प्राथमिक देखभाल में गुणवत्ता खुला एक्सेस


Right to health care and materials required for intermittent catheterization: a comparison between Germany and Brazil

Faleiros F, Toledo C, Gomide M.F.S, Faleiros RG, K?ppler C

Purpose: This study aimed to conduct a comparative analysis of the effectiveness of the fundamental social right to health in regard to the acquisition of materials for intermittent catheterization (IC) in subjects with spina bifida (SB) in Brazil and Germany.

Design/Methods: This quantitative, descriptive, correlational, multicenter, interdisciplinary study comprised two stages: the first in Brazil (2008/2009) and the second in Germany (2010–2012). The sample comprised 200 individuals (100 in each country) with SB and an experience in performing IC.

Findings: In Germany, the most common type of catheter used contains hydrophilic coating, and all participants reported acquiring IC materials via health insurance and using a new catheter at every procedure. In Brazil, the most common type of catheter used is made of uncoated plastic, with 31% of participants reporting having acquired IC materials from the health system and 27% reporting financial difficulty in acquiring these.

Conclusions: The treatment of SB related neurogenic bladder should come under the umbrella of the “existential minimum” a concrete means of ensuring human dignity. Thus, the materials necessary to complete IC should be provided by the state, even if necessary under a court order. Clinical Relevance: In Germany, all individuals can easily access their required IC materials, however, in Brazil, many patients have difficulty in acquiring materials, being forced to either reuse catheters or suspend the procedure, which can lead to health complications and reduced social participation.

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