Izinsiza Zokuqeda Umshuwalense ukuya eMedicaid
Ukubhema kuyisici esingavinjelwe esenza inani eliphakeme kakhulu lokulahlekelwa iminyaka-impilo phakathi kwabantu abane-HIV ezweni elithuthukile. Eqinisweni, amaphesenti angu-42 abantu abaphila negciwane lesandulela ngculaza namuhla abhekwa njengababhemayo bamanje, ngokweqile ukulinganisa kazwelonke.
Lezi zibalo ziqokomisa isidingo sokungenelela okuphumelelayo, lapho abantu abasanda kutholakala ukuthi banesandulela ngculaza bahlolisiswa ukusetshenziselwa ukubhema futhi banikeze amathuluzi okuyeka ukusukela ekudleni okunzima kwezentengiselwano, ezomnotho, ezingokwengqondo nezokwelashwa komphakathi we-HIV.
Ukuhlanganisa Ukuqeda Ukubhema Kwangena e-HIV Care
Kusukela emuva eminyakeni yama-1980, ucwaningo luye lwabonisa ukusebenza kahle kokuhlanganisa ukwelulekwa kokuyeka ukubhema ekunakekelweni kwegciwane lesandulela ngculaza . Ngokudabukisayo, ukusetshenziselwa kokusebenza sekuye kwashiywa emuva, kanti abangaphansi kwamaphesenti angama-50 abahlinzeki bokunakekela i-HIV banikeza iziguli zabo ukubhema ukungenelela kokungasebenzi noma ukuhanjiswa, ngokusho kwedatha evela eMnyangweni Wezilwane Zase-United States.
Kodwa-ke, kuye kwaba nemizamo eminyakeni yamuva ukuthuthukisa ukuhlanganiswa phakathi kwabahlinzeki, izincomo eziyinhloko zazo ezibandakanya:
- Ukuhlinzeka iziguli ngolwazi ngezingozi ze-HIV nokubhema , kufaka phakathi izifo ezinjenge-cardiovascular disease, umdlavuza wamaphaphu , kanye nesifo esingavamile se-pulmonary (COPD).
- Ukulawula imithi emibili yokuyeka ukubhema ngokuhambisana nokululekwa okuvamile kanye nokulandela.
- Ukubhekisela kweziguli kubachwepheshe (isib. Abahlinzeki bempilo yengqondo, izinhlelo zokusebenzisa izidakamizwa, abasebenzi bezenhlalakahle, amaqembu okusekela ), njengoba kudingeka.
- Ukuvuselela kabusha imishanguzo yokuyeka ukubhema ngemuva kokubuyela emuva. Izifundo zibonise ukuthi ababhemayo bazozama ukuyeka izikhathi ezinhlanu kuya kweziyisikhombisa, ngokwesilinganiso, ngaphambi kokuphumelela. Ukulandelwa okuqhubekayo nokusekelwa kubonakala kuyisihluthulelo ekuboneni (futhi ekubhekiseni) ukubhema okuphindayo.
Phakathi naleso sikhathi, amanye amaqembu ahlola izindlela zokuthuthukisa imodeli edidiyelwe.
Esicwaningweni esisodwa esenziwa eNyuvesi yaseTexas, abacwaningi babonise ukuthi ukwelashwa esikhundleni se-nicotine (NRT), lapho kusetshenziselwa ukuhambisana nokwelulekwa kwefoni yeselula, ngcono izinga lokuzigwema kubantu abane-HIV ngamaphesenti angaba ngu-400 ngaphezu kweNRT yendabuko, engasekelwa.
Izinketho zokuqeda ukubhema Ngaphansi koMthetho Wokunakekelwa Onganakekelwayo
Ngaphansi koMthetho Wokunakekelwa Onganakekelwa (ACA) , umshuwalense wangasese owadalwa emva kukaMashi 23, 2010 kumele ufake ukuhlinzekwa kwezinsizakalo zezempilo zokuvimbela mahhala, kufaka phakathi ukuhlolwa kokusetshenziswa kogwayi kubantu abadala kanye nokungenelela kokuyeka ukubhema kwabasebenzisi begwayi. Ngokufanayo, ukunwetshwa kwe-Medicaid izinzuzo manje kunika ukwelashwa kokuyeka ukubhema kubo bonke abantu abadala (lapho izinzuzo kwezinye izifunda zilinganiselwe kwabesifazane abakhulelwe kuphela).
Ukwehla kokuhlinzekwa ngumhlinzeki kanje:
- Ukuxilongwa - Ukukhuliswa kokubhema kokuyeka ukubhema kwabo bonke abantu abadala base-US kusho ukusebenza ngoJanuwari 1, 2013. I-ACA ibuye ikhulise ukufaneleka kukaMedicaid kubo bonke abantu abadala abahola imali.
- I-Medicare - i-Nicotine yama-nasal spray, i-nicotine inhaler, i-bupropion ne-varenicline, kanye nokululekwa ngabanye, kokubili ukuyeka imizamo ngonyaka. Ukuvala i-Medicare Part D "umgodi wokudonsa" nakho kwenza imithi engabizi kakhulu ngezindleko ezingaphandle kwezindleko.
- Ukuthengiselana Kwempilo Yomshwalense WezeMpilo - Kudinga zonke izinhlelo zokubheka izinzuzo zezempilo ezibalulekile, okubandakanya ukuyeka ukubhema (nakuba izinzuzo zingahluka ngecebo kanye / noma umhlinzeki).
- Umshuwalense oxhaswe ngumqashi - Kudinga ukuhlinzekwa kwazo zonke izinsizakalo zokuvimbela ezinikezwe isilinganiso "A" noma "B" yi-US Preventive Services Task Force, okubandakanya ukuyeka ukubhema (nakuba izinzuzo zingahluka ngecebo kanye / noma umhlinzeki).
Ukuze ufunde kabanzi mayelana nokufaneleka noma ukufinyelela kokwelashwa, xhumana no-1-800-QUIT-MANJE (1-800-784-8669) ukuxhuma ngqo nge-hotline esebenzayo esifundazweni sakho. I-National Cancer Institute inikeza futhi umlayezo osheshayo we-LiveHelp hotline (ngesiNgisi kuphela) kusukela ngo-8: 00 ekuseni kuya ku-8: 00 ntambama EST.
Imithombo:
Amasevisi aseMelika okuLawula nokuvimbela izifo (CDC). "Ukubhema ugwayi phakathi kwabantu abadala - i-United States, ngo-2011." Ukulimala nokufa Kwembiko Yamaviki onke (MMWR). NgoNovemba 9, 2012; 61 (44): 889-994.
UMdodo, R .; I-Frazier, E .; UMattson, C .; et al. "Ukubhema ugwayi phakathi kwabantu abadala abane-HIV: ukunakekelwa kwezokwelapha, i-US, 2009." Ingqungquthela ye-20 yama-Retroviruses kanye nezifo ezivame ukubhekana nazo (CROI 2013). I-Atlanta, Georgia; Mashi 3-6, 2013: Abstract 775.
UHughes, J. "Ukwelapha okusha kokuyeka ukubhema." I-CA: A Cancer Journal for Clinicians. May-June 2000; 50 (3): 143-145.
Vidrine, D .; I-Arduino, i-R .; I-Lazev, A .; et al. "Isivivinyo esingahleliwe sokungenelela kwefoni ngomakhalekhukhwini kubantu abathintekayo abane-HIV / AIDS." AIDS. NgoJanuwari 9, 2006; 20 (2): 253-260.
I-American Lung Association. " Ukusiza Ababhemayo Bayeke - Ukwelashwa Ukubhema Ugwayi : Yini Ehlanganisiwe?" Washington, DC; 2012.