Ukunakekelwa kwezimo eziphuthumayo okusekelwe esibhedlela ukuphela kwendlela yokwelashwa abantu baseMelika abanelungelo layo elingokomthetho, kungakhathaliseki ukuthi bayakwazi ukukhokha.
I-Emergency Medical Treatment and Active Labour Act (EMTALA) yaphasiswa yiCongress ngo-1986 futhi idinga izibhedlela kanye nenkonzo ye-ambulensi ukunikeza ukunakekelwa kunoma ubani odinga ukwelashwa okuphuthumayo kungakhathaliseki ukuthi uyisakhamuzi, isimo esingokomthetho, noma ikhono lokukhokha. Umthetho ubeka ukuthi azikho izinhlinzeko zembuyiselo.
ER/ED njengendawo oya kuyo
Idatha yocwaningo lwe-New York State (2017-2018) ibhala ukuthi abantu abangaphezu kwezigidi ezingu-4 benza cishe ukuvakasha kwezigidi ezingu-7 ngonyaka eminyangweni yezimo eziphuthumayo esibhedlela (ED); nokho, azibangeli ukuba alaliswe esibhedlela. Ukungena ngokujulile esizeni esiyinhloko salokhu kuvakasha kwe-ED kubonisa ukuthi abaningi bebengase basizwe endaweni ehlukile, engabizi kakhulu yokunakekelwa okuyisisekelo noma yokuvimbela. Ukungabi bikho kwezinye izindlela kuholele ku-$8.3 billion ezindleko ezengeziwe embonini (Modernhealthcare.com). Kutholwe ukuthi amaphesenti angu-60 okuvakasha (izigidi ezingu-4.3) agxile ezimweni ezingapheli ze-6: isifuba somoya, isifo se-pulmonary obstructive, isifo sikashukela, ukwehluleka kwenhliziyo, umfutho wegazi ophakeme, kanye nezimo zempilo zokuziphatha ezifana nempilo yengqondo noma izinkinga zokusebenzisa kabi izidakamizwa.
Ezingeni likazwelonke, abantu abayizigidi ezingu-130 e-USA bavakashele isikhungo se-ED nokuvakasha okuyizigidi ezingu-35 okuhlobene nokulimala. Ekuvakasheni komnyango wezimo eziphuthumayo, abangu-16.2 million baholele ekutheni bangeniswe esibhedlela abangu-2.3 million okuholele ekutheni bangeniswe ezikhungweni zabagula kakhulu. Ekuvakasheni kweziguli, amaphesenti angu-43.5 abonakale emaminithini angaphansi kwe-15 ngamaphesenti angu-12.4 okubangele ukulaliswa esibhedlela futhi amaphesenti angu-2.3 kuphela aphetha ngokudluliselwa esibhedlela esihlukile (sezengqondo noma esinye) (Ifayela Lokusetshenziswa Komphakathi le-NHAMCS ka-2018).
Ucwaningo lwango-2018 lwathola ukuthi iqembu eliyinhloko elivakashela i-ED lingaphansi konyaka ongu-1, ngamaphesenti angu-52 abaneminyaka engu-75+. Izinga lokuvakashelwa kwe-ED kwabesifazane laliwukuvakasha okungu-44 kubantu abayi-100, ngaphezulu kwesilinganiso sabesilisa (ukuvakasha okungu-37 kubantu abayi-100). Ngo-2018, izinga lokuvakasha kwe-ED kubantu abansundu okungewona ama-Hispanic noma abantu base-Afrika baseMelika lalivakashelwe izikhathi ezingama-87 kubantu abayikhulu, laliphezulu kunamanani abantu bazo zonke ezinye izinhlanga nezinhlanga. Amazinga okuvakasha e-ED kubantu base-Hispanic noma baseLatino (abantu abangu-100 kubantu abayi-36) kanye nabamhlophe okungewona ama-Hispanic ayengama-100 kubantu abayi-35.
Izinga lokuvakashelwa kwe-ED laliphezulu ezigulini ezine-Medicaid (ukuvakasha okungu-97 kubantu abayi-100) elinenani eliphansi kakhulu leziguli ezinomshwalense wangasese (ukuvakasha okungu-23 kubantu abayi-100) (Isikhungo Sikazwelonke Sezibalo Zezempilo, Isigaba Sezibalo Zokunakekelwa Kwezempilo).
Amasistimu asendulo
Nakuba izinhlobo eziningi zezibhedlela zithinteka, inkinga yokuminyana inzima kakhulu ezibhedlela zasemadolobheni nezokufundisa. Ukuhlola okwenziwa yi-American Hospital Association ngo-2010 kwembula ukuthi izibhedlela zasemadolobheni nezokufundisa ezingaphezu kwamaphesenti angu-50 ezahlolwa zazinama-ED ayenamandla noma angaphezu kwamandla akhe. Okwandisa inkinga ukuthambekela okushaqisayo kwenani elinciphayo lama-ED kanye nenani elandayo lokuvakasha kwe-ED.
Ukuhlangana okubi
Nakuba bonke abakwa-ED bezabalaza nezinkinga zokuminyana kanye nezilinganiso ezinwetshiwe zabasebenzi nesiguli, ukuxhaswa ngezimali okuncane, izingqinamba zezinsiza ngokuhambisana nenani labantu abasengozini enkulu kanye namaphutha okuxilonga ayingozi kakhulu kudala indawo eklanyelwe inhlekelele.
Ama-ED akuyona indawo yokugcina yeziguli eziningi kodwa kunalokho ikhefu endleleni eya kwenye indawo (okungukuthi, ikhaya, iyunithi ekhethekile, umbhede weziguli) okuholela ekutholakaleni kwemibhede yezimo eziphuthumayo ngokuvamile ngomusa wezinsiza ezilinganiselwe zeminye iminyango yesibhedlela. kanye namanye amayunithi ohlelo lokunakekelwa kwezempilo.
