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    Imaging, QoL and Patient-Reported Outcome and Supportive Care

    'Perceptions of Brazilian Hematologists in the Care of Patients with Multiple Myeloma in the Unified Health System: Brazil of Contrasts

    P-139: 'Perceptions of Brazilian Hematologists in the Care of Patients with Multiple Myeloma in the Unified Health System: Brazil of Contrasts

    Wednesday, September 25, 2024
    Introduction: Studies point to blood cancer, multiple myeloma (MM), as an emblematic example of discrepancies in access to pharmacological treatment, when we consider the realities of the public and private health sectors in Brazil. These contrasts impact the quality of life and survival of these patients. Until now, no national studies have highlighted these discrepancies from the point of view of Brazilian hematologists. This work is a segment of a larger project.

    Methods: Exploratory study based on narratives of a qualitative nature using thematic-categorical content analysis. Data was collected between November 2018 and May 2019 pre coronavirus 19 pandemic. The target population consists of Brazilian hematologist doctors who worked in the public health sector caring for patients with MM. The number of participants was determined a posteriori from the saturation of the answers, and the recruitment of experts was performed by the non-probabilistic technique Snowball. The data collection instrument was a semi-structured interview, the content analysis was based on the reading and rereading of the transcribed interviews, performed by the researchers.

    Results: A total of 15 interviewees, mean age of 46.8 years, 8 women, with representativeness in all Brazilian geographic regions, work relationship as a doctor or teacher, and the majority in federal public hospitals. As premises, exploring the perceptions of hematologists about the Unified Health System (UHS) was not possible without comparing it to the private sector, and the scope of UHS is restricted to the realm of tertiary care (hospital care). One of the categories identified is "Care for patients with MM: Brazil of contrasts". Topics: 1. Public sector, negative aspects, scarcity of resources limited access to new drugs, beds, and professionals leading to lower patient survival; positive aspects, rich field of professional experience and associated academic activity 2. Private sector, negative aspects, are isolated clinical practice and loss of autonomy; positive aspects, are greater access to treatment and resoluteness 3. Quality of patient care varies and depends on local factors such as the Federative State, discrepancies in UHS management, disease staging, and hospital resources 4. Cultural divergence of patients ranging from extreme resignation to great demands 5. Judicialization of health with divergent interpretations of the law.

    Conclusions: Overall, the interviewees are significantly impacted by the scarcity scenario and state that the theoretical NHS differs from the real NHS, but they acknowledge the positive aspects of this clinical practice. The private sector has negative and positive characteristics that are opposite and complementary to the public sector and vice versa. The quality of care for patients with MM in the UHS is directly related to state/regional realities, hospital care structures, and the profile of patients, which impacts the judicialization of health.