I-340% yokurhweba ngamagqirha e-ER ngokumalunga no-110% umrhumo wabangaphandle be-ER
Isifundo seMeyi ka-2017 esapapashwa kwi- JAMA Internal Medicine sibonisa ukuba amanani aphakamileyo aqhelekileyo kwiSebe lase-Amerika eliphuthumayo-kakhulu inokuchaphazela kakubi izigulane ezihluphekileyo, ezincinci.
Ngokubanzi, iinkonzo ezinikezwa ngamagqirha eyeza ngokukhawuleza zaphawulwa ngamaphesenti angama-340 xa kuthelekiswa nokulungiswa kweepesenti ezingama-110 kwiinkonzo ezinikezelwa ngabafundi ngaphandle kwegumbi loxakeka.
Sibanzi
Ixabiso elihlawulwe kwiinkonzo ezifanayo lihluka ngokubanzi kwiSebe elixakekayo kwisebe elingxamisekileyo. Ukongezelela, kuhlala kubiza kakhulu ukufumana unyango kwimeko yesebe elingxamisekileyo kunokufumana unyango kwiofisi yonyango okanye kwiziko lokunyamekela ngokukhawuleza.
Abantu abaninzi abafumana iindleko eziphezulu kakhulu kwizibhedlele ngabo bangenako ukubanceda: abayingcinci abangenayo i-inshurensi. Iindleko zezonyango eziphezulu zingakhokelela ekuhlaleni kwaye ziyizona zizathu ezibangela ukuba abantu bathenge i-bankruptcy.
Uloyiko malunga nokuba izibhedlele zihlawulisa njani zidibanisa abantu ukuba bafune ukunakekelwa okuyimfuneko. Aba bantu baphela ekugqibeleni bavelise kwiSebe eliphuthumayo ngeemeko zengxubevange ezingathathi nje kuphela umlinganiselo omkhulu kumgangatho wobomi kodwa zigqitywe ngeendleko ezingaphezulu.
Ixabiso leMisebenzi
Izibhedlele zisebenzisa izixhobo zokuhlawula, eziluhlu lweenkonzo kunye neendleko zabo, ukuqokelela ibhilikhwe yesigulane. Nangona kunjalo, intlawulo yexabiso lenkonzo ihluka ngoxhomekeke kuhlobo lwe-inshorensi yesigulane kunye nesimo senethiwekhi.
Izigulane ezise-network kunye ne-inshurensi yazo zihlawula ngaphantsi; nangona, izigulane ezingaphandle kwe-network kwaye zingenayo i-inshorensi zihlawula iindleko ezipheleleyo zesibhedlele, ezinokuthi ziphindwe kabini kwiiMedare. Ezi zibhedlele ezibiza kakhulu zinokuhlawulisa ngaphezu kweepesenti ezingama-900 ngaphezu kweyonyango.
Ukuphanda i-ER Intengo
Kulo cwaningo lohlalutyo lwamanani, abaphandi bahlalutya iirekhodi zokuhlawula ezivela kumayeza angama-12,337 ogqirha ogqirha asebenza kwizibhedlele ezingama-2,707 kulo lonke elaseUnited States. Ngokufanayo, bahlolisisa iirekhodi ezingama-57,607 oogqirha bamayeza angaphakathi abahlala kwizibhedlele ezingama-3,669.
Ukusebenzisa ezi ngxelo, abaphandi babala "inqanaba leetyala ezingaphezu kweemali ezisebenzisa ukulingana kwemali, okuyiyo imilinganiselo yeerhafu ezihlawulweyo kwi-Medicare yemali evumelekileyo." Nge-Medicare yemali evumelekileyo "isixa semali ehlawulwayo, inkokhelo kunye neengqinisiso isixa esixhamliweyo sinomthwalo wokuhlawula, kwaye nayiphi na imali enomntu wesithathu onoxanduva lokuhlawula. "
Ukongezelela, abaphandi bazimisela iimpawu ezilandelayo kwisebe ngalinye lexakeka :
- Size
- Indawo
- Inzuzo yenzalo
- Isimo sokufundisa
- Idolophu okanye indawo yasemaphandleni
- Isibhedlele-sikhundla esibhedlele
Ngokusekelwe kwimiba enikezelwa ngabalo-mabango baseMerika, abaphandi baqikelela oku kulandelayo:
- Ubuthathaka
- Isiqinisekiso esingenakuqinisekiswa
- Abancinci abantu
Ukufumanisa ukungafani kwexabiso
Xa iinkonzo ezifanayo zenziwa ngunyango ogqityiweyo okanye ugqirha we-internist, umrhumo wawusenyuka kakhulu kwiinkonzo ezinikezelwa ngugqirha weyeza lonyango.
Ngokomzekelo, ukuhlawulwa komda we- electrocardiogram kwakuyi- $ 95 xa kuchazwa ngugqirha wegumbi loxakeka; nangona, ukufundwa ngumfundi we-internist kubiza i-$ 62.
Ngokutsho kwabaphandi:
Ekuqwalaseleni zonke iinkonzo ze-ED, zonke iirhafu ezingama-100 kwi-Medicare zivumelekile, izibhedlele ezahlukeneyo zizalise izigulane phakathi kwama-$ 100 (u-markup ratio, 1.0) kunye ne-$ 12,600 (umlinganiselo wemali, i-12.6), ene-median ye-$ 420 (uhlawulelo lwemali, 4.2); Ngokwahlukileyo, inkokhelo yonyango yangaphakathi yesibhedlele yayiza kuba yi-200 zama-200 (umlinganiselo werhafu, 2.0).
Nazi ezinye iziphumo ezifunyenweyo ezivela kwisifundo:
- Amagqirha angxamisekileyo agqiba ukuhlawula i-$ 4 yezigidigidi, phantse i-$ 3.1 yezigidigidi ngaphezu kweeMarike ezivumelekileyo.
- Ukumaketha kwakunobuninzi bokuxubuliswa kweentambo (oko kukuthi, ukuvalwa kwesilonda).
- Iingcingo ze-CT zentloko zazinokuhlukana kakhulu kwixabiso kwizibhedlele ezihlolwe. Ngamanye amazwi, ukuhlolwa kwe-CT kwintloko kwakuninzi kwixabiso.
- Amasebe angxamisekileyo athe ahlawulisa kakhulu ayingxenye yezibhedlele zenzululwazi kwaye zifumaneka eMidwest nakumazantsi-mpuma eMerika. Amasebe angxamisekileyo akhonza amaninzi amakhulu aseSpain kunye nabantu base-Afrika baseMerika.
ILizwi
Xa umntu ephathwa ngesebe eliphuthumayo, ngokuqhelekileyo enokuzikhethela, baxhomekeke kwii-vagaries zamanani. Ngokutsho kwabalobi, "Ngoku, kuninzi kunini ngaphambili, ukukhusela izigulane ezingaxhaswanga nakwii-network ezivela kwizibhedlele eziphambene nezibhedlele kufuneka zibe yimpumelelo ephambili."
Iziphumo zolu pho nonongo lubonisa ukuba kufuneka kuveze ngakumbi kwiibhidi zesikhalazo. Baxhasa nenkxaso yemithetho yelizwe kunye neyomthetho ukukhusela izigulane ezichasene namaxabiso aphakanyisiweyo.
> Imithombo:
> I-Medline. Electrocardiogram.
> I-Medline. Xa ufuna ukusebenzisa igumbi lexakeka.
> Xu, T, et al. Utshintsho kwiCandelo eliPhezulu eliPhathelene neNkcitho yeNgaphakathi kwiMicrosoft Medicine Excesses ku-United States. JAMA lwangaphakathi lweMithi. 2017.