Public accountability and health policy: the case of the 60-day Law in ensuring access to breast cancer treatment in São Paulo State.

IF 1.1 Q2 MEDICINE, GENERAL & INTERNAL
Einstein-Sao Paulo Pub Date : 2026-06-26 eCollection Date: 2026-01-01 DOI:10.31744/einstein_journal/2026AO2286
Fernanda Borges Keid, Nivaldo Carneiro Junior, Vânia Barbosa do Nascimento
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引用次数: 0

Abstract

Objective: This article analyzed the impact of Law No. 12,732/2012 on breast cancer care in São Paulo State (Brazil) between 2013 and 2024, as well as the role of external oversight.

Methods: This qualitative-quantitative study used 58,892 records from the São Paulo Oncocenter Foundation database and cases judged by the São Paulo State Court of Accounts.

Results: The analysis revealed significant and persistent delays in diagnosis (31.3-66.8%) and treatment initiation (38-72%) across all Regional Health Directorates, although delays fluctuated over time, no consistent trend toward reduced delays was observed between the 2013-2024 period. The São Paulo State Court of Accounts, as an external oversight mechanism, focused on formal analyses rather than results-oriented evaluations, particularly regarding the identified delays.

Conclusion: Our findings led us to conclude that the 60-day Law has had a limited impact in ensuring timely access to breast cancer diagnosis and treatment in the state, as delays have remained high and have not consistently improved over time. It is recommended that external control strategically strengthen this public policy by inducing managerial accountability and ensuring the right to access and comprehensive care.

公共问责制和卫生政策:在圣保罗州确保获得乳腺癌治疗的60天法律案例。
目的:本文分析了2013年至2024年期间巴西圣保罗州(Brazil)第12,732/2012号法律对乳腺癌护理的影响,以及外部监督的作用。方法:本定性定量研究使用了圣保罗肿瘤中心基金会数据库中的58,892条记录和圣保罗州会计法院判决的案件。结果:分析显示,所有地区卫生局的诊断延误(31.3-66.8%)和开始治疗延误(38-72%)显著且持续,尽管延误随时间波动,但在2013-2024年期间没有观察到减少延误的一致趋势。圣保罗州审计法院作为一个外部监督机制,侧重于正式分析,而不是注重结果的评价,特别是关于已查明的延误。结论:我们的研究结果使我们得出结论,60天法在确保该州及时获得乳腺癌诊断和治疗方面的影响有限,因为延误仍然很高,并且随着时间的推移并没有持续改善。建议外部控制通过引入管理问责制和确保获得和全面护理的权利,从战略上加强这一公共政策。
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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