INTRODUCTION:
The judicialization of public health in Brazil is a multifactorial phenomenon in which users of the Unified Health System (SUS - Brazil’s public healthcare system) resort to the judiciary to secure their constitutional rights. In Espírito Santo, this phenomenon is particularly evident in Specialized Outpatient Care (SOC), represented by demands for consultations and exams. The study analyzes how judicial provisions reflect bottlenecks in health management, revealing management priorities and impacting resource allocation and planning.

METHODS:
Descriptive, analytical, and longitudinal study with a mixed approach. Data were sourced from the Capixaba Observatory of the Right to Health¹ and the Strategic Intelligence Center for State Management of the SUS², covering the three-year period from 2022 to 2024. Next, waiting times, access indicators, and costs of legal proceedings were compared with those of standard administrative flows.

RESULTS:
The SOC accounts for the largest volume of litigation - 11846 cases in the three-year period (29.58% of the total), most of which (72.43%) focus on consultations - but its numerical relevance is low compared to the scale of the network: the litigated volume corresponds to less than 0.1% of total administrative production. The cost of judicial compliance exceeds the administrative cost by more than 340 times, revealing a cost discrepancy of 34.053% over the standard cost base. Serious difficulties were identified in accessing consultations with neuropediatricians and colonoscopy exams, procedures that have an average waiting time of 832 days.

CONCLUSIONS:
Litigation in Espírito Santo embodies a a paradox of “microjustice,” where individual guarantees can compromise “macrojustice” and collective planning. However, judicial demands serve as vital indicators for identifying structural bottlenecks in the network. Strengthening secondary care and implementing innovative mediation tools, such as the Center for Preventive Health Negotiation, are essential to promoting equity and reducing litigation.