproductive Age ◽  
Cross Sectional ◽  
Regional Inequalities ◽  
Unified Health System ◽  
Contraception Use ◽  
High Prevalence ◽  
Modern Methods ◽  
Low Prevalence

Abstract Introduction There are gaps in knowledge regarding the neglected and vulnerable subgroups of FP actions in Brazil, such as postpartum women and women in general, regardless of their marital status. Objective To assess changes in the prevalence of use and in the contraceptive pattern of Brazilian women up to two years after pregnancy, between 2006 and 2013. Methods Cross-sectional, descriptive and analytical study which used secondary data from national surveys. We studied Brazilian women with up to 2 years postpartum, of reproductive age, sexually active, non-pregnant and menstruating, and compared them with all the other women. We estimated the prevalence of use, contraception pattern of contraception and ranking of modern methods. Percentual change in indicators between the years was evaluated by calculating the difference between estimates. Results 85% of Brazilian women used CM, remaining stable in 2006 and 2013, with a high prevalence of modern methods use. An increase in the use of CM was observed among those with up to six months postpartum (71.0% to 89.0%). Pills and condoms accounted for about 60% of modern methods used in the postpartum period in both surveys. There was an increase in dual protection (2.9% to 10.1%) and contraceptive insecurity (1.6% to 5.7%) and a reduction in sterilization (16.2% to 13.4%) and traditional methods (2.1% to 1.4%). Conclusions Even with the maintenance of a high prevalence of use of CM and with the increase in contraception among women with up to six months postpartum, regional inequalities in access to CM and low prevalence of the use of other methods made available by the Unified Health System (SUS) persist, pointing out the maintenance of the insufficient care, failures in the means to regulate fertility and that public policies still hinder to guarantee the sexual and reproductive rights of the most vulnerable population. Key messages Regional inequalities in access to contraceptive methods and low prevalence of other methods made available by the Unified Health System (SUS) persist. There was an increase in contraception use among women with up to six months postpartum in Brazil.

scholarly journals Prevalence and factors associated with Metabolic Syndrome in elderly users of the Unified Health System

2014 ◽  
Vol 17 (4) ◽  
pp. 805-817 ◽  
Author(s):  
Edna Cunha Vieira ◽  
Maria do Rosário Gondim Peixoto ◽  
Erika Aparecida da Silveira
Keyword(s):  
Metabolic Syndrome ◽  
Health System ◽  
Health Workers ◽  
The Elderly ◽  
World Health ◽  
Fat Percentage ◽  
Cross Sectional ◽  
Factors Associated ◽  
Unified Health System ◽  
The Metabolic Syndrome

OBJECTIVE: To evaluate the prevalence and factors associated with metabolic syndrome in the elderly. METHODS: Cross-sectional study, with 133 individuals randomly selected in the Unified Health System in Goiania, Goiás. The following variables were researched: anthropometric (BMI, waist circumference, fat percentage by Dual X-ray absorptiometry), sociodemographic (gender, age, color, income, marital status and years of schooling), lifestyle (physical activity, smoking and risk alcohol consumption) and food intake (risk and protective foods). The metabolic syndrome was assessed according to harmonized criteria proposed by the World Health Organization (WHO). The combinations were tested by Poisson regression for confounding factors. RESULTS: The prevalence of metabolic syndrome was 58.65% (95%CI 49.8 - 67.1), with 60.5% (95%CI 49.01 - 71.18) for females and 55.7% (95%CI 41.33 - 69.53) for males. Hypertension was the most prevalent component of the syndrome in both men, with 80.8% (95%CI 64.5 - 90.4), and women, with 85.2% (95%CI 75.5 - 92.1). After the multivariate analysis, only the excess of weight measured by body mass index (prevalence ratio = 1.66; p < 0.01) remained associated with the metabolic syndrome. CONCLUSIONS: The prevalence of metabolic syndrome in this sample was high, indicating the need for systematic actions by health workers in the control of risk factors through prevention strategies and comprehensive care to the elderly.

scholarly journals Risk factors associated with the severity of COVID-19 in a region of the Brazilian Amazon

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Daniele Melo Sardinha ◽  
Rosane do Socorro Pompeu de Loiola ◽  
Ana Lúcia da Silva Ferreira ◽  
Carmem Aliandra Freire de Sá ◽  
Yan Corrêa Rodrigues ◽  
...  
Keyword(s):  
Risk Factors ◽  
Brazilian Amazon ◽  
The State ◽  
Metropolitan Region ◽  
Epidemiological Surveillance ◽  
Cross Sectional ◽  
Factors Associated ◽  
Risk Of Death ◽  
Increased Risk ◽  
Brazilian Amazon Region

AbstractThe Brazilian Northern region registered a high incidence of COVID-19 cases, particularly in the state of Pará. The present study investigated the risk factors associated with the severity of COVID-19 in a Brazilian Amazon region of 100,819 cases. An epidemiological, cross-sectional, analytical and demographic study, analyzing data on confirmed cases for COVID-19 available at the Brazilian Ministry of Health's surveillance platform, was conducted. Variables such as, municipalities of residence, age, gender, signs and symptoms, comorbidities were included and associated with COVID-19 cases and outcomes. The spatial distribution was performed using the ArcGIS program. A total of 100,819 cases were evaluated. Overall, patients had the mean age of 42.3 years, were female (51.2%) and with lethality reaching 4.79% of cases. Main symptoms included fever (66.5%), cough (61.9%) and sore throat (39.8%). Regarding comorbidities, most of the patients presented cardiovascular disease (5.1%) and diabetes (4.2%). Neurological disease increased risk of death by nearly 15 times, followed by obesity (5.16 times) and immunodeficiency (5.09 time). The municipalities with the highest incidence rate were Parauapebas, Canaã dos Carajás and Jacareacanga. Similarity between the Lower Amazon, Marajó and Southwest mesoregions of Pará state were observed concerning the highest morbidity rates. The obtained data demonstrated that the majority of cases occurred among young adults, females, with the classic influenza symptoms and chronic diseases. Finally, data suggest that the highest incidences were no longer in the metropolitan region of the state. The higher lethality rate than in Brazil may be associated with the greater impacts of the disease in this Amazonian population, or factors associated with fragile epidemiological surveillance in the notification of cases of cure.

scholarly journals Epidemiological and sociodemographic characterization of women and men with cancer in a State in the Brazilian Amazon

2020 ◽  
Vol 8 (6) ◽  
pp. 545-576
Author(s):  
Carlos Alberto Paraguassu Chaves ◽  
Allan Kardec Duailibe Barros Filho ◽  
Carlos de Andrade Macieira ◽  
Fabrício Moraes de Almeida ◽  
Lenita Rodrigues Moreira Dantas ◽  
...  
Keyword(s):  
The State ◽  
Primary Data ◽  
Cross Sectional ◽  
Unified Health System ◽  
Informed Consent Form ◽  
Health Council ◽  
Reference Hospital ◽  
Therapeutic Procedures ◽  
Epidemiological Profile

Objective: Objective: Analyzes the epidemiological and sociodemographic characterization of women and men with cancer in the State of Rondônia, Western Amazon (Brazil), diagnosed over a period of 2 (two) years. Materials and Methods: It is a documentary, cross-sectional and descriptive study, with the systematization of primary data, according to the methodological model recommended by Paraguassú-Chaves et al [25]. We used an instrument developde by Paraguassu-Chaves et al [26], semi-structured, divided into two blocks: (a) Block I – sociodemographic profile and (b) Block II – epidemiological profile. The Ethics Committee on Human Research at the reference hospital was asked to waive the Informed Consent Form. The research project is in accordance with Resolution 196/96 of the National Health Council of Brazil. Results: Of the 3.333 new cases of cancer, 53.4% ​​were female and 46.5% male. The 10 (ten) most common types of cancer among men and women in Rondônia over a 2-year period were non-melanoma skin (C44), breast (C50), prostate (C61), cervix (C53), stomach (C16), thyroid gland (C73), bronchi and lungs (C33-C34), colon (C18), reticuloendothelial hematopoietic system (C42) and rectal cancer (C20). An age range of 50 to 69 years was predominant in both sexes and patients with low educational level. The highest frequency was for married patients. There was a predominance of brown skin, patients born in the State of Rondônia (22.6%) and agricultural workers. The Unified Health System - SUS was responsible for the entry for treatment of 99.5% of patients. Most patients underwent “other isolated therapeutic procedures” and with the disease in advanced stages. Conclusions: The estimate of new cancer cases in Rondônia follows an increasing trend. The scenarios selected from the variables of the sociodemographic and epidemiological indicators of the research require the public health authorities of Rondônia, urgent redirection of actions and strategies for the prevention, control, assistance and treatment of cancer in women and men in Rondônia.

scholarly journals Referral and counter-referral for the integrality of care in the Health Care Network

2021 ◽  
Vol 31 (1) ◽  
Author(s):  
Cleise Cristine Ribeiro Borges Oliveira ◽  
Elaine Andrade Leal Silva ◽  
Mariluce Karla Bomfim de Souza
Keyword(s):  
Health Care ◽  
Content Analysis ◽  
Qualitative Study ◽  
Health System ◽  
Family Health ◽  
Ethics Committee ◽  
The State ◽  
Healthcare Network ◽  
Unified Health System ◽  
Health Care Network

Abstract The objective was to analyze the functioning of the referral and counter-referral system for integral care in the Healthcare Network. Qualitative study performed through interviews with 66 participants - managers, workers and users of a town of the state of Bahia, Brazil, and upon approval by the Ethics Committee, opinion number nº 334.737. The material was analyzed using the Content Analysis proposed by Bardin, finished in 2014. Various conceptions of referral and counter-referral were identified, as follows: referral of users, user’s broader view; non-fragmented care; and integral care. For the users, the difficulties and facilities in the flows are concentrated in the Regulation and Scheduling Center and Family Health Units. It is concluded that, to enable the establishment of the network in an integral way, it is necessary to identify important strategies provided by the Unified Health System (SUS) and strengthen these strategies, as well as to identify any drawbacks to remedy them.

scholarly journals Use of generic medicines by the Brazilian population: an evaluation of PNAUM 2014

2016 ◽  
Vol 50 (suppl 2) ◽  
Author(s):  
Andréa Dâmaso Bertoldi ◽  
Paulo Sergio Dourado Arrais ◽  
Noemia Urruth Leão Tavares ◽  
Luiz Roberto Ramos ◽  
Vera Lucia Luiza ◽  
...  
Keyword(s):  
Health System ◽  
Statistical Significance ◽  
Population Based ◽  
Cross Sectional Study ◽  
Education Level ◽  
Generic Medicines ◽  
Cross Sectional ◽  
Significance Level ◽  
Economic Class ◽  
Unified Health System

ABSTRACT OBJECTIVE To analyze the existence of differences in the use of generic medicines in Brazil according to demographic and socioeconomic variables and acquisition sources of the medicines. METHODS Population-based cross-sectional study, conducted with data from the Pesquisa Nacional de Acesso, Utilização e Promoção do Uso Racional de Medicamentos (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines). Data collection took place between September, 2013 and February, 2014 in homes of Brazilian cities (urban area). The use of medicines has been investigated in relation to the treatment of chronic diseases and, in the case of acute events, regarding use over the previous 15 days. Generics were identified by visualization of packaging presented by the users of the medicines. The independent variables used were sex, age, education level, economic class, and region of the Country. The statistical significance of differences between the groups was evaluated by Pearson’s Chi-squared test, considering a 5% significance level. RESULTS The prevalence of generic medicines use was 45.5% (95%CI 43.7–47.3). There was no difference considering education level. The prevalence was higher in females (47.0%; 95%CI 44.9–49.0) than in males (43.1%; 95%CI 40.5–45.8), and were higher with increasing age. Generic medicines were more used in the economic class C (47.0%; 95%CI 44.9–49.1) and in the South (50.6%; 95%CI 46.6–54.6) and Southeast (49.9%; 95%CI 46.8–53.0) regions. Generics accounted for 37.3% of the medicines provided by the Brazilian Unified Health System. CONCLUSIONS Currently, there is a choice of purchase or free provision by the Brazilian Unified Health System, characterized by quality assurance and reduced price regarding branded medicines considered as reference. In the private market, a considerable part of the population is choosing generic medicines thanks to the availability of this option for virtually all medicines most used by the population.

scholarly journals Descriptive study of HTLV infection in a population of pregnant women from the state of Pará, Northern Brazil

2012 ◽  
Vol 45 (4) ◽  
pp. 453-456 ◽  
Author(s):  
Carina Guilhon Sequeira ◽  
Bruna Pedroso Tamegão-Lopes ◽  
Eduardo José Melo dos Santos ◽  
Ana Maria Revoredo Ventura ◽  
Maria Isabel Moraes-Pinto ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Descriptive Study ◽  
The State ◽  
Metropolitan Region ◽  
Htlv Infection ◽  
Control And Prevention ◽  
Northern Brazil ◽  
First Time ◽  
Brazilian Studies ◽  
Basic Health Units

INTRODUCTION: In Brazil, studies have shown that HTLV seroprevalence among pregnant women varies from 0 to 1.8%. However, this seroprevalence was unknown in the State of Pará, Brazil. The present study describes, for the first time, the HTLV seroprevalence among pregnant women from the State of Pará, Northern Brazil. METHODS: 13,382 pregnant women were submitted to HTLV screening during prenatal care, and those with non-seronegative results to anti-HTLV were submitted to Western blot (WB) test to confirm and separate HTLV-1 and HTLV-2 carriers. RESULTS: HTLV seroprevalence in the population of pregnant women was 0.3%, and HTLV-1 was identified in 95.3% of patients. The demographic profile of HTLV carriers was as follows: women with age between 20 and 40 years old (78.4%); residing in the metropolitan region of Belém, Pará (67.6%); and with educational level of high school (56.8%). Other variables related to infection were as follows: beginning of sexual intercourse between the age of 12 and 18 years old (64.9%) and have being breastfed for more than 6 months (51.4%). Most of the women studied had at least two previous pregnancies (35.1%) and no abortion (70.3%). Coinfections (syphilis and HIV) were found in 10.8% (4/37) of these pregnant women. CONCLUSIONS: Seroprevalence of HTLV infection in pregnant women assisted in basic health units from the State of Pará, Northern Brazil, was 0.3% similar to those described in other Brazilian studies. The variables related to infection were important indicators in identifying pregnant women with a higher tendency to HTLV seropositivity, being a strategy for disease control and prevention, avoiding vertical transmission.

Sign in / Sign up

Export Citation Format

Share Document