Resumo

CUESTA-NOVA, Antonio José; VALLEJO, Sergio Andrés; BAUTISTA, Jaime Eduardo  e  MOCKUS, Ismena. Access to bariatric surgery in Colombia: legal actions as protection mechanism for obese patient. rev.fac.med. [online]. 2015, vol.63, n.1, pp.81-86. ISSN 0120-0011.  https://doi.org/10.15446/revfacmed.v63n1.47451.

Background. Bariatric surgery is an effective treatment for obesity. In Colombia, this surgery is denied to many patients by insurance companies, prompting them to seek legal action (for example, through tutela) in order to protect their health rights and gain access to a treatment for this disease. Objective. Evaluate the effectiveness of legal action (tutela) in gaining access to bariatric surgery. Determine the characteristics of those who appeal for legal action, and the factors and considerations related to the subsequent approval or disapproval of the procedure. Materials and Methods. Analysis and evaluation of legal action (tutela) in bariatric surgery cases by generation of a database through systematic search with the verdict search tool of the Constitutional Court of Colombia. Results. 42 verdicts were analyzed. There was an overall approval of 72 % of legal actions. The prevalence of stage III obesity with associated comorbidities was 69 %. Infringement of the right to access to health care and that bariatric surgery is not covered by the mandatory health plan, were the most frequent arguments used by the plaintiffs and health promoting entities, respectively. Conclusions. The legal action known as "tutela" is an effective method for the obese patient to access bariatric surgery in Colombia.

Palavras-chave : Obesity; Bariatric Surgery/legislation and jurisprudence; Insurance; Health.

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