Health litigation and cancer survival in patients treated in the public health system in a large Brazilian city, 2014–2019

Detalhes bibliográficos
Autor(a) principal: Castro, Mônica Silva Monteiro de
Data de Publicação: 2023
Outros Autores: Silva, Gabriela Drummond Marques da, Figueiredo, Iara Veloso Oliveira, Miranda, Wanessa Debôrtoli de, Magalhães Júnior, Helvécio Miranda, Santos, Fausto Pereira Dos, Sousa, Rômulo Paes de
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da FIOCRUZ (ARCA)
Texto Completo: https://www.arca.fiocruz.br/handle/icict/57930
Resumo: René Rachou Institute. Oswaldo Cruz Foundation. Belo Horizonte, MG, Brazil.
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spelling Castro, Mônica Silva Monteiro deSilva, Gabriela Drummond Marques daFigueiredo, Iara Veloso OliveiraMiranda, Wanessa Debôrtoli deMagalhães Júnior, Helvécio MirandaSantos, Fausto Pereira DosSousa, Rômulo Paes de2023-04-24T13:57:56Z2023-04-24T13:57:56Z2023CASTRO, Mônica Silva Monteiro de et al. Health litigation and cancer survival in patients treated in the public health system in a large Brazilian city, 2014–2019. BMC Public Health, v. 23, n. 1, 534, 2023. doi: 10.1186/s12889-023-15415-2.1471-2458https://www.arca.fiocruz.br/handle/icict/57930engBioMed CentralHealth litigation and cancer survival in patients treated in the public health system in a large Brazilian city, 2014–2019info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleRené Rachou Institute. Oswaldo Cruz Foundation. Belo Horizonte, MG, Brazil.René Rachou Institute. Oswaldo Cruz Foundation. Belo Horizonte, MG, Brazil.René Rachou Institute. Oswaldo Cruz Foundation. Belo Horizonte, MG, Brazil.Nursing School. Universidade Federal de Minas Gerais. Belo Horizonte, MG, Brazil.René Rachou Institute. Oswaldo Cruz Foundation. Belo Horizonte, MG, Brazil.René Rachou Institute. Oswaldo Cruz Foundation. Belo Horizonte, MG, Brazil.René Rachou Institute. Oswaldo Cruz Foundation. Belo Horizonte, MG, Brazil.Background: Litigation for health care, also known as health judicialization, is frequent in Brazil. It involves recourse to the court system to access health services. The study aimed to evaluate whether cancer patients in Belo Horizonte, Minas Gerais, Brazil, increased their overall survival by increasing access to certain drugs or treatments through litigation, controlling for the effect of demographic and disease-related variables. Methods: A retrospective cohort study was conducted. Patients with breast, prostate, brain, lung, or colon cancers from 2014 to 2019 were included. Survival analysis was performed using the Cox proportional hazards model. Results: In the multivariate analysis, litigation was significantly associated with increased survival in cancers of breast (HR = 0.51, 95%CI 0.33-0.80), prostate (HR = 0.50, 95%CI 0.30-0.85), colon (HR = 0.59, 95%CI 0.38-0.93), and lung (HR = 0.36, 95%CI 0.22-0.60). Five-year survival rates of patients who sued for treatment were 97.8%, 88.7%, 59.3%, and 26.0%, compared to median survival of 95.7%, 78.7%, 41.2%, and 2.4%, respectively, among patient that did not resort to court action. The study suggests that litigation for access to cancer treatment may represent a step forward in obtaining more effective treatment. This study´s main limitations are the lack of patients´ clinical information for use as control variables and the lack of variables to assess patients´ quality of life. The study also found that many cases involved claims that could have been solved by administrative rather than legal action. Some claims thus reflect the lack of adequate administrative procedures. Conclusion: When based on scientific evidence, access to new therapies, combined with other technologies already available, can favor patient survival. Access to new therapies through litigation may increase health inequalities since low-income patients have limited access to legal recourse against the State to meet their needs. The timely approval of new effective therapies can mitigate the judicialization of cancer treatmentBrazilCancerCancer drugsJudicial actionsPublic healthSurvival analysesinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZORIGINALHealth litigation and cancer survival in patients.pdfHealth litigation and cancer survival in patients.pdfapplication/pdf3535544https://www.arca.fiocruz.br/bitstream/icict/57930/2/Health%20litigation%20and%20cancer%20survival%20in%20patients.pdfff0c0b38a7dc86eac1792f59ab1711a3MD52LICENSElicense.txtlicense.txttext/plain; charset=utf-82991https://www.arca.fiocruz.br/bitstream/icict/57930/1/license.txt5a560609d32a3863062d77ff32785d58MD51icict/579302023-04-24 10:57:58.256oai:www.arca.fiocruz.br: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ório InstitucionalPUBhttps://www.arca.fiocruz.br/oai/requestrepositorio.arca@fiocruz.bropendoar:21352023-04-24T13:57:58Repositório Institucional da FIOCRUZ (ARCA) - 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dc.title.en_US.fl_str_mv Health litigation and cancer survival in patients treated in the public health system in a large Brazilian city, 2014–2019
title Health litigation and cancer survival in patients treated in the public health system in a large Brazilian city, 2014–2019
spellingShingle Health litigation and cancer survival in patients treated in the public health system in a large Brazilian city, 2014–2019
Castro, Mônica Silva Monteiro de
Brazil
Cancer
Cancer drugs
Judicial actions
Public health
Survival analyses
title_short Health litigation and cancer survival in patients treated in the public health system in a large Brazilian city, 2014–2019
title_full Health litigation and cancer survival in patients treated in the public health system in a large Brazilian city, 2014–2019
title_fullStr Health litigation and cancer survival in patients treated in the public health system in a large Brazilian city, 2014–2019
title_full_unstemmed Health litigation and cancer survival in patients treated in the public health system in a large Brazilian city, 2014–2019
title_sort Health litigation and cancer survival in patients treated in the public health system in a large Brazilian city, 2014–2019
author Castro, Mônica Silva Monteiro de
author_facet Castro, Mônica Silva Monteiro de
Silva, Gabriela Drummond Marques da
Figueiredo, Iara Veloso Oliveira
Miranda, Wanessa Debôrtoli de
Magalhães Júnior, Helvécio Miranda
Santos, Fausto Pereira Dos
Sousa, Rômulo Paes de
author_role author
author2 Silva, Gabriela Drummond Marques da
Figueiredo, Iara Veloso Oliveira
Miranda, Wanessa Debôrtoli de
Magalhães Júnior, Helvécio Miranda
Santos, Fausto Pereira Dos
Sousa, Rômulo Paes de
author2_role author
author
author
author
author
author
dc.contributor.author.fl_str_mv Castro, Mônica Silva Monteiro de
Silva, Gabriela Drummond Marques da
Figueiredo, Iara Veloso Oliveira
Miranda, Wanessa Debôrtoli de
Magalhães Júnior, Helvécio Miranda
Santos, Fausto Pereira Dos
Sousa, Rômulo Paes de
dc.subject.en.en_US.fl_str_mv Brazil
Cancer
Cancer drugs
Judicial actions
Public health
Survival analyses
topic Brazil
Cancer
Cancer drugs
Judicial actions
Public health
Survival analyses
description René Rachou Institute. Oswaldo Cruz Foundation. Belo Horizonte, MG, Brazil.
publishDate 2023
dc.date.accessioned.fl_str_mv 2023-04-24T13:57:56Z
dc.date.available.fl_str_mv 2023-04-24T13:57:56Z
dc.date.issued.fl_str_mv 2023
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.citation.fl_str_mv CASTRO, Mônica Silva Monteiro de et al. Health litigation and cancer survival in patients treated in the public health system in a large Brazilian city, 2014–2019. BMC Public Health, v. 23, n. 1, 534, 2023. doi: 10.1186/s12889-023-15415-2.
dc.identifier.uri.fl_str_mv https://www.arca.fiocruz.br/handle/icict/57930
dc.identifier.issn.en_US.fl_str_mv 1471-2458
identifier_str_mv CASTRO, Mônica Silva Monteiro de et al. Health litigation and cancer survival in patients treated in the public health system in a large Brazilian city, 2014–2019. BMC Public Health, v. 23, n. 1, 534, 2023. doi: 10.1186/s12889-023-15415-2.
1471-2458
url https://www.arca.fiocruz.br/handle/icict/57930
dc.language.iso.fl_str_mv eng
language eng
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv BioMed Central
publisher.none.fl_str_mv BioMed Central
dc.source.none.fl_str_mv reponame:Repositório Institucional da FIOCRUZ (ARCA)
instname:Fundação Oswaldo Cruz (FIOCRUZ)
instacron:FIOCRUZ
instname_str Fundação Oswaldo Cruz (FIOCRUZ)
instacron_str FIOCRUZ
institution FIOCRUZ
reponame_str Repositório Institucional da FIOCRUZ (ARCA)
collection Repositório Institucional da FIOCRUZ (ARCA)
bitstream.url.fl_str_mv https://www.arca.fiocruz.br/bitstream/icict/57930/2/Health%20litigation%20and%20cancer%20survival%20in%20patients.pdf
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repository.name.fl_str_mv Repositório Institucional da FIOCRUZ (ARCA) - Fundação Oswaldo Cruz (FIOCRUZ)
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