Enforcing the right to health in private health systems through Judicialization what can we learn from the scoping review of the cross-national perspective?

BACKGROUND: Private sector acting in healthcare does not remove the public nature of a health system, nor mitigate the right to health as a human right. METHODS: This scoping review aims to answer the question: what factors influence the pattern of lawsuits seeking to enforce the right to health in private healthcare systems? The search was carried out in Pubmed, SciELO, DOAJ and Scopus. RESULTS: Out of 464 articles found, after inclusion and exclusion criteria, 30 articles were included. The survey covered 36 different countries and four main factors were identified. The socioeconomic context, the health system model, the incorporation of the right to health in legislation, and the model of regulation of private health. CONCLUSIONS: Understanding these patterns help understanding the difficulties of implementing and guaranteeing universal health. Health systems must be based on responsibility, solidarity, equity, and distributive justice, since the sum of these values generates mutualism. Judicial decision-making regarding to health access must be reasoned on equity and distributive justice, scientific evidence and ethical factors. Even private health systems must be funded in a well-defined ethical platform and social moral valuation.

Padrão epidemiológico da pancreatite aguda no hospital de referência da região dos Campos Gerais / Epidemiological pattern of acute pancreatitis in the referral hospital of the region of Campos Gerais

Objetivo: Descrever o perfil clínico e epidemiológico da pancreatite aguda em pacientes internados em hospital de referência regional para doenças biliopancreáticas no estado do Paraná. Métodos: Foram categorizados todos os pacientes internados por pancreatite aguda no ano de 2017. As variáveis analisadas foram sexo, idade, etiologia, necessidade de tratamento cirúrgico, tempo de internamento, tempo de jejum e severidade. Resultados: Não houve diferença entre sexos. A incidência foi maior entre 51 e 70 anos, divergindo do padrão epidemiológico da doença. Nos casos de etiologia biliar (59,7%), o tratamento cirúrgico no internamento foi realizado em 70,27% dos casos. Os demais foram submetidos à CPRE ou tiveram a cirurgia contraindicada. A maioria apresentou gravidade leve (41%). O tempo de jejum foi de 2 dias, sem intercorrências após o retorno alimentar. Conclusão: O início cada vez mais precoce da dieta e intervenção cirúrgica em tempo ótimo, quando indicada, geram baixo tempo de internamento e impactam positivamente.

Objective: Stablish and describe the clinical and epidemiological profile of patients with acute pancreatitis attended in a regional referral hospital for pancreato-biliary diseases in Paraná. Methods: All patients admitted with acute pancreatitis in 2017 were categorized. The data studied are sex, age, etiology, need for surgical treatment, length of stay, fasting time during hospitalization and severity classification Results: No difference between genders. The incidence by age was higher in the group of 51-70 years old. Considering the biliary etiology (59,7%), surgical treatment during hospitalization was performed in 70,27% of cases. The other patients underwent ERCP or presented conditions that contraindicated surgery procedures. Mold patients presented themselves with mild severity of acute pancreatitis. Fasting time was of 2 days. Conclusions: The increasingly early star of feeding and surgery in optimal time generate a shorter hospital stay and are measures of positive impact for patients with acute pancreatitis.