Ukhathalelo olungxamisekileyo olusezibhedlele lulo lonyango kuphela apho abantu baseMelika banelungelo elisemthethweni, kungakhathaliseki ukuba banako ukuhlawula.
I-Emergency Medical Treatment and Active Labour Act (EMTALA) yapasiswa yiCongress kwi-1986 kwaye ifuna izibhedlele kunye nenkonzo ye-ambulensi ukubonelela ngononophelo kuye nabani na ofuna unyango olungxamisekileyo kungakhathaliseki ukuba ngummi, isimo somthetho, okanye ukukwazi ukuhlawula. Umthetho uthi akukho malungiselelo embuyekezo.
ER/ED njengendawo yokuya
Idatha yophando ye-New York State (2017-2018) irekhoda ukuba abantu abangaphezu kwezigidi ezi-4 benza malunga nokutyelela kwezigidi ezi-7 ngonyaka kumasebe angxamisekileyo esibhedlele (ED); nangona kunjalo, aziphumeleli ekubeni alaliswe esibhedlele. Ukuntywila nzulu kwisizathu esiphambili solu tyelelo lwe-ED lubonisa ukuba abaninzi bebenokuncediswa kwindawo eyahlukileyo, engabizi kakhulu okanye ilungiselelo lonyango lokuthintela. Ukungabikho kwezinye iindlela kuye kwakhokelela kwi-US $ 8.3 yezigidigidi kwiindleko ezongezelelweyo kwishishini (Modernhealthcare.com). Kufunyenwe ukuba iipesenti ze-60 zokutyelela (i-4.3 yezigidi) zijoliswe kwiimeko ezi-6 ezingapheliyo: i-asthma, isifo se-pulmonary obstructive, isifo sikashukela, ukungaphumeleli kwentliziyo, uxinzelelo lwegazi, kunye neemeko zempilo yokuziphatha ezifana nempilo yengqondo okanye imiba yokusetyenziswa kakubi kweziyobisi.
Kwinqanaba likazwelonke, i-130 yezigidi zabantu e-USA batyelela indawo ye-ED kunye nokutyelela kwe-35 yezigidi ezinxulumene nokulimala. Kutyelelo lwesebe olungxamisekileyo, i-16.2 yezigidi ikhokelele ekulalisweni esibhedlele kunye ne-2.3 yezigidi ezibangele ukwamkelwa kwiiyunithi zokhathalelo olubalulekileyo. Ukutyelelwa kwezigulane, iipesenti ze-43.5 zibonwe ngaphantsi kwemizuzu ye-15 kunye neepesenti ze-12.4 ezibangele ukwamkelwa esibhedlele kunye neepesenti ze-2.3 kuphela eziphela ekudluliseleni kwisibhedlele esahlukileyo (ingqondo okanye enye) isibhedlele (i-2018 NHAMCS yeFayile yokusetyenziswa koLuntu).
Uphando lophando lwe-2018 lufumene ukuba iqela eliphambili elityelela i-ED lingaphantsi kweminyaka eyi-1, kunye neepesenti ze-52 ezineminyaka eyi-75 +. Ireyithi yokutyelela i-ED yabasetyhini yayikutyelelo lwe-44 ngabantu be-100, ngaphezulu kwereyithi yamadoda (utyelelo lwe-37 ngabantu be-100). Ngo-2018, ireyithi yokundwendwela i-ED kubantu abangengabo abeSpanishi okanye abantu base-Afrika baseMelika yayikutyelelo lwama-87 ngabantu abali-100, ngaphezulu kwemilinganiselo yabantu abavela kuzo zonke ezinye iintlanga nezizwe. Amazinga okutyelela i-ED kubantu base-Hispanic okanye baseLatino (i-36 ngabantu be-100) kunye nabantu abamhlophe abangengabo base-Hispanic babeyi-35 ngabantu abayi-100.
Izinga lokutyelela i-ED laliphezulu kwizigulane ezine-Medicaid (utyelelo lwe-97 ngabantu be-100) kunye neqondo eliphantsi kakhulu kwizigulane ezine-inshurensi yabucala (ukutyelela ama-23 kubantu abayi-100) (iZiko leSizwe leNkcazo yezeMpilo, iCandelo leNkcazo yezeMpilo).
Iinkqubo zamandulo
Nangona uninzi lweentlobo zezibhedlele zichaphazeleka, ingxaki yokuxinana inzima kakhulu kwizibhedlele zasezidolophini nezifundisayo. Uhlolisiso olwenziwa yiAmerican Hospital Association ngo-2010 lwabonisa ukuba ngaphezu kwama-50 ekhulwini kwizibhedlele zokufundisa ezisezidolophini nezokufundisa abantu abanengxaki yeED abanazo okanye bangaphezu kwamandla abo. Ukwandisa ingxaki yindlela eyoyikisayo yokuhla kwenani le-ED kunye nokwanda kwenani lokutyelela kwe-ED.
Iindibano ezimbi
Nangona zonke ii-EDs zisokola ngemiba yokuxinana kunye nokwandiswa kwabasebenzi ukuya kwisigulane, inkxaso-mali engaphantsi, imiqobo yezibonelelo ngokubambisana nabantu abasengozini enkulu kunye neempazamo zoxilongo ezikwingozi enkulu zidala imeko eyilelwe intlekele.
Ii-EDs aziyondawo yokugqibela kwizigulana ezininzi kodwa kukunqumama kwindlela eya kwenye indawo (oko kukuthi, ikhaya, icandelo elikhethekileyo, ibhedi yezigulane) okukhokelela ekubeni kubekho iibhedi ezingxamisekileyo rhoqo ngenxa yenceba yezibonelelo ezinqongopheleyo zamanye amasebe esibhedlele. kunye namanye amacandelo enkqubo yokhathalelo lwempilo.
