Ukunakekelwa okuphuthumayo vs. ukuvakashelwa kwamagumbi okuphuthumayo: Uyini umehluko?

Inkampani

Uma ngabe uke waba nenkinga yezempilo elinganiselayo kuya kwelinzima, mhlawumbe uke waya egumbini lezimo eziphuthumayo noma esikhungweni sokunakekelwa esiphuthumayo. Ingxenye eyodwa enzima kakhulu yokubhekana nenkinga yezempilo ukunquma ukuthi kufanele uye kuphi ukuze uthole ukwelashwa. Ake sibheke umehluko phakathi kwezikhungo zokunakekela eziphuthumayo namagumbi ezimo eziphuthumayo - nezindleko zawo - ukuze waziswe kangcono mayelana nokuthi ungaya kuphi uma kwenzeka isidingo sikhona ngokuzayo.

Ukunakekelwa okuphuthumayo vs. igumbi eliphuthumayo

Ngaphandle kwezikhungo ezinkulu zezibhedlela, imitholampilo ehamba ngezinyawo, izikhungo zokunakekela eziphuthumayo, namakamelo okuphuthumayo awavamile ukubekwa ndawonye esakhiweni noma endaweni efanayo. Kwesinye isikhathi isikhungo sokunakekela esiphuthumayo singabekwa eduze kwegumbi labezimo eziphuthumayo, kepha lokhu akuhlali kunjalo. Lapho ogcina uye khona kuzoncika ohlotsheni lokwelashwa oludingayo, kanti imitholampilo ehlukene yakhelwe ukwelapha izinkinga ezehlukene zezempilo.

Imitholampilo yokuhamba ngezinyawo ukuhlinzeka ngezinsizakalo zokwelashwa eziyisisekelo njengokugoma. Abantu abanokulimala okuncane kanye nokugula ngokujwayelekile bangaya emtholampilo wokuhamba ngaphandle kwe-aphoyintimenti futhi bathole ukunakekelwa kumhlengikazi noma umsizi kadokotela. Abahlengikazi kanye nama-MDs kwesinye isikhathi bangatholakala futhi.

Izikhungo eziphuthumayo zokunakekelwa zenzelwe ukwelapha abantu ababhekene nezimo ezingezona eziphuthumayo, ukugula okuncane nokulimala. Banikela ngosizo lwezokwelapha ngokushesha kanye nezinsizakalo ezingalaliswayo kubantu abanezimo ezingaba zimbi kakhulu ngaphandle kokunakekelwa ngokushesha. Izikhungo eziningi zokunakekelwa okuphuthumayo zivulekile ngomhla ka-24/7 futhi ziyizinketho ezinhle kubantu abangakwazi ukwenza i-aphoyintimenti yosuku olufanayo nodokotela wabo wokunakekelwa okuyisisekelo. Izikhungo zokunakekela ezisheshayo azenzelwanga ukuhlinzeka ukwelashwa kweziguli eziqhubekayo ngaphandle kokuvakashelwa okukodwa noma ukwelashwa okulinganiselwe, kwesikhashana.

Amakamelo okuphuthumayo (ERs) eyabantu ababhekene nokugula noma ukulimala okusongela impilo. Zenzelwe ukwelapha abantu abanezimo zezempilo ezingasongela impilo uma bengelashwa kungakapheli amahora angama-24. Ama-ER nawo ayindawo evamile yokungena esibhedlela kubantu abadinga ukwelashwa esibhedlela okungalalisiwe ngenxa yokugula noma ukulimala. Izikhathi zokulinda emagumbini okuphuthumayo zivame ukuba zinde kakhulu kunezikhungo zokunakekela eziphuthumayo.

Nayi eminye umehluko omkhulu phakathi kwemitholampilo yokuhambahamba, izikhungo zokunakekela eziphuthumayo, namagumbi okuphuthumayo.

Imitholampilo yokuhamba ngezinyawo

• Ungakwazi ukwelapha ukulimala okuncane nezifo
• Akukho ukuqokwa okudingekayo
• Iziguli zibonwa ngokokuqala kokufika
• Kungenzeka kungabi nemishini efana nemishini ye-X-ray
• Kungenzeka kungabi nama-MDs atholakalayo nsuku zonke, futhi esikhundleni salokho bangasebenzisa ama-NP noma abasizi bodokotela
• Kubiza kakhulu kunokunakekelwa okuphuthumayo noma amakamelo okuphuthumayo

Kuyaphuthuma lokho

• Ungaphatha ukulimala okuncane noma okulingene nokugula
• Imvamisa akukho ukuqokwa okudingekayo-okuvame ukuvula izinsuku eziyisikhombisa ngesonto, kepha kufanele ushayele indawo yakho yokunakekelwa okuphuthumayo ukuqinisekisa amahora wokusebenza
• Iziguli zibonwa ngokokuqala kokufika
• Yiba nemishini yezokwelapha efana nemishini ye-X-ray futhi ingaphatha amathambo aphukile
• Imvamisa kuba nodokotela osizayo ngaso sonke isikhathi
• Ngokuvamile une-copay ephakeme kunokuvakashelwa kokunakekelwa okuyisisekelo

Amakamelo okuphuthumayo

• Ingaphatha ukulimala okubucayi nokusongela impilo kanye nezifo ngezinga eliphakeme lokunakekelwa
• Akukho ukuqokwa okudingekayo — ukuvula okungu-24/7, noma kunjalo, izikhathi zokulinda zivame kakhulu ukwedlula izindawo zokunakekela noma zokunakekela eziphuthumayo
• Yiba nezinhlelo zokubeka izinto ezibeka phambili iziguli ezinezimo ezibucayi kakhulu kunalezo ezinezimo ezingezinhle kangako
• Yiba nemishini yokwelashwa edingekayo yokwelapha izimo ezisongela impilo
• Yiba nabahlengikazi, odokotela, nodokotela abahlinzayo abatholakala ngaso sonke isikhathi, noma amandla okuthola usizo oluphuthumayo oludingayo ngokushesha
• Kungabiza kakhulu uma kuqhathaniswa nezikhungo zokunakekelwa eziphuthumayo zokuhamba nokuhamba phambili zezinhlelo ezithile zokunakekelwa kwezempilo

Kufanele ngiye ekunakekelweni okuphuthumayo noma ekamelweni labezimo eziphuthumayo?

Ukwazi ukuthi ungaya nini ekunakekelweni okuphuthumayo kuqhathaniswa negumbi labezimo eziphuthumayo kungahle kukuongele isikhathi nemali. Kuya ngezinhlelo ezithile zokunakekelwa kwezempilo kwesiguli kodwa ngeke ufune ukuchitha isikhathi nemali eningi egumbini lezimo eziphuthumayo lapho isimo sakho besingaphathwa ngendlela efinyelelekayo ngokunakekelwa okuphuthumayo.

Izinsizakalo zokunakekelwa okuphuthumayo

Nalu uhlu lwezimo, izimpawu, nokulimala okungalashwa esikhungweni sokunakekelwa esiphuthumayo:

• Izimpawu ezivamile zomkhuhlane nomkhuhlane
• Ukukhwehlela nomphimbo obuhlungu
• Kusha okuncane
• Amathambo aphukile
• Ukutheleleka ezindlebeni
• Imfiva ephezulu
• Ama-sprains amancane noma imisipha edonswayo
• Ukuqedwa okuncane nokusikeka

Lezi ngezinye nje zezimo eziningi imitholampilo yokunakekelwa okuphuthumayo eyelaphayo nsuku zonke, kusho uJay Woody, MD,umhlanganisi we Ifa le-ER & Ukunakekelwa Okuphuthumayo . Kepha khumbula: Noma lezi zakhiwo can run services advanced diagnostic and laboratory, lokho akusho ukuthi isimo esisongela impilo singelashwa lapha. Ngaphezu kwalokho, udokotela wokunakekela ophuthumayo ojwayelekile ubona iziguli eziyi-4,5 ngehora, okusho ukuthi isikhathi sakho sokulinda ekugcineni siyoba sifushane.

Izinsizakalo zegumbi lezimo eziphuthumayo

Izimo ezibucayi kakhulu kufanele ziphathwe emnyangweni ophuthumayo. Nalu uhlu lwezimo, izimpawu, nokulimala okubhekwa njengesimo esiphuthumayo sezokwelapha:

• Ubuhlungu besifuba
• Ukopha kakhulu
• Amanxeba ajulile
• Ubuhlungu obukhulu besisu
• Ukusabela okweqile komzimba
• Ukuqhekeka kwamakhemikhali
• Ukulimala ekhanda
• Ukuphefumula kanzima
• Ukushaya ngamandla kwenhliziyo
• Ubunzima obungazelelwe bokukhuluma noma ukuqonda inkulumo
• Umbono ongazelelwe uyashintsha
• Ukopha kwesitho sangasese sowesifazane ngesikhathi sokukhulelwa
• Imfiva ephezulu (ikakhulukazi ezinganeni ezisanda kuzalwa)
• Umbono wokuzibulala nezinye izimo eziphuthumayo zengqondo

Lezi zimpawu nezimo akufanele zinganakwa ngoba zingaba yingozi enkulu empilweni yakho. Abasebenzi bezimo eziphuthumayo bonke baqeqeshiwe futhi bahlonyiselwe ukubhekana nalezi zimo egumbini lezimo eziphuthumayo, kuchaza uDkt.Woody.

Izinsizakalo zokunakekelwa okuyisisekelo

Ngenkathi amakamelo ezimo eziphuthumayo nezikhungo zokunakekela eziphuthumayo zinhle, kwesinye isikhathi akudingekile ukuthi uye nakwezinye. Abazali bangakugwema ukuhamba okungadingekile beya ehhovisi likadokotela futhi bonge imali eningi ngokuthi ukufunda ukwelapha ukusikeka okuncane kwezingane zabo nokukhuhla ekhaya.

Abantu abadala nezingane kufanele babone umhlinzeki wokunakekela oyinhloko wezinto ezinjenge:

• Ukuhlolwa konyaka
• Ukuphathwa kokugula okungalapheki
• Ukwelashwa okuvamile komkhuhlane nomkhuhlane
• Ukunakekelwa kokuvimbela
• Izindlebe
• Imigomo
• Ukugoma
• Ukutheleleka kwe-Urinary tract (UTI's)

Ukuya kudokotela wakho wokunakekela oyinhloko walezi zinhlobo zezinto kuhlale kungumqondo omuhle ngoba udokotela wakho uyakwazi wena nomlando wakho wezokwelapha. Uma uzama ukwenza i-aphoyintimenti nodokotela wakho futhi babhukhishwa noma baye eholidini, khona-ke uhambo oluya emtholampilo wokuhambahamba noma esikhungweni sokunakekelwa okuphuthumayo kuyinto elandelayo engcono kakhulu.

Uma wena noma izimpawu zengane yakho kubi kakhulu noma uqala ukuzwa ubuhlungu besifuba, ukuphefumula kanzima, ukopha okungalawuleki, noma ezinye izimpawu ezinzima, bese kuyisikhathi sokushayela u-911 noma uvakashele igumbi labezimo eziphuthumayo.

Ingabe ukunakekelwa okuphuthumayo kushibhile kunegumbi labezimo eziphuthumayo?

Lapho uya khona ukuze uthole ukwelashwa kuzonquma kancane ukuthi ugcina ukhokha malini. Ukubona udokotela wokunakekelwa okuyisisekelo kuzoba kubiza kancane kunokuya esikhungweni sokunakekelwa okuphuthumayo, futhi ukuya esikhungweni sokunakekelwa esiphuthumayo ngokuvamile akubizi kakhulu kunohambo oluya e-ER. Uma unomshuwalense wezempilo futhi uya kwenye indawo ukwelashwa, uzoba ne-copay noma i-coinsurance okufanele uyikhokhe ngokuya ngezidingo zakho ezingadonswa.

TO ikopay Izinga eliphansi lapho udokotela, isikhungo esiphuthumayo sokunakekelwa, noma igumbi labezimo eziphuthumayo elizokhokhisa izinsizakalo zabo zokunakekelwa. Izinga linqunywa uhlelo lwakho lokunakekelwa kwezempilo. Ukunakekelwa okuphuthumayo nokuvakashelwa kwamagumbi okuphuthumayo kuvame ukuba namakhophi aphakeme kakhulu kunokuvakashelwa okuvamile kwehhovisi lodokotela.

Ngokuvamile, kungcono (futhi kubiza kakhulu) ukuya ezikhungweni zokunakekelwa okuphuthumayo ngaphakathi uma kungenzeka. Kodwa-ke, amakamelo ezimo eziphuthumayo ahlukile. Izinkampani zomshuwalense azikwazi ukujezisa abanikazi bezinqubomgomo nge-copay ephakeme uma ufuna ukunakekelwa okuphuthumayo esibhedlela esingaphandle kwenethiwekhi. Qaphela: Noma ngabe unomshuwalense, izivivinyo ezithile nabahlinzeki kungenzeka bangakhokhelwa inethiwekhi yakho yomshuwalense, ngakho-ke ungakhokhiswa ngezinsizakalo ezithile. Uhlelo lomshuwalense wezempilo wawo wonke umuntu lwehlukile, ngakho-ke ngaso sonke isikhathi kungcono ukubuza inkampani yakho yomshuwalense ukuthola isilinganiso sokuthi yini ongagcina uyikhokha uma kufanele uye esikhungweni sokunakekelwa esiphuthumayo noma egumbini lezimo eziphuthumayo.

Izikhungo eziningi zokunakekela eziphuthumayo zizobona abantu noma bengenawo umshuwalense wezempilo, kodwa banelungelo lokwenqaba umuntu uma bengeke bakwazi ukukukhokhela. I-Emergency Medical Treatment and Active Labor Act eyaphasiswa Ngo-1986 kudinga wonke amakamelo ezimo eziphuthumayo ukuthi alaphe futhi asimamise noma ngubani ongena, kungakhathalekile ukuthi unakho yini ukukhokha noma isimo somshuwalense.

Ngaphandle komshuwalense, ukuvakashelwa kwesikhungo esiphuthumayo kungabiza noma yikuphi kusuka ku- $ 100 kuya ku- $ 200. Uma udinga i-X-ray noma olunye uvivinyo olwenziwe, lokhu kungabiza kakhulu. Ngenkathi, uhambo oluya egumbini labezimo eziphuthumayo lungabiza amakhulu noma izinkulungwane zamaRandi ngaphandle komshwalense ngokuya ngenkonzo oyidingayo.

Akungabazeki ukuthi ukuya egumbini lezimo eziphuthumayo noma emtholampilo wokunakekelwa okuphuthumayo kungabiza, ikakhulukazi uma ungenayo umshuwalense omuhle wezempilo. Isilinganiso esidonswayo e-United States singama- $ 4,544, futhi cishe Ama-61% esikweletu sezokwelapha e-U.S. kusuka ekuvakasheni kwamagumbi okuphuthumayo.

Isiphetho sendaba: Beka impilo yakho phambili kunezindleko zezokwelapha

Isici sezezimali akufanele sikuvimbe ekufuneni ukunakekelwa kwezokwelapha lapho sikudinga, noma kunjalo. Oyedwa ku- ezintathu Abantu baseMelika bathi bakugweme ukufuna usizo lwezempilo lapho beludinga ngoba bekhathazekile ngezindleko. Lokhu kusho ukuthi izinkulungwane zabantu baseMelika zibeka impilo yazo engcupheni noma ngabe zidinga ukwelashwa.

Uma uke waya esikhungweni sokunakekelwa esiphuthumayo noma egumbini lezimo eziphuthumayo futhi unemali enkulu yezokwelapha, kunezindlela zokuthola usizo. Izibhedlela eziningi zinikela ngezinhlelo zokukhokha futhi zingakudlulisela ezinhlelweni zosizo lwezezimali endaweni yangakini. Izibhedlela eziningi nazo zihlinzeka ngosizo lokupha ngesihle noma zingakusiza ngokufaka isicelo somshuwalense wezempilo. Futhi-ke, ungahlala njalo sebenzisa i-SingleCare ukonga kumithi yakho kadokotela.

Uma kukhulunywa ngokuhlala uphilile, umcabango wezikweletu zezokwelapha akufanele ungene endleleni. Kuhlale kungumqondo omuhle ukuthi uphephe futhi uzinakekele.