Effectiveness of the law on priority for the elderly in health claims in Rio de Janeiro

Azevedo, Aldilene Abreu de; Girianelli, Vania Reis; Bonfatti, Renato José

doi:10.1590/0103-11042022E610I

Acessibilidade / Reportar erro

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

ORIGINAL ARTICLE • Saúde debate 46 (spe6) • Dec 2022 • https://doi.org/10.1590/0103-11042022E610I copy

Effectiveness of the law on priority for the elderly in health claims in Rio de Janeiro

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

The growth of older adults is a global event. The study aimed to evaluate the effectiveness of the law on priority for the elderly in relation to the procedural processing of health claims made in the Lower Courts of Justice of the judicial district of the Capital of Rio de Janeiro State. A descriptive cross-sectional study of the proceedings assigned in the period from 2018 to 2019 was conducted. The total sample included 1,040 identified cases, but only 240 were eligible (23%). Most claims were related to home care services (26.3%), particularly for adults aged 80 years and over (54.7%). The legal effectiveness of the law for the 60- to 79-year-old age group was 86% and 97.3% for other elderly people. The processing time of the lawsuits, however, was shorter for mature adults than for older people (p=0,020) and similar between older adults aged 80 years or above and other elderly adults (p=0,400). Monitoring the impact of this law on society is essential, older people are at a stage of life in which the issue of time is essential, particularly when the claim is related to health.

KEYWORDS
Aged rights; Aged; 80 and over; Legislation; Human rights; Health judicialization.

Characteristics	Total		40 to 59 y.o		60 and over		p value	60 to 79 y.o		80 and over		p value
Characteristics	N	%	N	%	N	%	p value	N	%	N	%	p value
Gender
Male	107	44.6	16	36.4	91	46.4	0.296	62	51.2	29	38.7	0.116
Female	133	55.4	28	63.6	105	53.6		59	48.8	46	61.3
Municipality of residence
Capital:	218	90.8	36	81.8	182	92.9	0.045	111	91.7	71	94.7	0.624
Others	22	9.2	8	18.2	14	7.1		10	8.3	4	5.3
Marital Status
Single	41	17.1	15	34.1	26	13.3	0.005	17	14.0	9	12.0	<0.001
Married or consensual union	101	42.0	17	38.6	84	42.9		61	50.4	23	30.7
Divorced	31	12.9	6	13.6	25	12.8		19	15.7	6	8.0
Widower	51	21.3	3	6.8	48	24.5		19	15.7	29	38.7
Ignored	5	2.1	3	6.8	13	6.6		5	4.1	8	10.7
Retired
Yes	187	77.9	16	36.4	171	87.2	<0.001	99	81.8	72	96.0	0.008
No	53	22.1	28	63.6	25	12.8		22	18.2	3	8.3
Nationality
Brazilian	225	93.8	43	97.7	182	92.9	0.389	116	95.9	66	88.0	0.073
Foreigner	15	6.3	1	2.3	14	7.1		5	4.1	9	12.0

Characteristics	Total		40 to 59 y.o		60 and over		p valor	60 to 79 y.o		80 and over		p valor
Characteristics	N	%	N	%	N	%	p valor	N	%	N	%	p valor
Defendant (Private Health Plan)
Amil	140	58.3	31	70.5	109	55.6	0.049	72	59.5	37	49.3	0.213
Unimed Rio	100	41.7	13	29.5	87	44.4		49	40.5	38	50.7
Representative
Attorney	198	82.5	37	84.1	161	82.1	0.93	99	81.8	62	82.7	1.00
Public Defender’s Office	42	17.5	7	15.9	35	17.9		22	18.2	13	17.3
Duty Court
Yes	86	35.8	17	38.6	69	35.2	0.799	44	36.4	25	33.3	0.781
No	154	64.2	27	61.4	127	64.8		77	63.6	50	66.7
Type of Action
Complaint	232	96.7	42	95.5	190	96.9	0.975	117	96.7	73	97.3	1.00
Interlocutory relief^* * Urgent request before the action is brought. If granted, the plaintiff must amend such petition within 15 days or longer period as determined by the judge. If not performed within such deadline, the case is dismissed.	8	3.3	2	4.5	6	3.1		4	3.3	2	2.7
Outcome of the case
Granted	109	45.4	20	45.5	89	45.4	0.118	59	48.8	30	40.0	0.134
Rejected	9	3.8	2	4.5	7	3.6		3	2.5	4	5.3
Merit not judged due to settlement or resolved administratively	21	8.8	8	18.2	13	6.6		11	9.1	2	2.7
Merit not judged due to withdrawal or abandonment	16	6.7	4	9.1	12	6.1		7	5.8	5	6.7
Merit not judged due to death.	27	11.3	2	4.5	25	12.8		10	8.3	15	20.0
Merit not judged due to procedural error.	7	2.9	2	4.5	5	2.6		3	2.5	2	2.7
Not judged	51	21.3	6	13.6	45	23.0		28	23.1	17	22.7

Claim	Total		40 to 59 y.o		60 to 79 y.o		80 and over
Claim	N	%	N	%	N	%	N	%
Hospitalisation	22	9.2	5	11.4	11	9.1	6	8.0
Medication	42	17.5	11	25.0	28	23.1	3	4.0
Surgery	46	19.2	7	15.9	26	21.5	13	17.3
Transplant	9	3.8	2	4.5	6	5.0	1	1.3
Performance of examinations	12	5.0	5	11.4	6	5.0	1	1.3
Hospital Transfer	4	1.7	2	4.5	1	0.8	1	1.3
Hospital at home or home care	63	26.3	4	9.1	18	14.9	41	54.7
Supply of inputs	6	2.5	1	2.3	3	2.5	2	2.7
Chemotherapy, radiotherapy or haemodialysis	7	2.9	0	0.0	5	4.1	2	2.7
Services	7	2.9	1	2.3	4	3.3	2	2.7
Medical treatment	22	9.2	6	13.6	13	10.7	3	4.0
Total	240	100.0	44	100.0	121	100.0	75	100.0

Centro Brasileiro de Estudos de Saúde Av. Brasil, 4036, sala 802, 21040-361 Rio de Janeiro - RJ Brasil, Tel. 55 21-3882-9140, Fax.55 21-2260-3782 - Rio de Janeiro - RJ - Brazil
E-mail: revista@saudeemdebate.org.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Conflict of interests: non-existent