Ingabe Iziguli Zithola Imali Yabo Imali?
Uma unenkinga yangemva , useningi. Ukulinganiswa kuyahluka, kepha cishe u-60% kuya ku-80% wethu uzothola ubuhlungu obunzima emuva esikhathini esithile ekuphileni kwethu. Ngonyaka ka-2007 kuphela, abantu abadala abangaba ngu-27 base-US abaneminyaka engu-18 noma ngaphezulu (11% wabantu abadala) babika ukuthi babe nobuhlungu emuva, ngokusho kwe-Agency for Healthcare Research and Quality. Cishe abangu-70% balaba bantu - 19.1 million - udokotela ufune ukwelashwa, kusho i-agency.
Ithi futhi abesifazane abaningi (10.9 million) bathola ukwelashwa ngenxa yokubuhlungu kwabo emuva kunabantu (8.2 million).
Amazinga omzimba wezinhlungu zangemuva angase avela ebuhlungu obuhlobene nemisipha kanye nokuhamba okuhlobene nokulimala okungenzeka kube nokubulala okuphazamisa intambo yomgogodla. Izindaba ezinhle ukuthi isikhathi esiningi, ubuhlungu bomhlane buyaphumelela (noma ngokuncane noma ngokuphelele) okubhekiswe ngokuzivocavoca , ukwelashwa okulindelekile, kanye nezinye izindlela zokwelashwa .
Izingozi Zezingozi
Ubuhlungu bebukhoma bungenzeka cishe nganoma yisiphi isikhathi ngesikhathi sempilo. Ucwaningo lubonisa ukuthi izingane zisengozini, abasebenzi basengozini, futhi abantu abakhuthele abaneminyaka engama-35 no-55 basengozini. Abantu abadala kanye nabantu asebekhulile banengozi enkulu yokuwa, okungabangela ukwehluleka kwentamo . Ukucwaninga kubonisa nokuthi izakhi zofuzo zingadlala indima ekunciphiseni i-disc , okuvame ukubangela ubuhlungu.
Nakuba kungenayo iphrofayili ecacile yomuntu onenkinga yangemuva, inhlolovo ka-2008 eyabika kwi- Journal of the American Medical Association yabika izinga eliphezulu lezinkinga zomgogodla phakathi kwabafazi abamhlophe nomshuwalense womphakathi.
Abantu abakuleli qembu nabo babonisa ukuthambekela okukhulu okungenani isikhathi esifushane sokuntuleka kwemisebenzi, ukuba abadala, nokushada noma ubudlelwane obuzinikele.
Izindleko eziphelele
Ubuhlungu be-back isinye sezinkinga zempilo ezibizayo kakhulu, nakuba imithombo ihluka ngokuqondene nokuthi ikuphi lapho kunezimo ezivamile ezifana nesifo senhliziyo, isifo, umdlavuza, isifo sikashukela, nesifo samathambo.
Ngokusho kwe-AHRQ, ngo-2007 inani elilodwa lamaRandi ayizigidi ezingu-30,3 likhokhwa kubahlinzeki, njengabadokotela, abahlinzeka ngemithi , nabanye ama-pharmacy. I- Journal ye-American Medical Association ibika ukuthi izindleko zokunakekela umhlane zifinyelela ku-$ 85.9 billion ngo-2005.
Kodwa ukwelashwa kwesikhashana kuyingxenye yemboni yezempilo ye $ 2.2 trillion. Nakuba izindleko zazingaphezulu (ngokweqile, ngombono wami), imibiko ye-AHRQ imelela kuphela u-3% wezindleko zezokwelapha eziphelele kuphela e-US ngo-2007. I- Journal of The American Medical Association ithi ukuhlupheka okuphansi emuva (okuwukuphela kwodwa) kwaba yi-2% bonke abavakashele udokotela ngo-2005.
Izindleko Ezijwayelekile Zabantu Abagulayo Ngamanye
Ucwaningo lwango-2008 olwakhulunywa yi- Journal of the American Medical Association okukhulunywe ngaye ngenhla ludinga cishe abangaba ngu-23 000 abantu abangenazo izinkinga zempepha mayelana nokuthi izindleko zabo zezempilo ziningi kangakanani. Abacwaningi bathola ukuthi ngokwesilinganiso, abantu abanezinkinga zangemuva noma ezintanyeni basebenzisa imali engaba ngu-6 690 ngo-2005, kanti izinsizakalo zabo zempilo ezinempilo zilinganiselwa ku $ 3,056 ngonyaka owodwa. I-AHRQ ibika ukuthi ngesinye isikhathi ngo-2007, izindleko zokwelapha izimpumputhe zazibalelwa ku-$ 1500- $ 1600 ngomuntu ngamunye.
Esikhathini esiningi, i-AHRQ ithi, imali yokuvakashelwa kwamahhovisi kanye nemithi ehlanganisiwe yabhalwa ngumshuwalense wangasese (45.2%).
Kodwa i-Medicare ikhiphe ngo-23% kanti wena, umthengi wezempilo, ukhokhe cishe ngo-16.8% wezindleko zakho zokwelashwa ngendlela yezindleko zangaphandle.
Futhi, baseMelika bachitha cishe ama-dollar ayizigidi eziyizinkulungwane ezingu-7 emapokothini abo okunye okwelashwa okwelapha emuva konyaka ka-2007. Qaphela: Le nombolo yafika ngokubala amaphesenti wezindleko eziphelele ($ 33.9 billion) esetshenziselwa i-CAM ngenxa yobuhlungu emuva (17.1%) nobuhlungu bentamo (5.9%), ngokusekelwe kolwazi oluhlinzekwa yiNational Center for Complementary and Alternative Medicine website (NCCAM).
Ukuphumelela kokwelapha
Mhlawumbe okuphazamisayo nakakhulu kunezindleko eziphakeme zokunakekelwa yiqiniso lokuthi izindleko zokwelapha sezilokhu zenyuke iminyaka eminingi ngaphandle kokuthuthukiswa okuhambisanayo nekhwalithi yokuphila kwabathengi bezempilo.
Ngokusho kwe-AHRQ, izindleko zokuqoqa ubuhlungu emuva ziphindwe kabili kusukela ngo-2004, kanti inhlolovo ye-Journal of the American Medical Association ithole ukuthi izindleko eziphelele zokunakekelwa kwentamo nensizakalo yenyuka zanda ngo-65% phakathi kuka-1997 no-2005.
Nakuba izindleko zokunakekelwa emuva zanda ngokushesha kakhulu kunokunyuka kwezindleko zokunakekelwa kwempilo ngesikhathi esifanayo (ngokunyuka okuncane nje kwenani labantu abafuna ukwelashwa ngenxa yezinhlungu zabo emuva), lolu cwaningo alutholakele "ukuhlonishwa" kwezempilo empilweni abaphendulile. (Abacwaningi babuza abaphendulile ukuthi bahlole isimo sabo sezempilo, futhi babuze imibuzo mayelana nokukhubazeka, ukusebenza, ukunciphisa umsebenzi kanye nezindima zomphakathi.)
Pho, imali eyengeziwe yahamba kuphi? Imithi iphakamisa uhlu, ilandelwa ukuvakasha kwamahhovisi. Abacwaningi basikisela ukuthi "ukusetshenziswa okubanzi kwezidakamizwa ezintsha kungase kubhekane nokunye kwalokhu kwanda." Imithi emisha ihlanganisa i-gabapentin, i- fentanyl , ne-oxycodone yokukhululwa kwesikhathi. Abacwaningi baphinde bathi ngemva kuka-2003, lapho i-COX-2 inhibitors isuswe emakethe, ukusetshenziswa kwezidakamizwa zobuhlungu be-narcotic ngenxa yobuhlungu bomgogodla banda.
Imithombo:
UMartin, B., Deyo, RA, et. al. Izindleko Zokuqala Zokunikezwa Nezimo Zempilo Phakathi Kwabantu Abadala abanezinkinga ze-Back and Neck. I-JAMA. 2008; 299 (6): 656-664.
Isikhungo Sikazwelonke seMithi Ephelele Neyomunye. Ukusetshenziswa kweMithi eQinisekayo neyezinye izindlela e-United States: Imininingwane Yezindleko.
Soni, A. PhD. Izinkinga Emuva: Ukusetshenziswa Nezindleko Zabantu Abadala base-US , 2007. Isifinyezo seSatisiti # 289. Inhlolovo Yomphakathi Wezindleko Zezokwelapha. I-Agency for Research and Health Quality.