Impact evaluation of technical notes issued by NATJUS on healthcare judicialization.

IF 0.9 Q2 MEDICINE, GENERAL & INTERNAL
Einstein-Sao Paulo Pub Date : 2025-06-13 eCollection Date: 2025-01-01 DOI:10.31744/einstein_journal/2025GS0766
Lucas Reis Correia, Luís Gustavo Nascimento de Paula, Julio Trecenti, Bruno Daleffi da Silva
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引用次数: 0

Abstract

Introduction: Technical Support Centers of the Judiciary (NATJUST), provide health technology assessments to judges in health-related litigations against both public and private healthcare systems. These centers provide technical notes, that can assist Brazilian Courts in making provisional rulings and determining patient access to health services during legal proceedings.

Objective: This study aimed to evaluate the impact of NATJUS technical notes on preliminary injunctions in lawsuits against the Brazilian Unified Health System. Specifically, we analyzed the alignment between judicial decisions and technical notes recommendations, assessed lawsuit costs, and examined NATJUS-generated savings for Brazilian Unified Health System. Furthermore, we examined the technical notes issued by Hospital Israelita Albert Einstein, which manages the national NATJUS.

Methods: We constructed a database of lawsuits with and without NATJUS technical notes. Using random forest models, we predicted the potential outcomes of preliminary injunctions where technical notes were available. Savings were estimated by examining the relationship between preliminary injunctions and case values, then compared with potential injunctions incorporating technical notes recommendations.

Results: The technical notes recommendations and judges' decisions were aligned in 76% of the cases, with median savings from lawsuits amounting to BRL10,120. The estimated impact of NATJUS technical notes for Brazilian Unified Health System indicated median savings of BRL1,312.74 per case per year. Between 2020 and 2022, NATJUS resulted in total savings of BRL111.4 million. Focusing on Hospital Israelita Albert Einstein NATJUS, the cost savings for Brazilian Unified Health System amounted to BRL27 million, which indicates a return on investment of BRL1.66 per BRL1 invested in the project.

Conclusion: Our findings indicate the economic importance of technical notes in shaping preliminary injunctions, not only elevating decision quality but also fostering evidence-based judicial processes.

评价美国国家司法学会发布的技术说明对医疗保健司法化的影响。
简介:司法技术支持中心(NATJUST),在针对公共和私人医疗系统的卫生相关诉讼中为法官提供卫生技术评估。这些中心提供技术说明,帮助巴西法院作出临时裁决,并确定患者在法律诉讼期间获得保健服务的机会。目的:本研究旨在评估NATJUS技术说明在针对巴西统一卫生系统的诉讼中对初步禁令的影响。具体来说,我们分析了司法判决和技术说明建议之间的一致性,评估了诉讼成本,并检查了natjuss为巴西统一卫生系统带来的节省。此外,我们审查了管理国家NATJUS的以色列阿尔伯特·爱因斯坦医院发布的技术说明。方法:建立有NATJUS技术记录和无NATJUS技术记录的诉讼数据库。使用随机森林模型,我们预测了技术说明可用的初步禁令的潜在结果。通过审查初步禁令与案件价值之间的关系,然后与包含技术说明建议的潜在禁令进行比较,估计节余。结果:在76%的案件中,技术说明的建议和法官的判决是一致的,诉讼节省的中位数为10,120巴西雷亚尔。NATJUS技术说明对巴西统一卫生系统的估计影响表明,每年每个病例节省的中位数为1,312.74巴西雷亚尔。在2020年至2022年期间,NATJUS共节省了1.114亿巴西雷亚尔。以以色列阿尔伯特·爱因斯坦NATJUS医院为重点,巴西统一卫生系统节省的成本达2,700万巴西雷亚尔,这表明该项目每投资1雷亚尔可获得1.66雷亚尔的投资回报。结论:我们的研究结果表明,技术说明在形成初步禁令方面的经济重要性,不仅可以提高决策质量,还可以促进循证司法程序。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Einstein-Sao Paulo
Einstein-Sao Paulo MEDICINE, GENERAL & INTERNAL-
CiteScore
2.00
自引率
0.00%
发文量
210
审稿时长
38 weeks
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