In Brazil in 2016 there were over 1,300,000 health-related lawsuits, which represents an increase of 47% in a one-year period.
To describe an initiative of the National Justice Council and the Ministry of Health of Brazil, supported by Cochrane Brazil and other HTA (Health Technology Assessment) centres, to facilitate evidence-based decision-making for health-related lawsuits across the nation.
Efforts to facilitate health-related decision-making using the principles of evidence-based health care have been strengthened by the creation of other HTA centres. Some of these are now partners with Cochrane Brazil in this endeavor. Recently, the National Justice Council and the Ministry of Health of Brazil have agreed to maximize efforts. Firstly, the Núcleo de Avaliação de Tecnologias de Saúde (NATS) will closely collaborate with healthcare professionals working at the level of judicial jurisdiction, who are in charge of providing technical elements for decision-making. This will provide high-quality and continuous training for these professionals. Secondly, e-NatJus has been created: a centralized database of technical reports on technologies that repeatedly lead to health-related judicialisation. The aim of e-NatJus is to reduce duplication of effort in analyzing subjects that have previously been the focus of investigation, and also to speed up the process of responding to judicial demands. E-NatJus will be available for consultation by judges and professionals involved in decision-making.
Technical reports are included in e-NatJus. Over 50 technical reports were prepared by the HTA centres. These technical reports were developed to conform with best practice for conducting systematic reviews. Methods for promoting the collaboration of HTA centres with healthcare professionals working at the level of judicial jurisdictions are being refined and will be implemented in the near future.
These strategies aim to increase the effectiveness of decision-making in the context of health-related judicialisation.
Patient or healthcare consumer involvement:
From the individual perspective, decision-making based on the best available evidence reduces the risk that ineffective or potentially harmful interventions are used. From the societal perspective, it brings better utilization of resources and better value for money.