Ukuhluleka Kwezinso, Dialysis, Transplants, nokuningi
Izinso ziyizimbilini ezihlangene ezingasemuva kwesisu esiseceleni komgogodla. Bayibophezele ukuhlunga igazi, ukulinganisa i-electrolytes (isb., I-sodium, i-potassium), nokususa uketshezi okwedlulele nokudaka emzimbeni. Ngaphandle okungenani okungenani eyodwa kwezinso ezisebenzayo, awukwazi ukuhlala.
Kungase kube nezikhathi lapho izinso zakho zizabalazela ukusebenzela konke okusemandleni abo.
Lezi zinkinga zingase zibe umphumela wokungcoliswa kwamanzi, ukuvezwa kwamakhemikhali, ukutheleleka , noma noma iyiphi inamba yokucindezeleka. Ezimweni eziningi, izinso zizophola uma inkinga ebalulekile ilungiswa.
Kwezinye izimo, ungabanjwa nesifo sezinso eside. Eqinisweni, i-National Institute of Diabetes and Digestive and Kidney Diseases ibika ukuthi amaphesenti ayisishiyagalolunye amaMelika anesifo esithile esingenasifo senyanga , ngifakwe nge-V. Uma leso sifo esingapheli sifo siphula ngokwanele (isigaba V), uzothola isifo se-renal sokugcina (ESRD), okusho ukuthi izinso zakho zihluleka. Ngaphandle kwe-dialysis noma ukufakelwa komzimba, impilo yakho isengozini.
Abantu abangaba ngu-660,000 e-United States bahlushwa yi-ESRD abangaphezu kuka-468,000 ku-dialysis futhi abangaba ngu-190,00 abaphila nokuguqula izinso. Abantu abangaphezu kuka-93 000 baseMelika manje balinde ukufakelwa kwezinso .
Ukufaneleka nokubhalisa ku-Medicare
Ukuba nesifo sokuqeda isiteleka sokuphela kungakufanelekela ku-Medicare.
Njalo kunjalo ngisho noma ungakabi naminyaka engama-65 ubudala. Ungacabangi ukuthi uhulumeni ukhululekile. Kunezinye izindlela okufanele nazo zihlangane nazo:
- Kumele ukwanelise izidingo zokufaneleka zokuba uMshuwalense Wokukhubazeka Kwezenhlalakahle noma Izinzuzo zeBhodi YezeMhlalaphansi.
- Wena, oshade naye, noma umgcini wakho (uma ungumuntu othembekile) kumele ukuthi ukhokhe kakade okungenani amakhilomitha angu-40 (iminyaka engu-10) yentela yokukhokha ku-Medicare ne-Social Security.
Ngokungafani nabantu abanezinye izinhlobo zokukhubazeka, akudingeki ukuba ulinde izinyanga ezingu-24 ngaphambi kokuba ufanelekele uhlelo. Okufanayo kuya kubantu abane- amyotrophic lateral sclerosis (ALS) . Ngokushesha nje lapho izinqubo ezingenhla zihlangene, kufanele ufake isicelo se-Medicare . Izinzuzo zakho zokufinyelela kuzokwehla ezinyangeni ezintathu ngemuva kokuqala ukwelashwa kwe-dialysis.
Uma U-Dialysis
I-Dialysis ayiyona isayizi eyodwa ifaka konke. Yikholelwa noma cha, unezinketho. Ungathola i-hemodialysis (i-dialysis esebenzisa isihlungi esenziwe umuntu) noma i-peritoneal dialysis (i-dialysis isebenzisa i-membrane ye-peritoneal esiswini sakho njengesihlungi). Ungathola i-dialysis njengesiguli, njengesiphili, noma ekhaya. I-Medicare inikeza ukukhokhelwa ngayinye yalezi zinketho zokwelashwa kodwa ukuthi ikhokha kanjani inkonzo ngayinye ihluke:
- I-Dialysis yesifo esingelapheki: I- dialysis yesifo esithathelwanayo kusho ukuthi uyangeniswa esibhedlela ukuze uthole ukwelashwa. Lokhu kungase kube yilapho okokuqala uthola i-dialysis noma uma i-dialysis idingeka ngokushesha. Njengesiguli, ukunakekelwa kwakho kuzokhokhiswa ku- Medicare Part A. Lokhu kukwenza ube nesibopho sokudonswa kwe $ 1,316 ukuze uhlale esibhedlela ngasinye. Noma yimuphi udokotela onakekelayo oyitholayo esibhedlela uzokhokhiswa ku-Medicare Part B, okudinga ukuthi ukhokhe ukuqinisekiswa kwama-20% wamasevisi.
- I-Dialysis yokuphulukisa ngaphandle: I- dialysis yangaphandle ingenziwa ekliniki eqinisekisiwe ye-dialysis noma ngisho nasesibhedlela esivunyelwe yi-Medicare. Umehluko wukuthi awuvunyelwe esibhedlela njengesiguli. Izinsizakalo zokuphulukiswa kweziguli zikhokhwa ngaphansi kweMedricare Part B. Lokhu kusho ukuthi uzokhokha imali engama-20% yezinkokhelo ze-dialysis ngasinye. Lokhu kuzobandakanya ukuhlolwa kwe-laboratory, imithi, nokunakekela odokotela okusetshenziselwa ukwelashwa kwakho kwe-dialysis.
- I-Dialysis yaseKhaya: Ukuthola i-dialysis ekhaya (noma noma ikuphi okulula kuwe) kungaba yindlela ekhangayo kunazo zonke-isikhathi esihlakaniphile, kodwa ivela ngezingozi . I-Medicare Part B ikhokhela ukuqeqeshwa kwe-dialysis ekhaya ukusuka kusikhungo se-dialysis, ukuqeqesha wena nabanakekeli abazohlinzeka nge-dialysis ekhaya, nangokwakha imishini ye-dialysis, izimpahla kanye nemithi. Uzodinga futhi ukubona udokotela ophethe okungenani kanye ngenyanga. Futhi, ushiywe ukukhokha ukuqinisekiswa kwe-20%.
Uzofuna ukucabangela ukuthi ukwelashwa okuthe xaxa kuzokukhokhela kanjani ephaketheni ngaphambi kokuthi uzinikele kuhlobo olulodwa lwe-dialysis phezu kwesinye.
Uma Uthola Ukufakelwa Kwezinso
Njengoba kufana ne-dialysis yesifo sofuba, i-Medicare Part A izokumboza ukuze uthole ukufakelwa kwezinso . Lokhu kuzodinga ukuthi ukhokhe imali eyi-$ 1,316 yokudonswa kokuhlala esibhedlela kanye namaphesenti angama-20 okudonswa ngamasevisi odokotela abuyele ngaphansi kwe-Medicare Part B.
Yini ehlukile mayelana nokufakelwa kwezinso zezinso ukuthi i-Medicare izophinde ihlanganise izindleko ezigcwele zokunakekela umhlinzeki ophilayo. Wena noma umnikeli ngeke nidinge ukukhokhela ipenki eyodwa ngaphandle kwephaketheni lokunakekela kwabo, ngisho noma kunezinkinga ezivela enkambisweni .
Emva kokuthola ukufakelwa kwezinso, kuzodingeka ubeke izidakamizwa ze-immunosuppressive impilo yakho yonke. Lezi zidakamizwa zidinga ukuvimbela umzimba wakho ukuba unqabe izinso ezitshalisiwe. I-Medicare izokhokhela le mithi uma uM Medicare ehlanganisa ukufakelwa kwezinso zakho (okungukuthi, wawuseMedare Part A) futhi uma nje uqhubeka ube ne-Medicare Part B.
Ungalindeli ukuthi iMedare kufanele ikunake ngemuva kokufakelwa kwezinso, kodwa okungenani hhayi ukudonsa isikhathi eside. Bazohlinzeka ngokufaka izinyanga ezingu-36 ngemuva kokufakelwa kokugunyazwa kweMedare. Ngemuva kwalokho, uma izinso zakho ezintsha zihlala zisebenza, ngeke usakwazi ukuthola i-Medicare, futhi uzolahlekelwa ukufakwa kwakho. Yilokho okwenzekayo noma ngabe udinga ukuqhubeka nokwelashwa kwe-immunosuppressive.
Indlela kuphela izinzuzo zakho ezizoqhubeka uma ngabe useMedareri ngesizathu esithile, kungakhathaliseki ukuthi yikudala noma omunye ukukhubazeka .
Izwi elivela
Isifo sezinso yinkinga ekhulayo ezweni lethu, engozini izimpilo zabantu abangaphezu kuka-600,000 baseMelika. Ukuqonda ukuthi i-Medicare ihlanganisa nini, lapho kuqala ukuqala, nokuthi ungalindela kangakanani ukukhokhela lezo zinsizakalo yingxenye ye-puzzle. Yazi amalungelo akho futhi uthole ukunakekelwa okungcono kakhulu ngesikhathi esifanele.
> Imithombo:
> Umbiko wonyaka wonyaka 2016 - Isahluko 11: Izindleko zemithi zabantu abane-ESRD. Iwebhusayithi ye-United States Renal Data System. https://www.usrds.org/2015/view/v2_11.aspx. Ishicilelwe ngo-2016.
> Ukuphela Kwezinkinga Zamaqhwa E-United States. Iwebhusayithi ye-National Kidney Foundation. https://www.kidney.org/news/newsroom/factsheets/End-Stage-Renal-Disease-in-the-US. Kushicilelwe ngo-January 2016.
> Izibalo Zezifo Zezinso e-United States. I-National Institute of Diabetes ne-Digestive and Kidney Diseases iwebhusayithi. https://www.niddk.nih.gov/health-information/health-statistics/Pages/kidney-disease-statistics-united-states.aspx. Kushicilelwe ngo-December 2016.
> I-Waitlist Yokufaka Ukutshala Kwezinso - Okudingeka Ukwazi. Iwebhusayithi ye-National Kidney Foundation. https://www.kidney.org/atoz/content/transplant-waitlist. Kubuyekezwe ngo-Februwari 10, 2017.
> Ukwelashwa kwemithi yeDilysis Dialysis kanye nezinsizakalo zokuThunjelwa kwezinso. Amasevisi we-website ye-Medicare ne-Medicaid Services. https://www.medicare.gov/Pubs/pdf/10128-Medicare-Isibuyekezo-ESRD.pdf. Kubuyekezwe uMeyi 2016.