Evidence map›Paper›PMID 36944943›Full record

ArticleBMC public health2023

Health litigation and cancer survival in patients treated in the public health system in a large Brazilian city, 2014-2019.

Mônica Silva Monteiro de Castro, Gabriela Drummond Marques da Silva, Iara Veloso Oliveira Figueiredo, Wanessa Debôrtoli de Miranda, Helvécio Miranda Magalhães Júnior, Fausto Pereira Dos Santos, Rômulo Paes de Sousa

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Article in BMC public health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Mônica Silva Monteiro de CastroRené Rachou Institute, Oswaldo Cruz Foundation (IRR - Fiocruz), Av. Augusto de Lima, 1715 - Barro Preto, Belo Horizonte, MG, 30190-002, Brazil. monica.castro@fiocruz.br.
Gabriela Drummond Marques da SilvaRené Rachou Institute, Oswaldo Cruz Foundation (IRR - Fiocruz), Av. Augusto de Lima, 1715 - Barro Preto, Belo Horizonte, MG, 30190-002, Brazil.
Iara Veloso Oliveira FigueiredoRené Rachou Institute, Oswaldo Cruz Foundation (IRR - Fiocruz), Av. Augusto de Lima, 1715 - Barro Preto, Belo Horizonte, MG, 30190-002, Brazil.
Wanessa Debôrtoli de MirandaNursing School, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil.
Helvécio Miranda Magalhães JúniorRené Rachou Institute, Oswaldo Cruz Foundation (IRR - Fiocruz), Av. Augusto de Lima, 1715 - Barro Preto, Belo Horizonte, MG, 30190-002, Brazil.
Fausto Pereira Dos SantosRené Rachou Institute, Oswaldo Cruz Foundation (IRR - Fiocruz), Av. Augusto de Lima, 1715 - Barro Preto, Belo Horizonte, MG, 30190-002, Brazil.
Rômulo Paes de SousaRené Rachou Institute, Oswaldo Cruz Foundation (IRR - Fiocruz), Av. Augusto de Lima, 1715 - Barro Preto, Belo Horizonte, MG, 30190-002, Brazil.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLitigation for health care, also known as health judicialization, is frequent in Brazil. It involves recourse to the court system to access health services. The study aimed to evaluate whether cancer patients in Belo Horizonte, Minas Gerais, Brazil, increased their overall survival by increasing access to certain drugs or treatments through litigation, controlling for the effect of demographic and disease-related variables.

methodsA retrospective cohort study was conducted. Patients with breast, prostate, brain, lung, or colon cancers from 2014 to 2019 were included. Survival analysis was performed using the Cox proportional hazards model.

resultsIn the multivariate analysis, litigation was significantly associated with increased survival in cancers of breast (HR = 0.51, 95%CI 0.33-0.80), prostate (HR = 0.50, 95%CI 0.30-0.85), colon (HR = 0.59, 95%CI 0.38-0.93), and lung (HR = 0.36, 95%CI 0.22-0.60). Five-year survival rates of patients who sued for treatment were 97.8%, 88.7%, 59.3%, and 26.0%, compared to median survival of 95.7%, 78.7%, 41.2%, and 2.4%, respectively, among patient that did not resort to court action. The study suggests that litigation for access to cancer treatment may represent a step forward in obtaining more effective treatment. This study´s main limitations are the lack of patients´ clinical information for use as control variables and the lack of variables to assess patients´ quality of life. The study also found that many cases involved claims that could have been solved by administrative rather than legal action. Some claims thus reflect the lack of adequate administrative procedures.

conclusionWhen based on scientific evidence, access to new therapies, combined with other technologies already available, can favor patient survival. Access to new therapies through litigation may increase health inequalities since low-income patients have limited access to legal recourse against the State to meet their needs. The timely approval of new effective therapies can mitigate the judicialization of cancer treatment.

Indexed as

NeoplasmsPublic HealthBrazilHumansMaleQuality of LifeRetrospective StudiesSurvival AnalysisBrazilCancerCancer drugsJudicial actionsPublic healthSurvival analyses

Identifiers

PMID36944943
PMCPMC10029205

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.