Baqala kanjani futhi izici ezibafake
Izikhungo zokunakekelwa okuphuthumayo ezisetshenziselwa ukuhlala endaweni efanayo njengehhovisi likadokotela. Uma ubona isikhungo sokunakekelwa okuphuthumayo (esivame ukubizwa ngokuthi umtholampilo wokunakekelwa okuphuthumayo) ngawo-1970, mhlawumbe kwakukhona indawo efanayo ehhovisi lapho odokotela kanye nodokotela bamazinyo babekhona. Futhi iningi lalabo babesesibhedlela.
Isikhungo sokunakekelwa okuphuthumayo ngalezo zinsuku sanikezwa ukunakekelwa okungasiphuthumayo ngenxa yobunzima besimo sezokwelapha zesiguli.
Banikeza ukunakekelwa okuphuthumayo (okusho ngaphandle kokuqokwa) ukuze kube lula isiguli.
Lezo mitholampilo noma izikhungo zokunakekelwa kwakungavamile kakhulu. Umqondo wonke wawusha. Kwakungakaze kube sekupheleni kweminyaka eyizinkulungwane ukuthi izikhungo zokunakekelwa okuphuthumayo zaqala ukwandisa izinsizakalo zazo ukufaka ikhono lokuphatha izimo zezokwelapha ezibi kakhulu.
Izinsuku Zokudala
Ekuqaleni, lo mbono wawumane nje ukuthi iziguli ngeke zidingeke ukuba wenze i-aphoyintimenti ukuze ubone i-doc. Babengangena kalula. Iziguli ngaleso sikhathi zinezinketho ezimbili kuphela: yenza i-aphoyintimenti nodokotela wabo wangasese noma uye ku- ER . Izinkampani zomshuwalense zazikhungathekile iziguli ngoba azizange ziqokwe. Bavele baya ku-ER. Okungenani yilokho abakwa-inshuwalense bacabanga ngakho-futhi basacabanga lokho.
Idatha yokuhambela umnyango ophuthumayo ngaphambi kuka-2000 yinkimbinkimbi kakhulu ukuthola. Enye into eqinisekile: ababhalisi abazange bathande ukukhokha izindleko zokunyuka komnyango wezimo eziphuthumayo ngawo-1970 futhi abathandanga nanamuhla.
Ukuvakashela i-ER kungabiza izindleko eziphindwe izikhathi ezingu-10 ukuvakashela ehhovisi likadokotela. Izikhungo zokunakekelwa okuphuthumayo ziphakathi kwezinye izindawo.
Akekho Amalungiselelo Okugula
Iziguli azikaze zenze kahle ekuqokeni ama-aphoyintimenti. Ukulimala kanye nokugula kunomkhuba wokuza ngokuzumayo futhi udinga ukwelashwa ngokushesha ngaphandle kokuthi sekusele emva kuka-10 ngoMgqibelo ebusuku.
Iminyango yezimo eziphuthumayo ayifuni ukubona iziguli ngaphandle kokuthi zisezindlini zomnyango wezokufa kanye nezidakamizwa zizophendula ngenjabulo ifoni ngoMsombuluko ekuseni ukuhlela i-aphoyintimenti ngoLwesine ntambama.
Izikhungo zokunakekelwa okuphuthumayo zakuqala zivela ezindaweni ezimbili: noma odokotela abazimele babezama ukuguquguquka iziguli zabo ngokukhulisa amahora kusihlwa nangezimpelasonto, noma ama-ER azama ukuthola izindlela zokunakekela iziguli ezingenayo isiguli. ukuvukela emnyangweni ophuthumayo. Lezi zindawo ezimbili zakha izinhlelo ezimbili ezihluke kakhulu.
Umsebenzi Womshuwalense
Njengomuntu oyedwa, ngokuvamile oqashwe ngumqashi, umshuwalense wezokwelapha wavame ukwanda, ukuvakashelwa kwe-ER kwanda phakathi kwalabo abakhulelwe ngokugcwele ngoba izindleko zokuya kudokotela (emva kokulinda ukuqashwa) zazifana nokuhamba ku-ER futhi kubonakala ngokushesha . Iziguli ezingaqinisekisiwe zaya emnyangweni ophuthumayo ngaphandle kwesidingo. U-ER kwakuwukuphela kwendawo lapho isiguli singabonwa khona ngokusongela impilo yakhe (noma kubhekwa impilo esongela) kungakhathaliseki ukuthi uyakwazi ukukhokha. Izibhedlela kwakudingeka zihlolwe iziguli futhi zinikeze ukunakekelwa okuphuthumayo uma kudingekile.
Lokhu kwaba ukuqala kokungalingani emnyangweni wokukhokha.
Labo abanomshwalense babevame ukukhwehlela yonke inkokhelo ngoba umshuwalense, kunokuba isiguli, beyithatha ithebhu. Ngakolunye uhlangothi, iziguli ezingavunyelwe, ngokuvamile azikwazi ukukhokhela. I-ER yayisazobaphathisa, kodwa yakha ukunakekelwa mahhala emhlane wezinkampani zomshuwalense wokuthengisa.
Izindleko zezempilo zaqala ukuphakama kakhulu. Izibhedlela kwakudingeka zikhokhwe ukuze kugcinwe odokotela nabahlengikazi esibhedlela ngehora, njengoba nje ingxenye yesiguli isiguli noma ikhululekile. Ngaphambi kwalokhu, izindleko zokunakekelwa kwezokwelapha zazifana naso wonke umuntu, kodwa manje labo abangakhokha babesekela labo abangakwazi.
Abafaki besikhwama babecabanga ukuthi i-sting. Bathuthukisa izimboni zezimali ukushayela iziguli kude nomnyango ophuthumayo ngaphandle uma bezidinga ukunakekelwa okuphuthumayo.
I-Carrot, i-Stick, ne-Crystal Ball
Iziguli eziqinisekisiwe zazingathandi ukulinda futhi azizange zikwazi njalo ukuqoka. Ukuphoqa iziguli ukuba zihlele kangcono, abanikezeli bomshuwalense bafaka ukubuyiswa kwesilinganiso se-sliding. Iziguli zikhokha imali encane uma kuhanjelwa u-ER kwaholela ekwamukelwa esibhedlela. Kwacatshangwa ukuthi ukuvakasha kumele kube nokufanele uma udokotela egcina isiguli ngobusuku bonke.
Kodwa-ke, iziguli zaphoqeleka ukuba zikwazi ukuxilongwa ngaphambi kokuba ziye emnyangweni ophuthumayo. Uma bengenayo iphuthumayo, babezokhokha okuningi ngaphandle kwephaketheni. Kwakukhona isizathu sokuya ehhovisi likadokotela esikhundleni sesibhedlela ngaphandle kokuthi isiguli sasiqiniseke ukuthi uzofa.
Kodwa iziguli zisazange zihlele kahle. Babefuna ukuhamba kahle emsebenzini. Odokotela bodwa babephendula ngamahora ehhovisi ebusuku kanye neMgqibelo. Basuka epaki zehhovisi lezokwelapha nasezikhungweni zokudlela. Ngokushesha, abazali bangathatha uJunior ukuba babone uSanta futhi baqaphele uhambo lwakhe olufanayo. Le miitholampilo yesevisi esheshayo yayinezinhlobo zamagama, kodwa "ukunakekelwa okuphuthumayo" kunamathele. Kwakunomlomo wokuthi iziguli zithandile.
Konke Ukunakekelwa Akukwakhiwa Kulingana
Umehluko phakathi kweminyango ephuthumayo kanye nezikhungo zokunakekelwa okuphuthumayo yizo zombili zezezimali kanye nezinsizakalo ezinikeziwe. Izikhungo zokunakekelwa okuphuthumayo ngokuvamile zazingenaso okunye okuzosinikela ngaphandle kwehhovisi likadokotela. Iminyango yezimo eziphuthumayo, ngakolunye uhlangothi, yayiyizindlela zokusindisa impilo. I-ER ingakwazi ukusingatha noma yini.
Manje ukuthi iziguli ezibhekisiwe ziya ezindaweni zokunakekelwa okuphuthumayo ezinombolweni ezinkulu, iphesenti enkulu yeziguli ezingaqinisekisiwe zasala zelashwa emnyangweni ophuthumayo. Izindleko zokunakekelwa kwempilo zaqhubeka zikhuphuka njengoba izibhedlela zazama ukuhambisana nesisiguli esingaqinisekisiwe esingagunyaziwe. Abashuwalense baphikisana futhi wonke umuntu wagxeka iziguli ezingavunyelwe. Babenemigomo elula, bavame ukubuyela ku-ER izikhathi eziningi zokunakekelwa okufanayo. Ukwenza izinto zibe zimbi nakakhulu, iziguli ezingaqinisekisiwe zivame ukuba nezinkinga zezokwelapha ezingamukeleki emphakathini, ezifana nezindinganiso zempilo yengqondo noma ukulutha umlutha.
Umshwalense Omningi-Ingabe Uyosebenza?
I-push yokuthola abantu abaningi ababhekelelwe yisibambiso yabonakala njenge-panacea. Uma lezi ziguli ezingaqinisekisiwe zingaba nokufinyelela kangcono ekunakekelweni kwezempilo-noma ngakho-ke umcabango uya-bazofuna ukunakekelwa nodokotela wangasese kunokuvakashela i-ER.
Maye, bekungeke kube khona. Isibonisi sokuqala sifikile e-Oregon. Ukwandiswa kwezidakamizwa ngo-2008 kwenza ithuba elihle ukubona ukuthi ingabe umshuwalense owengeziwe ungabangela iziguli eza kudokotela kunokuba u-ER. Esikhundleni salokho, iziguli zaya emnyangweni wezimo eziphuthumayo nakakhulu. Uma uMthetho Wokunakekelwa Okungenakusiza ungene ngokugcwele, isenzo esifanayo senzeke kwezinye izifundazwe.
Ngisho Izinketho Ezengeziwe
Izikhungo zokunakekelwa okuphuthumayo zandiswe kanye nomshuwalense wezokwelapha, kodwa kanjalo nezikhungo zokunakekelwa kwezimo eziphuthumayo. Amakamelo okuphuthumayo e-Freestanding manje atholakale emazweni amaningi angama-35. Lezi ziyisiphambano phakathi kwesikhungo sokunakekelwa okuphuthumayo kanye no-ER. Banezinsizakalo zomnyango ophuthumayo, kodwa, njengesikhungo sokunakekelwa okuphuthumayo, abahlale benamathele noma behambisana nesibhedlela futhi badinga ukusebenzisa i- ambulensi ukuze bathole iziguli ekunakekelweni okuqondile.
Inguqulo engcono kakhulu yesikhungo sokunakekelwa okuphuthumayo (ngombono wami) ivela ngaphakathi komnyango ophuthumayo. Isiguli sihamba emnyango bese sibona umhlengikazi, ohlola isikhalazo bese ehambisa isiguli kwelinye lezindlela ezimbili: ER noma umtholampilo.
Izikhungo eziphuthumayo ze-Freestanding nezikhungo zokunakekelwa okuphuthumayo cishe zizohlala lapha. Ngaphandle kokuba umthetho wokunakekelwa kwezempilo usiphoqe ngendlela ehlukile, ukwehluleka kokusebenza odokotela jikelele kanye nezingokoqobo zezezimali zokunakekelwa kwempilo kubonisa imodeli ngaphandle komnyango ophuthumayo noma ehhovisi likadokotela. Ukunakekelwa kwezempilo kuyashintsha ngokushesha. Kunzima ukuqagela ukuthi siya kuphi, ngaphandle kokuya, hhayi ku-ER.
> Imithombo:
> (2017). Cdc.gov . https://www.cdc.gov/nchs/data/ahcd/NHAMCS_2011_ed_factsheet.pdf
> O'Malley JP, O'Keeffe-Rosetti M, Lowe RA, Angier H, Gold R, Marino M, Hatch B, Hoopes M, Bailey SR, Heintzman J, Gallia C, DeVoe JE. Izindleko zokusetshenziswa kwezempilo emva kokukhula kwe-Oregon ka-2008: Ukuhlukana phakathi kweqembu kanye nokuphakathi-Isikhathi phakathi kweqembu phakathi kwesikhathi esisha, ukubuyela kanye nokubhaliswa okubhalwe njalo. Ukunakekelwa komama . 2016 Nov; 54 (11): 984-991.
> Ucabanga ukuthi kwakuyisikhungo sokunakekelwa okuphuthumayo, uze uthole umthethosivivinywa. (2017). Izindaba ze-NBC . https://www.nbcnews.com/health/health-care/you-thought-it-was-urgent-care-center-until-you-got-n750906