JUDICIALIZAÇÃO DA SAÚDE NO NORDESTE: ASPECTOS DOCUMENTAIS E PERCEPÇÃO DOS GESTORES ESTADUAIS SOBRE O TEMA

Abstract

The Federal Constitution of 1988, in its article 196, establishes that health is a right of all and a duty of the State. However, upon realizing the gap between what was established in public health policies and what was offered by the State, i.e., the availability of services far below the minimum legally established, citizens began to turn to the Judiciary to have their health demands met, this being known as Judicialization of Health. Objectives: To analyze the determinants of the process of health judicialization based on the State Health Plans and the perception of health managers of the Northeastern region about the phenomenon. Theoretical Background: The judicialization of health promotes administrative and fiscal challenges for health managers, since it creates a new demand to allocate resources. This phenomenon can cause a budgetary imbalance, compromising resources destined to the community. The theme is increasingly discussed, in view of the budgetary impacts caused to the public budget. Methodological Path: The work was divided into 2 axes of analysis, the first being the evaluation of the SEPs, in which a cross-sectional, observational study was conducted, with retrospective collection of primary sources in the parameters of documentary research seeking descriptors related to the theme; the second was directed to the analysis of the managers' perception, being a cross-sectional and observational study, using the descriptive-analytical method based on the interpretation of an electronic questionnaire. Results and Discussion: Fifty-three descriptors related to the theme were found in the SEPs, most of them (66.03%) being incipient, i.e., with an approach with little context to the phenomenon. Maranhão was highlighted, where 30 descriptors were found, although this state follows the pattern of the region - most of the descriptors were considered incipient. As for the managers, the main causes pointed out for the phenomenon are budgetary difficulties, favorable jurisprudence, and the lack of SUS coverage. Among the main demands pointed out are medicines, ICU beds, and surgeries. Conclusions: Judicialization is a multifaceted phenomenon that involves several determinants, with emphasis on pharmaceutical assistance. The quantitative approach made in the SEP is satisfactory, however it contrasts with the quality of the descriptors found. In addition, health managers demonstrated ample knowledge about the theme, knowing how to identify its main causes and consequences.