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公共部门实施策略以应对医疗保健的司法化:系统评价方案。

Public sector implementation strategies to approach the judicialization of health care: a systematic review protocol.

机构信息

Graduate Program in Pharmaceutical Science, University of Sorocaba, Rodovia Raposo Tavares, Km 92,5 -, Sorocaba, SP, Brazil.

Oswaldo Cruz Foundation, Fiocruz, Brasília, DF, Brazil.

出版信息

Syst Rev. 2022 Aug 10;11(1):164. doi: 10.1186/s13643-022-02043-x.

Abstract

BACKGROUND

The judicialization of health care can be understood as a societal response to pressing healthcare needs, which probably are not being adequately addressed by the current healthcare system. This phenomenon increases the strain on service resources, both in the health sector and in the judiciary system as well, demanding an institutional reorganization to manage judicial actions. It is believed that each institution has developed strategies for coping with the problem in isolation and with little public disclosure. The purpose of this review will be to identify institutional strategies implemented and to investigate their effects in approaching the judicialization of health care.

METHODS

Electronic searches will be conducted up to December 2021 on 11 databases, supplemented with gray literature and references lists of secondary studies. The descriptor "judicialization of health" will be the basis for conducting the main research. Studies describing any strategy implemented by public institutions to approach the judicialization of health care will be included. Results related to the quality of services provided by the implemented strategy reported in the studies and those that report accessibility, usability, and potential adverse effects or harms caused by the implemented strategy will be investigated. In addition, it will be explored if there have been changes related to the value or characteristics of health litigation. Two reviewers will independently screen all citations, abstract data, and full-text papers. The risk of bias in each study will be appraised using a tool suggested by Cochrane Effective Practice and Care Organization Group (EPOC). Subsequently, the reviewers will also extract the data of interest and classify the findings of these studies according to their performance at the institutional level. The results obtained will be described as a narrative synthesis.

DISCUSSION

This review may provide evidence on the effects of the strategies implemented to approach the judicialization of health care. It will potentially benefit health care and legal professionals, decision-makers, and researchers by identifying the types and characteristics of strategies that have the potential to improve service delivery in the future.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42020160608.

摘要

背景

医疗保健的司法化可以被理解为社会对紧迫的医疗保健需求的回应,而当前的医疗保健系统可能无法充分满足这些需求。这种现象增加了服务资源的压力,无论是在卫生部门还是司法系统,都需要进行机构重组以管理司法行动。人们认为,每个机构都制定了应对问题的策略,但都是孤立地制定,且很少公开披露。本综述的目的将是确定实施的机构策略,并调查它们在处理医疗保健司法化方面的效果。

方法

将在 2021 年 12 月之前对 11 个数据库进行电子检索,补充使用灰色文献和二次研究的参考文献列表。将“医疗保健的司法化”这一描述符作为进行主要研究的基础。将纳入描述公共机构为处理医疗保健司法化而实施的任何策略的研究。将调查研究中报告的所实施策略提供的服务质量的结果,以及报告可及性、可用性以及所实施策略引起的潜在不利影响或危害的结果。此外,还将探讨是否与医疗诉讼的价值或特征有关的变化。两位评审员将独立筛选所有引文、摘要数据和全文论文。使用 Cochrane 有效实践和护理组织小组 (EPOC) 建议的工具评估每项研究的偏倚风险。随后,评审员还将提取感兴趣的数据,并根据机构层面的表现对这些研究的结果进行分类。将以叙述性综合的形式描述结果。

讨论

本综述可能为处理医疗保健司法化所实施的策略的效果提供证据。通过确定具有潜在改善未来服务提供的策略的类型和特征,它可能使医疗保健和法律专业人员、决策者和研究人员受益。

系统评价注册

PROSPERO CRD42020160608。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e28/9364593/77b78edc2263/13643_2022_2043_Fig1_HTML.jpg

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