Zogwiritsa Ntchito Zapamwamba Zikavala Malo Odzidzimutsa
Maulendo obwera kawirikawiri ndi odwala amene amasonyezanso mobwerezabwereza m'chipinda chodzidzimutsa kuchipatala. Amasankha kukwera ma ambulansi, kapena kupita ku dipatimenti yosavuta, mobwerezabwereza, m'malo mowona dokotala wawo. Amayendera nthawi zambiri kuti antchito amadziŵa dzina lawo. Kafukufuku wa chaka cha 2009 ku Texas adapeza kuti pakadutsa zaka zisanu ndi chimodzi, odwala asanu ndi anayi adayendera maulendo 2,678 ER, okwera madola 3 miliyoni - maulendo angapo omwe amapezeka mobwerezabwereza.
- Mafanowo: High-utilizer, super utilizer (SU), GOMER ndi GOOMER (tulukani mu chipinda changa chodzidzimutsa)
- Zina zapadera: maulendo ambiri
Kodi Odwala Othamanga Odwala Ambiri Ndi Otani?
Pakhoza kukhala zifukwa zingapo zogwiritsira ntchito maofesi ofulumira. Wodwala sangakhale ndi inshuwalansi ndipo sangathe kupeza dokotala wokhazikika. Wodwalayo amadziwa kuti ER ayenera kupereka mankhwala opulumutsa moyo. (onani EMTALA ). Panali chiyembekezo ndi ndondomekoyi komanso kukhazikitsidwa kwa ntchito yodalirika yogwirira ntchito ya 2010 kuti chipinda chodzidzimutsa chipinda chidzachepa chifukwa anthu ambiri adzakhala ndi inshuwalansi ya thanzi. Koma ngati izi zingasinthe chiwerengero cha maulendo obwera kawirikawiri sichikuwoneka.
Chifukwa chachiwiri chingakhale kufooka kwa maganizo. Pa maulendo asanu ndi anayi omwe amapezeka ku Texas, asanu ndi awiri anali ndi matenda a matenda aumphawi ndipo asanu ndi atatu anali osokoneza bongo.
Inde, ena ali chabe ofunafunafuna. Slang lotchedwa GOMER (kuchoka mu chipinda changa chodzidzimutsa) ndigwiritsidwa ntchito kwambiri mu slang zachipatala kwa odwala omwe amapezeka nthawi zambiri pazipatala zam'derali koma safunikira thandizo ladzidzidzi.
Zimachokera ku buku la Nyumba ya Mulungu ndi Samuel Shem.
Kafukufuku anapeza kuti maulendo omwe nthawi zambiri ankawombera amakhala ochepa, a ku Caucasus, osauka komanso a zaka zapakati pa 25-44. Iwo amatha kubwera ku chipinda chadzidzidzi madzulo ndi zizindikiro zochepa. Chochititsa chidwi n'chakuti kawirikawiri amakhala inshuwalansi kupyolera mu Medicaid mmalo mosavomerezedwa kapena kukhala ndi inshuwaransi yachinsinsi.
Kuyesera Kulimbana ndi Matenda Apamwamba Omwe Amagwiritsira Ntchito / Omwe Amapezeka
Mapulogalamu apamwamba akuyang'ana maulendo omwe amapezeka nthawi zambiri ndi odwala ena omwe amabwereza maulendo ambiri ndikugwira ntchito limodzi nawo kuti awatsogolere bwino kuti asakhale ndi ntchito zochepa. Nazi zitsanzo za mapulogalamu akuluakulu:
Mgwirizanowu wa Camden wa Healthcare Providers: Pulogalamuyi inayambira pokonza mapu otentha omwe odwala omwe amapita kuchipatala cha Camden, New Jersey akuchokera. Iwo adapeza mmodzi peresenti ya anthu omwe amagwiritsa ntchito zipatala za Camden chifukwa cha 30 peresenti ya ndalama zake. Iwo amalemba mndandanda wa maulendo obwereza kawirikawiri poyankhula ndi antchito ogwira nawo ntchito komanso madokotala ochipatala. Amalembetsa odwala komanso amayendera maulendo apanyumba ndi mafoni kuti awapatse chisamaliro chabwino chaumoyo ndikuletsa maulendo obwera mofulumira. Olemba olemba ntchito amagwira ntchito limodzi ndi gulu lokhala mmudzi kwa pafupi masiku 90, kuthetsa zolepheretsa khalidwe ndi zokhudzana ndi chikhalidwe komanso zachipatala.
Chigawo cha Oregon chinayamba pulogalamu mu Julayi 2012 kuti apereke chisamaliro chosamalidwa kwa odwala omwe amatha kupita ku Medicaid omwe amapita ku chipatala mofulumira katatu kapena kuposerapo pachaka. CCOs imayang'anitsitsa kupewa ndi kuthandiza anthu kuthetsa mavuto aakulu. Amafuna kuchepetsa kuchepa kwapadera kwa chipinda chamodzi monga zotsatira.
Zotsatira:
Kuthamanga, K., Weber, E., Showstack, J., Colby, D., & Callaham, M. (2006). "Zizindikiro za ogwiritsira ntchito kawirikawiri m'madipatimenti odzidzimutsa. Annals of Emergency Medicine, 48 (1), 1-8."
Jacobs, BJ, et al. (2012). Kugwiritsa ntchito chitsanzo chogwiritsa ntchito kwambiri cha Brenner [PowerPoint slides]. Mgwirizano wa Family Health Association Association wa 14th, October 4-6, 2012.