Indlela aqala ngayo kunye nemibandela eyabumba
Iziko lonakekelo oluphuthumayo ezisetyenziselwa ukuba zihlala kwindawo efanayo njengedolophu yegqirha. Ukuba ubone isikhungo sokunakekelwa ngokukhawulezileyo (esibizwa ngokuqhelekileyo ngokuthi yikliniki yokunakekelwa ngokukhawulezileyo) kwiminyaka yee-1970, mhlawumbi kwakukho idilesi efanayo apho oogqirha kunye namazinyo akho. Yaye ininzi yabo yayisibhedlele.
Iziko lokunyamekela ngokukhawuleza ngaloo mihla linikezelwa ngononophelo olungengxamisekileyo ngenxa yobunzima beli gulane lonyango.
Banikela ngoncedo ngokukhawuleza (intsingiselo ngaphandle kokuqeshwa) ukuze kube lula ukuba isiguli.
Ezi klinikhi okanye amaziko okunyamekela ayengavamile. Ingcamango yonke yayisitsha. Kwaye kwada emva kokubuya kwe-millennium ukuba amaziko okunakekelwa ngokukhawuleza aqalisa ukwandisa iinkonzo zabo ukubandakanya ukukwazi ukunyanga iimeko ezithile zonyango.
Imihla Yadala
Ekuqaleni, le ngcamango yayikuthi izigulane aziyi kuyenza inqununu ukuze ubone i-doc. Baya kungena nje. Izigulane ngelo xesha zazinokukhetha ezimbini: yenza idibaniselwano kunye noogqirha wabo wangasese okanye uye kwi- ER . Iinkampani ze-inshurensi zazixhalabise kwizigulane kuba azizange ziqeshwe. Baya ku-ER kuphela. Okungenani oko abo batshorensi bacinga-kwaye bacinga ukuba.
Idatha yezihlandlo zesebe eziphuthumayo ngaphaya kwe-2000 zinzima kakhulu ukuzifumana. Enye into eqinisekisiweyo: abaqinisekisi bengazange bathande ukuhlawula iindleko zonyuka kwiindwendwe eziphuthumayo kwiminyaka yee-1970 kwaye abayithandi nto namhlanje.
Ukutyelela i-ER kungabiza iindleko ezilihlandlo ezili-10 kwintlawulo ye-bill yokutyelela kwiofisi yegqirha. Iziko lononophelo eziphuculweyo ziphakathi kwendawo.
Akukho Cwangciso Sokugula
Izigulane azizange zenze kakuhle ngokumisela. Ukulimala kunye nezigulo zinomkhuba wokuza ngokukhawuleza kwaye zidinga unyango olukhawuleza nangona kunjalo emva kwe-10 ngoMgqibelo ebusuku.
Amasebe angxamisekileyo awazange afune ukubona izigulane ngaphandle kokuba zivule umnyango wokufa kwaye iiofisi zonyango ziza kubuya ziphendule ifowuni ngoMsombuluko kusasa ukuba zilungiselele ukuqeshwa ngoLwesine ntambama.
Amaziko okunakekelwa ngokukhawuleza aqala ngokukhawuleza avela kwiindawo ezimbini: ukuba ngaba oogqirha babucala babezama ukuguquguquka kwizigulane zabo ngokunyusa iiyure ngokuhlwa nakwiempelaveki, okanye ii-ER zizama ukufumana iindlela zokunakekelwa kwezigulana ezingenakunzima. ukujika kwisebe elingxamisekileyo. Ezi ndawo zimbini zakha ezimbini iinkqubo ezahlukeneyo.
Inxaxheba Yomshuwalense
Njengabucala, ngokuqhelekileyo umqeshi-mali unikezela, u-ER uhambele phakathi kwabo bafumana ingxelo epheleleyo ngenxa yokuba indleko yokuya kugqirha (emva kokulinda i-aphoyintimenti) yayifana nokuhamba kwi-ER kwaye ibonwa ngokukhawuleza . Izigulane ezingaqinisekanga zisiya kwisebe eliphuthumayo ngaphandle kokufuneka. I-ER yayikuphela kwendawo apho isigulane sinokubonwa ngenxa yokusongela ubomi bakhe (okanye ukubonakala esongela ubomi) ngokungxamisekileyo ngaphandle kokukwazi ukuhlawula. Izibhedlele zafuneka ukuba zihlolwe izigulane kwaye zinike uncedo lokongxamisekileyo xa kunesidingo.
Oku kwakuqala kokungalingani kwisebe lokuhlawula.
Abo babenomshuwalense babehlala bekhwehlela i-bill yonke ngenxa yokuba i-inshurensi, kunokuba isigulane, yayicima ityhubhu. Izigulane ezingaqinisekanga, ngakolunye uhlangothi, ngokuqhelekileyo azikwazi ukuhlawula. I-ER yayisayi kubaphatha, kodwa bazinyamekela ngokukhululekileyo kwiminyango ye-inshurensi yezoshishino.
Iindleko zonyango zaqala ukunyuka ngokukhawuleza. Izibhedlele kwakufuneka zihlawule ukugcina oogqirha kunye nabongikazi esibhedlele ngehora, njengokuba inxalenye yesigulane sabantu ikhululekile okanye ifuna ukunyamekela. Ngaphambi koku, indleko yononophelo lwezokwelapha yayinjalo kubo bonke abantu, kodwa ngoku abo bangakhokhela babanika inkxaso abo bangenako.
Abatshutshisi baziva bexakeka. Bakhuthaza izibonelelo zemali ukuqhubela izigulane ngaphandle kwesebe elingxamisekileyo ngaphandle kokuba befuna uncedo lwengxamiseko.
I-Carrot, i-Stick, ne-Crystal Ball
Izigulane eziqinisekisiwe azizange zithande ukulinda kwaye azizange zisoloko zinako ukuqeshwa. Ukunyanzelisa izigulane ukuba zicwangcise bhetele, i-insurers ifake imali yokubuyisela i-sliding scale. Izigulane zihlawulwe ixabiso elincinci xa kuhanjelwa i-ER kubangelwe ukungena esibhedlele. Kwakucatshulwa ukuba ukutyelelwa kufuneka kulungele ukuba ugqirha wagcina isigulane ubusuku bonke.
Noko ke, izigulane zanyanzeliswa ukuba zikwazi ukuxilongwa kwazo ngaphambi kokuba ziye kwiSebe elixakekileyo. Ukuba babengenayo ingxamisekileyo, babeza kuhlawula ngaphezulu kwepokothini. Kwakukho isizathu sokuya kwiofisi yegqirha endaweni yesibhedlele ngaphandle kokuba isiguli sasinesiqiniseko sokuthi uza kufa.
Kodwa izigulane azizange zicwangcise kakuhle. Bafuna ukulungele ukuhamba-enkonzweni. Oogqirha beeMfihlo baphendule kwii-ofisi zedini nakwiMigqibelo. Baye baphuma kwiiofisi zeevenkile zonyango nakwiivenkile. Kungekudala, abazali bangathatha iJunior ukuba bambone uSanta baze baqhube umlomo wakhe uhambo olufanayo. Ezi zonyango zeenkonzo zonyango zineenkcukacha zonke, kodwa "ukunakekelwa ngokukhawuleza" kubambelele. Kwakunomngcipheko kuwo izigulane ezizithandayo.
Yonke Inkathalo ayidalwe ngokulinganayo
Ulwahluko phakathi kwamasebe angxamisekileyo kunye namaziko okunakekelwa ngokukhawuleza asemabini nakwiinkonzo ezibonelelwe. Amaziko okunyamekela ngokukhawuleza ayengenanto yokunikela ngaphandle kweofisi yegqirha. Amasebe angxamisekileyo, ngakwelinye icala, yayisisango lokunakekelwa kwezempilo ngoncedo. I-ER inokusingatha nayiphi na into.
Ngoku ukuba izigulane ezikhuselekile ziya kumaziko okunakekelwa ngokukhawuleza kumanani amakhulu, ipesenteji enkulu yezigulane ezingaqinisekanga zishiywe ukuba ziphathwe kwisebe elingxamisekileyo. Iindleko zonyango ziqhubekile ukunyuka njengoko izibhedlele zazama ukuhambelana nesiseko sesigulane esingagqithwanga. Abatshutshisi balked kwaye wonke umntu ugweba izigulane ezingagqithwanga. Bebejoliswe lula, ngokuphindaphindiweyo babuya kwi-ER ezininzi ngezihlandlo zokunyamekela okufanayo. Ukwenza izinto zibe zibi nakakhulu, izigulane ezingaqinisekanga zihlala zineengxaki zonyango ezingenakwamkeleka kuluntu, njengengxaki yempilo yengqondo okanye umlutha.
Ingakumbi Ininshurensi-Iya Kusebenza?
Inkomfa yokufumana abantu abaninzi besikhorensi yabonwa njengentambo. Ukuba ezi zigulane ezingagqithwanga zingaba nokufikelela okungcono kunonophelo lwempilo-okanye ke ingcamango yahamba-bafuna ukunyamekela ngugqirha wabucala endaweni yokutyelela i-ER.
Hayi, bekungekho. Isibonakaliso sokuqala sifike eOregon. Ukwandiswa kweMalicaid ngo-2008 kwanika ithuba eligqibeleleyo lokubona ukuba i-inshurensi eyongezelelweyo iya kubakho kwiigulane eza kugqirha kunokuba i-ER. Kunoko, izigulane zaya kwisebe lexakeka ngakumbi. Emva kokuba uMthetho woNonophelo ongenakunqwenela wangena kwi-swing epheleleyo, into efanayo eyenzeka kwezinye iindawo.
Ngakumbi
Amaziko okunakekelwa ngokukhawuleza anyuliweyo kunye ne-inshurensi yonyango, kodwa kunjalo namaziko okunakekelwa ngxamisekileyo. Amagumbi okuphuthuma ngokukhululekayo ngoku ayatholakala kwiindawo ezingama-35. Le mnqamlezo phakathi kweziko lokukhathalela ngokukhawuleza kunye ne-ER. Bafumana iinkonzo zesebe eliphuthumayo, kodwa, njengendawo yokunakekelwa ngokukhawuleza, abahlala beqhotyoshelweyo okanye banxulumene nesibhedlele kwaye kufuneka basebenzise i- ambulensi ukufumana izigulane ukunyamekela.
Inguqu ebhetele yesikhungo sokunakekelwa ngokukhawulezileyo (kwimbono yam) ivela ngaphakathi kwisebe elingxamisekileyo. Isigulane sihamba emnyango kwaye sibona umongikazi, ovavanya isikhalazo aze anike isigulane kwenye yeendlela ezimbini: i-ER okanye iklinikhi.
Amaziko okuphucula amaziko angxamisekileyo kunye namaziko okunakekelwa okukhawulezileyo apha aya kuhlala apha. Ngaphandle kokuba umgaqo-nkqubo wokunakekelwa kwempilo usixhomekeke kwisikhokelo esahlukileyo, ukunqongophala kwamagqirha aqhelekileyo kunye neengxelo zezemali zonyango zimela umzekelo ngaphandle kweSebe lezengxamisekileyo okanye kwi-ofisi yegqirha. Ukunyanga kwezempilo kuya kutshintsha ngokukhawuleza. Kunzima ukuqagela apho sihamba khona, ngaphandle kokunyuka, kungekhona kwi-ER.
> Imithombo:
> (2017). Cdc.gov . https://www.cdc.gov/nchs/data/ahcd/NHAMCS_2011_ed_factsheet.pdf
> O'Malley JP, O'Keeffe-Rosetti M, uLowe RA, Angier H, iGolide R, iMarino M, iHatch B, iHoopes M, i-Bailey SR, i-Heintzman J, i-Gallia C, i-DeVoe IYI. IiRhafu zokuSebenza kwezeMpilo emva kwe-Oregon ka-2008 Ukwandiswa kweMilesiyali: I-Group-ngaphakathi kunye noPhakathi-Ukwahlukana kweqela phakathi kwexesha phakathi kweNtsha, ukuPhindwa, kunye nokuBhaliswa kweeNkxaso. Ukunyamekela . 2016 Nov; 54 (11): 984-991.
> Wacinga ukuba yindawo yokukhathalela ngokukhawulezileyo, de ube ufumana ibhilikhi. (2017). NBC News . https://www.nbcnews.com/health/health-care/you-thought-it-urgent-care-care-center-un-got-n750906