Abstract
BackgroundThe judicialization of health care is a social claim concerning the right to the access to health care. It usually occurs due to gaps in public policy or failures in its application. In Brazil, several public institutions have implemented strategies to approach this phenomenon. However, these strategies have not yet been systematized into functional categories.ObjectiveTo categorize and analyze the strategies implemented by public institutions in Brazil to approach the judicialization of health care.MethodA systematic scoping review was developed following the method proposed by the Joanna Briggs Institute. The descriptor ‘judicialization of health’ was used to conduct the searches for studies in 18 electronic databases and other types of documents in the gray literature until March 2019. Documents containing the reports of strategies implemented in public institutions to approach the judicialization of health care in Brazil were included. Two independent reviewers assessed the eligibility of the documents and extracted the data. The strategies identified were categorized using definitions from the World Health Organization and existing Brazilian legislation.ResultsSeventy eight implemented strategies were identified and organized into nine categories: i. Technical support to the judiciary; ii. State health committees; iii. Organization of assistance; iv. Compliance with court orders, v. Computerized information systems; vi. Administrative proceeding; vii. Defense of the public authority; viii. Pharmacy and therapeutics committee; ix. Alternative dispute resolution. These categories are not mutually exclusive and often act in concert or complement each other’s activities. They represent services either existing or provided for in legal provisions by the public administration to meet various types of demands.ConclusionsThe categories proposed to approach the judicialization of health care represent some of the recommendations for qualifying public administration or are provided for in Brazilian legislation, or both. The existence of recommendations and legislation facilitate, but do not guarantee, the implementation of strategies by public institutions.
Highlights
The judicialization of health care, mainly in Latin America and the Caribbean, can be considered as a social claim to a pressing need: access to adequate health care, whether services or medical supplies, is currently not being met due to various reasons
In Brazil, the judicialization of health emerged with the activism of people who live with the HIV virus who demanded drug treatment (Tribunal de Contas da União, 2017)
Documents were included concerning any type of institutional strategy that has been implemented to approach the judicialization of health care in Brazil, both in the areas of health care management and legal1
Summary
The judicialization of health care, mainly in Latin America and the Caribbean, can be considered as a social claim to a pressing need: access to adequate health care, whether services or medical supplies, is currently not being met due to various reasons. In Brazil, the judicialization of health emerged with the activism of people who live with the HIV virus who demanded drug treatment (Tribunal de Contas da União, 2017) This happened shortly after the promulgation of the Federal Constitution in 1988 and the creation of the Unified Health System (SUS in Portuguese) in 1990, where for the first time, the Brazilian government considered health as a fundamental right of those who live in the country (Brasil, 1988; Brasil, 1990). These strategies have not yet been systematized into functional categories
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