Unyaka ngamnye, ii- Centers for Disease Control and Prevention (CDC) zikhupha iinkcukacha kwizinto ezibangela ukufa e-United States , zombini ngenxa yesifo kunye nezinye izenzo ezingenasenzo. Ngokona nxalenye, izizathu ziye zahluka ngaphantsi kwexesha leminyaka edlulileyo, idatha ehlanganiswe kuphela kwiziqinisekiso zokufa ezikhutshwe ngabagqirha, abaxhasi, abaqondisi bemngcwabo kunye nabahloli bezonyango.
Nangona kunjalo, isifundo se-2016 esivela kwiYunivesithi yaseJohn Hopkins sishiye iparadigm kwindlebe yaso ngokubonisa ukuba imodeli ye-CDC ayinayo kuphela imingcele kodwa iphosakeleyo ngokwazi ukuvavanya okanye ukuchonga inxaxheba yempembelelo yezokwelapha ekubangela ukufa.
Ngokuthelekisa izibalo zokufa kwelizwe, ngezigulane ngezinga lokungeniswa kwezibhedlele, abaphandi bakwazi ukugqiba ukuba malunga nama-10 ekhulwini kubo bonke abafayo e-US babekho ngenxa yokunyamekela unyango.
Ukuba ichanekileyo, leyo iya kufaka impazamo yezobugqirha njengesona sesithathu esibangela ukufa e-US, ngokukhawuleza ukuxhaphaza, izingozi, i-Alzheimer, okanye imiphunga yemiphunga.
Isifundo sichaza i-Flaws kwiNqanaba lokuKhuselwa kwamaRhafu
Ekuqulunqeni isifundo sabo, iqela likaJohn Hopkins laphawula ukuba iindlela zemveli zokuqokelela iinkcukacha zokufa zixhomekeke kwinkqubo yekhowudi eyayiqulunqwe ekuqaleni kwenkonzo yomshuwalense kunye nokuhlawula ngonyango, kungekhona uphando lwe-epidemiological.
Le khowudi, ebizwa ngokuba yi- International Classification of Diseases (ICD) , yamkelwa yi-US ngo-1949 kwaye iyalungelelaniswa yiNational Health Organization (WHO) e-Geneva. Inkqubo ye-ICD yenzelwe ukubeka imephu yeemeko zempilo ethile kwikhowudi ehambelana nayo, emva koko i-coding eyongezelelweyo ye-alphanumeric inokunika ulwazi malunga neempawu ezithile, izizathu, iimeko kunye nezinye iziphumo ezingavamile.
Nangona i-US (njengeKhanada ne-Australia) iququzelele ukulungelelaniswa kwayo kwikhowudi ye-ICD , inkqubo ihlala ingaphezulu okanye ingaphantsi efana neyasetyenziselwa uphando lwe-epidemiological jikelele. Zizo iikhowudi eziza kugqirha oogqirha ukuba bahlule izizathu zokufa, leyo i-CDC iya kuthi yenze i-extrapolate yayo ingxelo yonyaka.
Ngokusekelwe kwizigaba ze-ICD, ii-CDC zibika ukuba ezili-10 ezibangela ukufa ngo-2014 zi:
- Isifo senhliziyo: 614,348
- Cancer: 591,699
- Izifo ezingapheliyo zokuphefumula: 147,101
- Izingozi (ukulimala ngokungenziyo) : 136,053
- Isibetho (izifo eziphazamisayo): 133,103
- Isifo se-Alzheimer : 93,541
- Isifo sikashukela: 76,488
- I-Influenza kunye ne-pneumonia: 55,227
- I-Nephritis, i-nephrotic syndrome, kunye nephrosis (isifo seengtso): 48,146
- Ukuzilimaza ngokwabo (ukuzibulala): 42,773
Abaphandi bathi, ukuba iikhowudi ze-ICD ezisetyenziselwa izatifikethi zokufa zihluleka ukubeka impazamo yezokwelapha njengento ehlukile kunye / okanye eyona nto. Oku kubangelwe kakhulu ukuba i-ICD yamkelwa ngelixa i-diagnostic okanye iimpazamo zekliniki ezingabonakaliyo kwiinkalo zonyango kwaye, ngenxa yoko, kungabandakanywa ngokungafunekiyo kwingxelo kazwelonke.
Inyaniso yokuba inkqubo ayitshintshi-kwaye iyaqhubeka nokubeka iikhowudi zokuhlawula ukuphanda-uphando-ngokuthe ngqo ukuba sikwazi ukubona kuphela kodwa ukunciphisa inani lokufa elibhekiselele kwimpazamo yonyango.
Iikhompyutheni zokuFunda kwi-Patient Deaths
Ukufa okubangelwa yimpazamo yezobugqirha akuyona into emitsha, yinto enye enzima ukulinganisa. Ngo-1999, ingxelo evela kwiziko lezeMpilo (i-IOM) yavelisa ingxoxo xa iqukumbela ukuba impazamo yezokwelapha yayijongene nokufa kwabantu abangama-44 000 no-98,000 eMelika ngamnye ngonyaka.
Uhlalutyo oluninzi oluye lwacetyiswa ukuba iinombolo ze-IOM ziphantsi kwaye ukuba inani elithile lihamba ngaphaya kwama-130,000 kunye nokufa okumangalisayo kwama-575,000. Ezi manani zichasene kakhulu njengoko zininzi kakhulu kwingcaciso yazo "yephulo lezonyango" okanye lincinci kakhulu.
Ekuphenduleni, abaphandi bakaJohn Hopkins banquma ukwenza enye indlela ngokuchaza ngokucacileyo "impazamo yezobugqirha" njengenye okanye ngaphezulu kwezi zinto zilandelayo:
- Isenzo esingalindelekanga (nokuba sisiphumo sokushiya okanye isenzo)
- Isenzo esingafezekisi isiphumo sayo esifanelekileyo
- Ukungaphumeleli kwesenzo esicwangcisiweyo (impazamo yokusebenza)
- Ukusetyenziswa kwesicwangciso esingalunganga ukuphumeza isiphumo (impazamo yokucwangcisa)
- Ukuphambuka kwenkqubo yokunyamekela okungenokuba yingozi
Ngokusekelwe kuloo nkcazo, abaphandi bakwazi ukuhlukanisa ukufa kwabantu abanesigulane, ukususela ngo-2000 ukuya ku-2008 ukusuka kwiSebe lezeMpilo lezeNkonzo zoLuntu eMelika. Lawo manani ayetyenziselwa ukuqikelela izinga lokufa kwesigulane ngonyaka, amanani awo asetyenziselwa kwisibhedlele esibamkelekileyo esibhedlele ngo-2013.
Ngokusekelwe kulolu hlobo, abaphandi bakwazi ukugqiba ukuba kwezi zigidi ezingama-35,416,020 zamkelwa esibhedlele ezibhalwe ngo-2013, ama-251,141 abafayo baba ngumphumo wempembelelo yonyango.
Kukho ngaphezu kwe-100,000 ngaphezu kwesifo esingapheliyo sokuphefumula (# 3 imbangela yokufa) kwaye phantse kabini izinga leyingozi (# 4) okanye isithintelo (# 5).
Isifundo sifaka ingxabano phakathi kwabaPhilo bezeMpilo
Nangona abaphandi bekhawuleza ukubonisa ukuba iimpazamo zonyango azikhupheli ngokwalo okanye zingabonakali zenzo zomthetho, zikholelwa ukuba zifuna ukuba uphando olungakumbi ukuba nje ufumane iingxaki zeenkqubo ezikhokelela ekufeni. Ezi ziquka ukunakekelwa kakubi phakathi kwabanikezeli bezempilo, amanethiwekhi e-inshurensi ehlukeneyo, ukungabikho okanye ukungasebenzisi phantsi kweendlela zokukhusela kunye neenkqubo, kunye nokungabikho kokuphendula uxanduva lokutshintshwa kwendlela yokusebenza.
Uninzi kuluntu lwezonyango alukhawulezi ngokuvisisana. Kwezinye iimeko, le nkcazo ye "mpazamo yezokwelapha" ivuselele ingxoxo njengoko ihluleka ukwahlula phakathi kwephutha kwisigwebo kunye nesiphumo esingalindelekanga. Oku kuyinyani ngokukodwa xa kuthethwa iingxaki zokuhlinzwa okanye izenzo ezithathwe kwizigulane ezinezifo zokugqibela. Akukho kwimeko apho ingxaki yezobugqirha ibonwa njengeyona nto ibangela ukufa, abaninzi bayabambana.
Abanye, okwangoku, bakholelwa ukuba iimpazamo ezifanayo kwisigqibo se-IOM sibetha isifundo se-Hopkins, apho ubunzima bezinto ezinobungozi bubekwe ngakumbi kwigqirha kunokuba zikhethwe ngendlela yokuphila eyenza ngokukhawuleza ingozi yokufa (kubandakanywa ukutshaya, ukutya ngokutya, ukusela ngokweqile, okanye uhlala ubomi obusondelene).
Nangona kunjalo, nangona ingxoxo eqhubekayo malunga nokuqinisekiswa kweengxelo zeHopkins, abaninzi bayavuma ukuba uphuculo kufuneka lwenziwe ukuba lube bhetele ukucacisa kwaye luhlule iimpazamo zonyango ngaphakathi kwimeko yokuhlolwa kwesizwe. Ngokwazisa ezi mpazamo, kukholelwa ukuba inani lokufa elibhekiselele kwimpazamo yezokwelapha lancitshiswa kakhulu phakathi koogqirha ngabanye nakwizinga lehlabathi.
> Imithombo:
> Amasebe okuLawula nokuVimbela (iCCDC). " Impilo, i-United States, 2015 : Itheyibhile 19." 2015; Atlanta, Georgia; Ukupapashwa kweLayibrari yeNgqungquthela 76-641496; 107-110.
> Makary, M. kunye noDaniel, M. "Impazamo yezobisi-yesithathu ibangela yokufa e-US." I- British Medical Journal. Meyi 3, 2016; 353: i2139.
> Landrigan, C; Parry, G; Amathambo, C; okqhubekayo. "Iimpawu zesikhashana kwiirhafu zesifo esiyingozi ngenxa yokunyamekela unyango." I-New England Journal of Medicine. 2010; 363: 2124-2134.