Navegando por Palavras-chave "julgamento de valor em saúde"

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    Julgamentos de valor no processo de incorporação de tecnologias de saúde no Brasil
    (Universidade Federal de São Paulo (UNIFESP), 2014-11-26) Santoro Neto, Luiz [UNIFESP]; Ferraz, Marcos Bosi Ferraz [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Introduction: Treating the shortage of health resources ethically and rationally seems to be the best way to face the dilemmas related to health technology assessment. Many aspects influence this process, including ethical, economic and social issues, which should serve as a basis for setting priorities in health and for the development of decision analysis. Objectives: To evaluate the value judgment on critical decisions involving the allocation of resources and the use of technologies in the Brazilian Health System, through the vision of health professionals and managers, and, by this appraisal, estimating implications that have potential influence on the health policies in the country. Methods: Cross-sectional exploratory study applied online, through a decision-making questionnaire for incorporation of health technologies, endowed with four scenarios that simulate real situations of resource allocation in an environment of severe budget constraints, which was completely answered by 193 managers and professionals from various health sectors. The scenarios presented trade-offs such as patient age, disease prevalence, reduction/extinction of current health programs, creation of taxes, and choices between prevention and treatment. The variations found in the responses were measured by Chi-square test. Results: The survey had a response rate of 27.3%. Of these, almost half were medical doctors, 90% had at least one post-graduation, and there was an equal distribution between men and women, as well as among those working in the public and private system. There was a diverse sample of respondents with participation of all proposed segments. Of the four presented scenarios, Scenarios 1, 2 and 3 involved some form of incorporation. In Scenario 1, 78% of respondents opted for decisions that nothing, or very little, affected the budget. In Scenario 2, 68% of respondents also opted for decisions that nothing, or very little, affected the budget. In Scenario 3, we find the highest trend for the incorporation among the studied scenarios, with 58% of respondents choosing XI for one of the options that involved incorporation. In Scenario 4, when comparing the results between treatment and prevention programs, the latter was prioritized for resource allocation, with 65% of responses. Conclusion: This study suggests that Brazilian health professionals and managers are significantly influenced by economic and budgetary issues when deciding about the allocation of resources for health technologies assessment in the country. In search of a paradigm for decision-making, most professionals and managers generally prioritized to save resources, instead of incorporating the technologies. Among the segments, the pharmaceutical industry showed the greater tendency for technological incorporation. We hope that this and other studies are able to collaborate in the establishment and strengthening of health policies that ensure economic feasibility for an effective incorporation of progressive technologies, avoiding an undesirable technological gap, because of the severe budget constraint of Brazilian health.