Institutional strategies as a mechanism to rationalize the negative effects of the judicialization of access to medicine in Brazil

Chagas, Virginia Oliveira; Provin, Mércia Pandolfo; Mota, Pedro Augusto Prado; Guimarães, Rafael Alves; Amaral, Rita Goreti

doi:10.1186/s12913-020-4929-9

Table 7 Determinants and effects of institutional strategies on the costs of medications requested in lawsuits from January 2003 to December 2015

From: Institutional strategies as a mechanism to rationalize the negative effects of the judicialization of access to medicine in Brazil

Variables	Bivariate regression		Multivariable regression³
Variables	β¹ (IC 95%)²	p	β¹ (IC 95%)²	p
Plaintiffs’ characteristics
Age (years)	0.05 (−0.10; 0.21)	0.517
Sex
Male	1.00
Female	−0.09 (− 0.38; 0.18)	0.502
Income (US$)	0.45 (0.23; 0.66)	< 0.001	0.41 (0.22–0.61)	< 0.001
Characteristics of the lawsuits
Quantity of medicines	0.13 (0.07; 0.19)	< 0.001	0.17 (0.12–0.23)	< 0.001
Origin of the prescriptions
Prescribed by a SUS clinician	1.00
Prescribed by a private system clinician	0.84 (0.42; 1.27)	< 0.001
Diseases
Certain infectious and parasitic diseases	−0.84 (−2.29; 0.60)	0.252
Neoplasms	1.40 (0.18; 2.62)	0.024
Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism	−1.84 (−3.45; −0.23)	0.025
Endocrine, nutritional and metabolic diseases	−0.25 (− 0.80; 0.01)	0.057
Mental and behavioural disorders	0.07 (−0.33; 0.46)	0.740
Diseases of the nervous system	−0.26 (− 0.64; − 0.12)	0.178
Diseases of the eye and adnexa	−0.55 (1.34; 0.24)	0.172
Diseases of the circulatory system	−0.21 (− 0.56; 0.13)	0.220
Diseases of the respiratory system	−0.04 (− 0.83; 00.75)	0.917
Diseases of the digestive system	0.19 (−0.43; 0.83)	0.543
Diseases of the musculoskeletal system and connective tissue	−2.42 (−4.99; 0.15)	0.066
Interventions	−0.29 (−0.92; 0.32)	0.348
DAMNP⁴
Before deployment	1.00		1.00
After deployment	−0.36 (−0.51; − 0.20)	< 0.001	− 0.20 (− 0.37; − 0.10)	< 0.001
CATS⁵
Before deployment	1.00		1.00
After deployment	−0.48 (− 066; − 0.31)	< 0.001	−0.25 (− 0.30; − 0.10)	< 0.001
			R²: 0.140
			R² adjusted: 0.132

¹Regression coefficient; ²Confidence interval of 95%;³Model adjusted by sex, age, origin of the prescription, quantity of medicines, neoplastic diseases, blood diseases, endocrine diseases, diseases of the osteomuscular system and strategies (DAMNP e CATS); ⁴Period before the deployment of ⁵Department of Assessment of Non-Standardized Medicines: 2003–2005/Period after the deployment of Department of Assessment of Non-Standardized Medicines: 2007–2015; ⁵Period before deployment of Technical Chamber of Health Assessment: 2003–2008/ Period after deployment of Technical Chamber of Health Assessment: 2010–2015

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