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2.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-LISBR1.1-46619

RESUMO

O Programa Nacional de Gestão de Custos (PNGC) é formado por um conjunto de ações que visam promover a gestão de custos no âmbito do Sistema Único de Saúde (SUS), a partir da geração, aperfeiçoamento e difusão de informações relevantes e pertinentes a custos, utilizadas como subsídio para otimização do desempenho de serviços, unidades, regiões e redes de atenção em saúde do SUS.


Assuntos
Controle de Custos , Sistema Único de Saúde
3.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue ; 31(5): 637-640, 2019 May.
Artigo em Chinês | MEDLINE | ID: mdl-31198155

RESUMO

OBJECTIVE: To explore the effect of lean management on cost control of single disease in patients with acute cerebral infarction (ACI) in stroke center. METHODS: A retrospective study was conducted. The patients with ACI who underwent intravenous thrombolysis in the stroke center of Taizhou Central Hospital in Zhejiang Province were enrolled. Thirty patients adopted traditional management procedures from July 2016 to September 2017 were enrolled in the control group, and 32 patients received lean management from October 2017 to December 2018 were enrolled in the lean group. The patients in the control group were treated with traditional intravenous thrombolysis, and the patients were sent to the neurology ward for intravenous thrombolysis. The patients in the lean group applied lean management value stream to optimize process management, the lean management team of the stroke center was established, and the green channel for stroke treatment was established to eliminate the waiting time as far as possible. The location of thrombolysis was changed from neurology ward to the neurological intensive care unit (NICU) in emergency department. The patients in the two groups were compared in terms of intravenous thrombolytic door-to-needle time (DNT), admission time to the neurologist's visit time (T1), CT examination time to neurology ward or NICU admission time (T2), neurology ward/NICU visit time to medication time (T3), and the proportion of patients with DNT controlled within 40 minutes, recovery of neurological impairment 7 days after thrombolysis [national institutes of health stroke scale (NIHSS) score], activity of daily living assessment (Barthel index), length of hospital stay, cost of hospital stay and patient satisfaction. At the same time, the main process quality and the implementation rate of easily missed indexes of cerebral infarction single disease were recorded. RESULTS: Compared with the control group, DNT, T1 and T2 in the lean group were significantly shortened [DNT (minutes): 39.56±11.12 vs. 63.03±19.63, T1 (minutes): 16.23±6.79 vs. 33.48±12.63, T2 (minutes): 13.45±3.84 vs. 17.47±5.56, all P < 0.01], T3 was slightly shortened (minutes: 9.88±1.95 vs. 10.95±2.69, P > 0.05), and the proportion of DNT control within 40 minutes was significantly increased [75.0% (24/32) vs. 16.7% (5/30), P < 0.01], the 7-day NIHSS score was decreased significantly (8.66±4.12 vs. 13.00±5.63, P < 0.01), 7-day Barthel index was increased significantly (71.6±16.7 vs. 54.7±17.1, P < 0.01), the length of hospital stay was significantly shortened (days: 9.69±4.06 vs. 12.47±3.83, P < 0.01), the hospital costs were significantly reduced (Yuan: 16 338±5 481 vs. 19 470±5 495, P < 0.05), the satisfaction of patients was improved significantly [(91.38±2.69)% vs. (86.53±2.78)%, P < 0.01]. In terms of the implementation rate of quality indicators such as pre-application evaluation of thrombolytic drugs, evaluation of dysphagia, and evaluation of vascular function, health education of ACI, rehabilitation evaluation and implementation within 24 hours, etc., the lean group was significantly improved as compared with the control group [(87.5% (28/32) vs. 53.3% (16/30), 96.9% (31/32) vs. 73.3% (22/30), 78.1% (25/32) vs. 43.3% (13/30), 100.0% (32/32) vs. 76.7% (23/30), 75.0% (24/32) vs. 33.3% (10/30), all P < 0.05]. CONCLUSIONS: Lean thinking can realize the standardization of stroke center process, effectively utilize medical resources, improve medical quality and reduce the cost of cerebral infarction single disease.


Assuntos
Infarto Cerebral/economia , Unidades Hospitalares/organização & administração , Infarto Cerebral/terapia , Controle de Custos , Humanos , Estudos Retrospectivos
4.
BMC Health Serv Res ; 19(1): 303, 2019 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-31077218

RESUMO

BACKGROUND: The global financial crisis and the economic and financial adjustment programme (EFAP) forced the Portuguese government to adopt austerity measures, which also included the health sector. The aim of this study was to analyse factors associated with HIV/AIDS patients' length of stay (LOS) among Portuguese hospitals, and the potential impact of the EFAP measures on hospitalizations among HIV/AIDS patients. METHODS: Data used in this analysis were collected from the Portuguese database of Diagnosis Related Groups (DRG). We considered only discharges classified under MCD 24 created for patients with HIV infection. A total of 20,361 hospitalizations occurring between 2009 and 2014 in 41 public hospitals were included in the analysis. The outcome was the number of days between hospital admission and discharge dates (LOS). Hierarchical Poisson regression model with random effects was used to analyse the relation between LOS and patient, treatment and setting characteristics. To more effectively analyse the impact of the EFAP implementation on HIV/AIDS hospitalizations, yearly variables, as well as a variable measuring hospitals' financial situation (current ratio) was included. RESULTS: For the 5% level, having HIV/AIDS as the principal diagnosis, the number of secondary diagnoses, the number of procedures, and having tuberculosis have a positive impact in HIV/AIDS LOS; while being female, urgent admission, in-hospital mortality, pneumocystis pneumonia, hepatitis C, and hospital's current ratio contribute to the decrease of LOS. Additionally, LOS between 2010 and 2014 was significantly shorter in comparison to 2009. Differences in LOS across hospitals are significant after controlling for these variables. CONCLUSION: Following the EFAP, a number of cost-containment measures in the health sector were implemented. Results from our analysis suggest that the implementation of these measures contributed to a significant decrease is LOS among HIV/AIDS patients in Portuguese hospitals.


Assuntos
Infecções por HIV , Hospitais Públicos/economia , Tempo de Internação/economia , Tempo de Internação/tendências , Adulto , Controle de Custos , Bases de Dados Factuais , Feminino , Custos de Cuidados de Saúde/tendências , Hospitalização/economia , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Alta do Paciente , Portugal
7.
BMC Health Serv Res ; 19(1): 231, 2019 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-30992013

RESUMO

BACKGROUND: Considering catastrophic health expenses in rural households with hospitalised members were unproportionally high, in 2013, China developed a model of systemic reform in Sanming by adjusting payment method, pharmaceutical system, and medical services price. The reform was expected to control the excessive growth of hospital expenditures by reducing inefficiency and waste in health system or shortening the length of stay. This study analyzed the systemic reform's impact on the financial burden and length of stay for the rural population in Sanming. METHODS: A total of 1,113,615 inpatient records for the rural population were extracted from the rural new cooperative medical scheme (NCMS) database in Sanming from 2007 to 2012 (before the reform) and from 2013 to 2016 (after the reform). We calculated the average growth rate of total inpatient expenditures and costs of different medical service categories (medications, diagnostic testing, physician services and therapeutic services) in these two periods. Generalized linear models (GLM) were employed to examine the effect of reform on out-of-pocket (OOP) expenditures and length of stay, controlling for some covariates. Furthermore, we controlled the fixed effects of the year and hospitals, and included cluster standard errors by hospital to assess the robustness of the findings in the GLM analysis. RESULTS: The typical systemic reform decreased the average growth rate of total inpatient expenditures by 1.34%, compared with the period before the reform. The OOP expenditures as a share of total expenditures showed a downward trend after the reform (42.34% in 2013). Holding all else constant, individuals after the reform spent ¥308.42 less on OOP expenditures (p < 0.001) than they did before the reform. Moreover, length of stay had a decrease of 0.67 days after the reform (p < 0.001). CONCLUSIONS: These results suggested that the typical systemic hospital reform of the Sanming model had some positive effects on cost control and reducing financial burden for the rural population. Considering the OOP expenditures as a share of total expenditures was still high, China still has a long way to go to improve the benefits rural people have enjoyed from the NCMS.


Assuntos
Gastos em Saúde , Hospitalização/economia , Hospitais Rurais/economia , Adulto , Idoso , China/epidemiologia , Controle de Custos , Feminino , Reforma dos Serviços de Saúde/economia , Humanos , Pacientes Internados/estatística & dados numéricos , Tempo de Internação/economia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Saúde da População Rural/economia
10.
Health Care Manag (Frederick) ; 38(2): 109-115, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30920990

RESUMO

States have engaged in medical malpractice litigation reforms over the past 30 years to reduce malpractice insurance premiums, increase the supply of physicians, reduce the cost of health care, and increase efficiency. These reforms have included caps on noneconomic damages and legal procedural changes. Despite these reforms, health care costs in the United States remain among the highest in the world, provider shortages remain, and defensive medicine practices persist. The purpose of this study was to determine how successful traditional medical malpractice reforms have been at controlling medical costs, decreasing defensive medicine practices, lowering malpractice premiums, and reducing the frequency of medical malpractice litigation. Research has shown that direct reforms and aggressive damage caps have had the most significant impact on lowering malpractice premiums and increasing physician supply. Out of the metrics that were improved by malpractice reforms, similar improvements were shown because of quality reform measures. While traditional tort reforms have shown some targeted improvement, large-scale, system-wide change has not been realized, and thus it is time to consider alternative reforms.


Assuntos
Reforma dos Serviços de Saúde/legislação & jurisprudência , Responsabilidade Legal/economia , Imperícia/economia , Imperícia/legislação & jurisprudência , Controle de Custos , Medicina Defensiva/economia , Custos de Cuidados de Saúde , Humanos , Médicos/provisão & distribução , Estados Unidos
12.
BMC Health Serv Res ; 19(1): 84, 2019 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-30709374

RESUMO

BACKGROUND: The increasing cost on healthcare exposes China's healthcare budgets and system to financial crisis. To control the excessive growth of healthcare expenditure, China's healthcare reforms emphasize the control of the global budget for healthcare, which leads to the release of relevant policy and a series of cost-control actions implemented by different hospitals. This work aims to identify the effects brought by the cost-control policy and actions via surveying and analysing feedback from clinicians. METHODS: Questionnaires on the cost-control policy and actions were designed for surveying 110 clinicians in hospitals from different regions of China. The data on the implementation of the cost-control actions and doctors' feedback on these actions were analysed using descriptive statistics. Pearson's chi-squared tests were performed to detect associations between doctors' opinions and specific cost-control actions. A value of p < 0.05 was considered statistically significant. Association relationships between doctors' opinions and cost-control actions were modelled into network models, and key factors were identified in a multi-variate framework. Last, we visualized our resultant data using a network model, and further multi-variate analysis was performed. RESULTS: There were three main findings. (1) The cost-control policy has been widely implemented in the sampled hospitals in different regions of China, with more than 80% of those surveyed acknowledging that their hospitals take actions of reducing average prescription fees for outpatients, drug costs, and in-hospitalization durations. (2) Most doctors have a negative view of some cost-control actions; this is mainly due to concerns about the effects of these actions on the doctors' own healthcare performance and patient satisfaction. (3) Cost-control actions that had a significant impact on doctors' performance included limiting average prescription fees for outpatients and limiting the use of examinations/drugs/surgeries. Decreased patient satisfaction was associated with fewer admissions of critically ill patients, reduced use of brand-name drugs, and increased total costs to patients due to increased frequencies of visits to the hospitals. CONCLUSIONS: Cost-control actions implemented in hospitals in response to the government's policy to reduce its national healthcare budget affect both doctors and patients in several ways. Moreover, the cost-control policy and actions can be improved.


Assuntos
Reforma dos Serviços de Saúde/economia , Política de Saúde/economia , Assistência Ambulatorial/economia , Atitude do Pessoal de Saúde , Orçamentos , China , Controle de Custos , Custos de Medicamentos , Economia Hospitalar , Hospitais/estatística & dados numéricos , Humanos , Pacientes Ambulatoriais , Satisfação do Paciente , Médicos/psicologia , Honorários por Prescrição de Medicamentos , Inquéritos e Questionários
13.
Stud Health Technol Inform ; 257: 115-124, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30741183

RESUMO

The availability of research and outcomes data is the primary limitation to evidence-based practice. Today, only a fraction of clinical decisions are based upon evidence derived from randomized control trials (RCTs), the gold-standard of knowledge discovery. At the same time, clinical trial complexity has steadily increased as has the effort required at clinical investigational sites. Direct use of electronic health record (EHR) data for clinical trials has the potential to address some of these needs, improving data quality and reducing cost.


Assuntos
Sistemas de Apoio a Decisões Clínicas , Troca de Informação em Saúde , Controle de Custos , Confiabilidade dos Dados , Registros Eletrônicos de Saúde , Troca de Informação em Saúde/normas , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto
14.
Stud Health Technol Inform ; 257: 133-139, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30741185

RESUMO

Telenursing triage and advice services are continuing to expand both nationally and internationally. A primary role of telehealth nursing triage is to channel patients or clients towards appropriate levels of care, thereby reducing healthcare costs and freeing up resources. PURPOSE: The objective of this research is to: (a) present an overview of the current research, (b) describe the extent to which telenursing services are fulfilling this role, (c) identify gaps in the literature and (d) propose future research directions. METHODS: The report consists of a scoping review of current literature based on the framework suggested by Arkseyand O'Malley (2005). RESULTS: Although the available research spans a variety of jurisdictions, which makes comparison difficult, there is some evidence that suggests telenursing services empower clients to access levels of care in keeping with the severity of their symptoms, as well as enabling clients to engage in self-care when appropriate. This in turn leads to cost savings for the broader health care system. CONCLUSION: More evaluation of telenursing programs is needed to identify consistent savings. Health outcomes should be a part of the research.


Assuntos
Custos de Cuidados de Saúde , Recursos em Saúde , Telemedicina , Telenfermagem , Triagem , Controle de Custos , Humanos , Telenfermagem/economia
15.
Int J Technol Assess Health Care ; 35(1): 1-4, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30714547

RESUMO

Digital health technologies (DHTs) such as health apps are rapidly emerging as a major disruptor of health care. Yet there is no well-established process of decision making for selecting DHTs that are worthy of investing resources in their validation to determine whether they are ready (safe, effective, and not too costly) for health related use. We report here on an Ontario-based initiative to support such decision making. Specifically, we developed a decision-making algorithm that uses approved criteria including the strategic direction of the health research institute and the hospital, and availability of resources. The Council of Academic Hospitals of Ontario has adapted our approach for other hospitals. We hope that other healthcare organizations, in and beyond Ontario, will consider this and alternative approaches, and that research will be conducted to evaluate such approaches.


Assuntos
Algoritmos , Aplicações da Informática Médica , Avaliação da Tecnologia Biomédica/métodos , Controle de Custos/normas , Tomada de Decisões , Eficiência Organizacional , Humanos , Aplicativos Móveis/normas , Ontário , Avaliação da Tecnologia Biomédica/normas , Estudos de Validação como Assunto
16.
Int J Technol Assess Health Care ; 35(1): 50-55, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30732667

RESUMO

OBJECTIVES: Procurement's important role in healthcare decision making has encouraged criticism and calls for greater collaboration with health technology assessment (HTA), and necessitates detailed analysis of how procurement approaches the decision task. METHODS: We reviewed tender documents that solicit medical technologies for patient care in Canada, focusing on request for proposal (RFP) tenders that assess quality and cost, supplemented by a census of all tender types. We extracted data to assess (i) use of group purchasing organizations (GPOs) as buyers, (ii) evaluation criteria and rubrics, and (iii) contract terms, as indicators of supplier type and market conditions. RESULTS: GPOs were dominant buyers for RFPs (54/97) and all tender types (120/226), and RFPs were the most common tender (92/226), with few price-only tenders (11/226). Evaluation criteria for quality were technical, including clinical or material specifications, as well as vendor experience and qualifications; "total cost" was frequently referenced (83/97), but inconsistently used. The most common (47/97) evaluative rubric was summed scores, or summed scores after excluding those below a mandatory minimum (22/97), with majority weight (64.1 percent, 62.9 percent) assigned to quality criteria. Where specified, expected contract lengths with successful suppliers were high (mean, 3.93 years; average renewal, 2.14 years), and most buyers (37/42) expected to award to a single supplier. CONCLUSIONS: Procurement's evaluative approach is distinctive. While aiming to go beyond price in the acquisition of most medical technologies, it adopts a narrow approach to assessing quality and costs, but also attends to factors little considered by HTA, suggesting opportunities for mutual lesson learning.


Assuntos
Proposta de Concorrência/organização & administração , Custos e Análise de Custo/normas , Tomada de Decisões , Avaliação da Tecnologia Biomédica/organização & administração , Canadá , Proposta de Concorrência/normas , Controle de Custos/organização & administração , Compras em Grupo/organização & administração , Humanos , Avaliação da Tecnologia Biomédica/economia , Avaliação da Tecnologia Biomédica/normas
17.
Am Econ Rev ; 109(2): 473-522, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30707004

RESUMO

We evaluate the consequences of narrow hospital networks in commercial health care markets. We develop a bargaining solution, "Nash- in-Nash with Threat of Replacement," that captures insurers' incentives to exclude, and combine it with California data and estimates from Ho and Lee (2017) to simulate equilibrium outcomes under social, consumer, and insurer- optimal networks. Private incentives to exclude generally exceed social incentives, as the insurer benefits from substantially lower negotiated hospital rates. Regulation prohibiting exclusion increases prices and premiums and lowers consumer welfare without significantly affecting social surplus. However, regulation may prevent harm to consumers living close to excluded hospitals.


Assuntos
Setor de Assistência à Saúde/economia , Reembolso de Seguro de Saúde/economia , Seguro Saúde/economia , Programas de Assistência Gerenciada/economia , Modelos Econômicos , Negociação , California , Controle de Custos , Hospitais , Humanos , Estados Unidos
18.
Cornea ; 38(4): 492-497, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30681517

RESUMO

PURPOSE: Severe corneal disease contributes significantly to the global burden of blindness. Corneal allograft surgery remains the most commonly used treatment, but does not succeed long term in every patient, and the odds of success fall with each repeated graft. The Boston keratoprosthesis type I has emerged as an alternative to repeat corneal allograft. However, cost limits its use in resource-poor settings, where most corneal blind individuals reside. METHODS: All aspects of the Boston keratoprosthesis design process were examined to determine areas of potential modification and simplification, with dual goals to reduce cost and improve the cosmetic appearance of the device in situ. RESULTS: Minor modifications in component design simplified keratoprosthesis manufacturing. Proportional machinist time could be further reduced by adopting a single axial length for aphakic eyes, and a single back plate diameter. The cosmetic appearance was improved by changing the shape of the back plate holes from round to radial, with a petaloid appearance, and by anodization of back plate titanium to impute a more natural color. CONCLUSIONS: We have developed a modified Boston keratoprosthesis type I, which we call the "Lucia." The Lucia retains the 2 piece design and ease of assembly of the predicate device, but would allow for manufacturing at a reduced cost. Its appearance should prove more acceptable to implanted patients. Successful keratoprosthesis outcomes require daily medications for the life of the patient and rigorous, frequent, postoperative care. Effective implementation of the device in resource-poor settings will require further innovations in eye care delivery.


Assuntos
Doenças da Córnea/cirurgia , Próteses e Implantes , Desenho de Prótese/métodos , Implantação de Prótese , Cegueira/cirurgia , Controle de Custos , Humanos , Próteses e Implantes/economia
19.
Rev Esp Quimioter ; 32(1): 73-77, 2019 Feb.
Artigo em Espanhol | MEDLINE | ID: mdl-30630308

RESUMO

OBJECTIVE: It is becoming increasingly necessary to automatize screening of urine samples to culture at Microbiology laboratories. Our objective was to estimate the budget threshold from which the Alfred 60/AST device would be profitable for our hospital. METHODS: Cost minimization study by decision trees, carried out in a General Hospital. The cost of traditional urine culture and urine processing using Alfred-60/AST were compared. Traditional processing involves the culture of all urine specimens received onto blood and MacConkey agar, and identification of every microorganism isolated by Vitek-2 system. The autoanalyzer would only inoculate the positive urines onto a chromogenic media, directly identifying the Escherichia coli isolates. RESULTS: The variables with the greatest economic impact in the model were the probability of obtaining a positive culture, the prevalence of E. coli in the urine cultures and the cost per sample using Alfred-60/AST. The multivariate sensitivity analysis showed that the model was solid. The bivariate sensitivity analysis showed that the model is suceptible to cost modification, mainly of the automatic device. At a threshold value of 1.40 euros/determination, the automatic processing would decrease the annual costs in 2,879 euros. CONCLUSIONS: The introduction of the Alfred-60/AST device in our laboratory at 1.40 euros/determination would reduce urine processing workload, saving time and costs.


Assuntos
Infecções Urinárias/microbiologia , Automação , Técnicas Bacteriológicas , Controle de Custos , Análise Custo-Benefício , Infecções por Escherichia coli/economia , Infecções por Escherichia coli/microbiologia , Citometria de Fluxo , Custos Hospitalares , Humanos , Laboratórios Hospitalares/economia , Estudos Retrospectivos , Infecções Urinárias/diagnóstico , Infecções Urinárias/economia
20.
Rio de Janeiro; s.n; 2019. 296 f p. fig, graf, tab.
Tese em Português | LILACS | ID: biblio-1005298

RESUMO

A Constituição da República Federativa do Brasil de 1988 (CRFB-88), ao considerar o direito à saúde como parte integrante do direito à vida para todos os cidadãos, está na base do conjunto de reflexões e debates sobre o processo de judicialização da saúde em curso no país desde a segunda metade dos anos 1990. Esse processo se intensificou desde então e ampliou seu impacto sobre o financiamento do sistema de saúde universal e integral adotado. A expansão dos gastos em saúde passou a ter impacto crescente sobre o orçamento público e, nesse sentido, a Emenda Constitucional nº 95 (EC-95), orientada para conter a expansão dos gastos públicos e, consequentemente, reduzir o impacto do processo de judicialização derivado do direito universal e integral à saúde, assumiu uma centralidade no tocante ao debate em torno dos direitos de cidadania dispostos na CRFB-88. Este estudo parte da premissa do direito constitucional à saúde e constrói um percurso com outros elementos essenciais para o debate do tema, entre eles, os conflitos entre os Poderes de Estado que surgem durante o fenômeno da judicialização da saúde, e a importância da economia e de temas correlatos, como orçamento público e equilíbrio fiscal. Trata-se de estudo exploratório e qualitativo que buscou qualificar o debate sobre a judicialização da saúde em contexto de austeridade e restrições orçamentárias para os gastos sociais e que tem a intenção de mostrar que as condições atuais de financiamento para o SUS configuram prováveis cenários pessimistas no futuro. Foram realizadas revisão bibliográfica, em vários artigos acadêmicos e documentos oficiais, e análises de cenários prospectivos de alguns estudos, o que permitiu traçar perspectivas futuras quanto ao financiamento do Sistema Único de Saúde (SUS) e para a judicialização da saúde. Ao fim do estudo exploratório e das análises dos cenários prospectivos, verifica-se que a EC-95 é incompatível com a necessidade de financiamento do SUS, condição que atinge a garantia constitucional ao efetivo exercício do direito à saúde. Haverá um impedimento de ordem orçamentária para o cumprimento do preceito constitucional de elevada significância para a sociedade e, nesse sentido, o direito à saúde colide com a possibilidade financeira de poder exercê-lo


The Brazilian Constitution of 1988 (CRFB-88), regarding the right to health as an integral part of the right to life for all citizens, is the basis of a series of reflections and debates on the process of judicialization of health since the second half of the 1990s. This process has intensified since then and expanded its impact on the financing of the universal and comprehensive health system adopted. The health spending expansion has had growing impact on the public budget and, in this sense, Constitutional Amendment 95 (EC-95), aimed at containing the expansion of public spending and, consequently, reducing the impact of the process of judicialization derived from the universal and integral right to health, assumed a central role in the debate on the rights of citizenship set forth in CRFB-88. This study starts from the premise of the constitutional right to health and builds a path with other essential elements for the debate of the theme, among them, conflicts between the State powers that arise during the phenomenon of health judicialization, and the importance of economy and related issues, such as public budget and fiscal balance. It is an exploratory and qualitative study that sought to qualify the debate on the judicialization of health in the context of austerity and budget constraints for social expenditures and which intends to show that the current financing conditions for the SUS are likely to create pessimistic scenarios in the future. A bibliographic review was carried out in several academic articles and official documents, and analyzes of prospective scenarios of some studies, which allowed for future perspectives on the financing of the Unified Health System (SUS) and on the judicialization of health. At the end of the exploratory study and analysis of the prospective scenarios, it is verified that the EC-95 is incompatible with the need for financing of the SUS, a condition that reaches the constitutional guarantee to the effective exercise of the right to health. There will be a budgetary impediment to the fulfillment of the constitutional precept of great significance for society and, in this sense, the right to health collides with the financial possibility of being able to perform it


Assuntos
Humanos , Sistema Único de Saúde , Direito à Saúde/legislação & jurisprudência , Controle de Custos , Financiamento da Assistência à Saúde , Judicialização da Saúde , Brasil
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