Teses e dissertações
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Navegando Teses e dissertações por Assunto "Acesso aos serviços de saúde"
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Dissertação Acesso aberto Medicamentos "sub judice" no sistema único de saúde do município de Tubarão - SC: uma abordagem econômica(2021) Mello, Alexandra Ferro deAim: Analyze lawsuits filed against Tubarão County in the year of 2010 focused on Economics Pharmaceutical. Methods: Retrospective descriptive study based on analysis of documents. We investigated patient profiles, the profile of requirements, medication required according to the Anatomical Therapeutic Chemical classification, health problems that motivated the requirements and spending ratios of drugs belonging to the standard lists of new drugs and, in addition, the average costs of lawsuits filed. Results: We identified and analyzed 223 lawsuits related to 212 patients. The patient profiles were identified in a portion of processes, in which case most women (61.3%) and aged between 10 months and 90 years. About procedural elements, we found the count and the State as required in 21.2% of the lawsuits 98.5% of this lawsuits had particular counselor and 60.6% of prescribers physicians were from the private sector. The court decision in 100% was to dispense medication in required by indeterminate time according to the physician prescription and there were 88.8% of injunction relief deferred. There were no indications of ICD in 28.0% of the lawsuits. The main problems reported were circulatory disease, mental and behavioral disorders. In the lawsuits analyzed were required 773 different medication in 392 specialties and the medium per patient was 3.7 (about 2.7) different medication with a variability of 14 medication per lawsuit with medium of three. The drugs required was distributed mainly in therapeutic classes of medications that act in nervous system cardiovascular system, digestive system and metabolism, blood and organs of hemapoietic system. The average value per lawsuit was R$ 1.864,24 . We observe that the spent per patient via lawsuits was approximately 406 times greater than the corresponding per capita value to use the basic pharmacy. We verified required medicines records and we identify 9.2% of new drugs which accounted 16.0% of total spending. Regarding the new drugs requirements it was found 68.6% of them were not prescribed by generic name. It was also determined the ratio of drugs presents in the standard lists. We found 42.5% of these drugs in one of these list at least; representing 44.3% of the value spent and 83.2% of these drugs were listed in the list of Component Specialized of Pharmaceutical Services. It was noteworthy that the Class L was used by 8.0% of the patients and it represented 50.0% of the total spending and a half of these medications were listed in the list of Component Specialized of Pharmaceutical Services. From those 392 specialties required we highlight that 10 of them represents 61.5% of drug spending by suitcases in the year found in this study. Conclusion: The information contained in the lawsuits about patient profiles, procedural elements healthy problems and medications shows signs of irrational use of drugs leading to an amount of spending by lawsuit higher than that of basic pharmacy.