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Inani elikhulayo le abazali abaphelelwe ithemba baletha izingane zabo ezigula ngengqondo emagumbini aphuthumayo, njengoba iningi lama-ER ezibhedlela lingahlonyiselwe ukusiza ngale kokubhekana nezinkinga zokuphepha ngokushesha.
Ucwaningo olusha olushicilelwe kujenali ye-Pediatrics ka-March 2023 (eyanyatheliswa ku-inthanethi ngo-Feb. 13) lwahlaziya isizindalwazi se-Medicaid futhi lwathola ukuthi ngaphezu kuka-26% wezingane ezivakashele i-ER ngezinkinga zempilo yengqondo waphindela esibhedlela phakathi nezinyanga eziyisithupha.
Ukwengeza, cishe uhhafu walezo zingane wabe usulandelelwa ukunakekelwa kwezempilo yengqondo zingakapheli izinsuku ezingama-30, kusho ucwaningo, olunesihloko esithi “Ukulandelela Ngemva Kokuvakasha Kwezimo Eziphuthumayo Zezempilo Yengqondo.”
I-OPIOID ENTSHA IYAQHUBEKA NJENGOBA IZIKOLE ZIBABAZA UKULWA NOBHUBHEDENI
Umbhali oholayo wocwaningo, uDkt. Jennifer Hoffmann, udokotela ohambela izimo eziphuthumayo kanye nomsizi kaprofesa wezifo zezingane e-Ann & Robert H. Lurie Children’s Hospital. waseChicagoutshele i-Fox News Digital nge-imeyili, “Kuningi kuphela okungafezwa ngesikhathi sokuvakasha kwe-ER okukodwa.”
Wengeze wathi, “Inhloso enkulu wukucacisa izinga ukunakekelwa kwempilo yengqondo okudingwa yinganekungakhathaliseki ukuthi ukulaliswa kwabagula ngengqondo esigulini esilalisiwe noma izinsizakalo zeziguli ezingalalisiwe, nokuxhuma ingane nokunakekelwa okuqhubekayo.”
Kube nokukhuphuka kwenani lezingane eziza ku-ER ezinokucindezeleka, ukuthambekela kokuzibulala, izinkinga zempilo yokuziphatha kanye nezinye izinkinga zempilo yengqondo, ngokusho kocwaningo olusha. (Izithombe zeTetra nge-Getty Images)
Amazinga aphansi okulandelela ngemva kokuvakasha kwe-ER ayinkomba yesistimu yengqondo ephukile yezingane, u-Hoffmann ukholelwa ukuthi.
Idatha yocwaningo yayisekelwe kusampula yezingane ezingu-28,551 ezinhlelweni ze-Medicaid eziphakathi kweminyaka engu-6 nengu-17 ubudala ezivakashele umnyango wakwa-ER ngenxa yesimo esiphuthumayo esihlobene nempilo yengqondo phakathi kukaJanuwari 2018 noJuni 2019.
Izingxenye ezintathu kwezine zalezo zingane zazinokuxilongwa kwempilo yengqondo okungaphezu kokukodwa, kodwa ngezinjongo zocwaningo, ngayinye yabelwa eyodwa.
Amaphesenti angamashumi amathathu nesishiyagalolunye ayenezinkinga zokucindezeleka, i-25.1% yayinokulawula ukucindezeleka noma ukuphazamiseka kokuziphatha, i-14.2% yayinezinkinga zokuhlukumezeka noma ezihlobene nokucindezeleka, i-8.2% yayizilimaza futhi i-13.5% inezinye izimo.
Inkinga yempilo yengqondo yezingane ihlukumeza uhlelo
Ubhubhane lwe-COVID kwabangela inkinga yezempilo yengqondo eyaziwa kabanzi.
Phakathi kuka-March 2020 no-Okthoba 2020, idatha ye-CDC ibonisa ukuthi ukuvakasha kwegumbi lezimo eziphuthumayo okuhlobene nempilo yengqondo kukhuphuke ngo-31% ezinganeni ezineminyaka engu-12 kuya kwengu-17 kanye no-24% ezinganeni ezineminyaka engu-5 kuya kwengu-11, uma kuqhathaniswa nonyaka odlule.
“Sisiza ekuqiniseni izingane ezisengozini eseduze,” kusho omunye udokotela wezifo eziphuthumayo zezingane, “kodwa ekugcineni zidinga ukungena ekwelapheni iziguli ezilashwayo ukuze zithole ukwelashwa kwengqondo noma imithi yokucindezeleka yesikhathi eside nanoma yiziphi zalezo zinto.” (REUTERS/Mike Blake)
UDkt. Anna K. McFarlin usebenza kwezokwelapha eziphuthumayo zezingane esibhedlela Sezingane eNew Orleans.
Uthe ubone ukunyuka kwesibalo sezingane eziza nazo kwi-ER ukucindezeleka, ukuthambekela kokuzibulala, izinkinga zempilo yokuziphatha kanye nezinye izinkinga zempilo yengqondo.
“Ekugcineni, singodokotela bezimo eziphuthumayo nodokotela bezingane, hhayi odokotela bengqondo.”
“Ngicabanga ukuthi umbono oyiphutha omkhulu wukuthi siyakwazi ukulungisa inkinga noma siqale ukwelashwa ku-ER,” kusho uDkt McFarlin etshela iFox News Digital engxoxweni yocingo.
“Ekugcineni, singodokotela bezimo eziphuthumayo nodokotela bezingane, hhayi odokotela bengqondo. Isibhedlela sinodokotela wengqondo ongena ingxenye ethile yosuku, kodwa akatholakali 2/47 ku-ER.”
Leso simo sisezingeni elihle ezweni lonke, kusho udokotela.
Sesikushilo lokho, uma kukhona ukukhathazeka ngokushesha kwezokuphepha – okufana nezingane ezisabisa ngokuzilimaza zona noma abanye – uDkt. McFarlin uthe i-ER ingasiza ukwenza lula ukwelashwa okufanele, kodwa ayikuhlinzeki ngempela lokho kwelashwa.
Phakathi kukaMashi 2020 no-Okthoba 2020, idatha ye-CDC ibonisa ukuthi ukuvakasha kwegumbi lezimo eziphuthumayo okuhlobene nempilo yengqondo kukhuphuke ngo-31% ezinganeni ezineminyaka engu-12 kuya kwengu-17 futhi ngo-24% ezinganeni ezineminyaka engu-5 kuya kwengu-11 uma kuqhathaniswa nonyaka odlule. (iStock)
“Akufani nokusikwa engikwazi ukukuthunga ngikulungise ngikuthumele endleleni,” kusho yena.
“Kufana nokuya kudokotela wezinyawo ngenxa yenkinga yakho yenhliziyo – asibona nje udokotela onjalo. Sisiza ekuqiniseni izingane ezisengozini eseduze, kodwa ekugcineni zidinga ukwelashelwa ngaphandle kwe-psychotherapy noma umuthi wokucindezeleka wesikhathi eside noma iyiphi yalezo zinto.”
UDkt. McFarlin uthe uyabona ukuthi lokhu kungakhungathekisa, kokubili kodokotela abafuna ukukwazi ukusiza le mindeni – nakubazali nezingane ezinomuzwa wokuthi azinazo ezinye izindlela.
Inkinga ‘yokufinyelela izinsiza zezempilo yengqondo ezisekelwe emphakathini’
Ochwepheshe bayavuma ukuthi ukunakekelwa kwezempilo yengqondo okulandelwayo kuyisihluthulelo ngemva kokuvakasha kwabakwa-ER – kodwa ucwaningo luka-Hoffmann lwathola ukuthi iningi lezingane alizange likuthole phakathi nezinsuku ezingu-30.
U-REDDIT USER UBUZA UKUTHI WAYENEPHUTHA ‘EKUKHISHWENI’ INTSHA ONGAYO NGEMVA KOKUBA IMITHI EKHOHLISA
“Lokhu kukhombisa ukuthi izingane nemindeni inenkinga yokuthola usizo lwezempilo yengqondo ezisekelwe emphakathini ngemuva kokuvakasha kwabakwa-ER,” kusho uDkt. Hoffmann.
“Imindeni ingase ibuyele kwa-ER ngoba ayikho enye indawo engaya kuyo ukuze ithole usizo lwengqondo oludingwa yingane yayo.”
“Sisiza ekusimamiseni izingane ezisengozini eseduze, kodwa ekugcineni kudingeka zelashwe ngaphandle kokwelashwa kwengqondo noma imithi yokucindezeleka yesikhathi eside nanoma yiziphi lezo zinto,” kusho omunye uchwepheshe. (iStock)
Esinye isizathu sokuntuleka kokulandelela ukushoda kochwepheshe bezempilo yengqondo.
Idatha evela ku-American Academy of Child & Adolescent Psychiatry, ekomkhulu eWashington, DC., kubonisa ukuthi e-US, kunodokotela bengqondo yezingane nentsha abayi-14 kuphela ezinganeni ezingu-100,000.
Lokhu kushoda kuholela ezikhathini zokulinda isikhathi eside.
Isikhathi esimaphakathi sokulinda sezinsizakalo zezempilo zokuziphatha yizinsuku ezingama-48, kutholwe uMkhandlu Kazwelonke Wokuphila Kwengqondo yaseWashington, DC.
Cishe uhhafu wezingane ezivakashela i-ER ngezinkinga zempilo yengqondo ezithola ukunakekelwa kokulandelela zingakapheli izinsuku ezingama-30.
“Amazinga okukhokha kanye nembuyiselo yezinsizakalo zezempilo yengqondo aphansi kakhulu,” kusho uDkt. Hoffmann.
“Ngenxa yalokho, bambalwa kakhulu abangena kulo mkhakha. Amazinga okubuyisela i-Medicaid kumele anyuswe ukuze ahehe futhi agcine ochwepheshe bezempilo yengqondo.”
Ukunwetshwa kwezinsizakalo zempilo yengqondo?
Njengoba impilo yengqondo yezingane iyancipha futhi igebe labahlinzeki/lesiguli likhula, uDkt. Hoffmann uthe angathanda ukubona ngcono ukufinyelela ku-telemedicine kanye nokwandiswa kwezinsizakalo zezempilo yengqondo ezikoleni nasemahhovisi odokotela bezingane.
Umbhali oholayo wocwaningo olusha olumayelana nokunakekelwa kwezempilo kwezingane angathanda ukubona ukwanda kwezinsizakalo zezempilo yengqondo ezikoleni nasemahhovisi odokotela bezingane. (iStock)
“Sidinga ngokushesha ukutshalwa kwezimali okwengeziwe ukuze kwakhiwe abasebenzi bezempilo yengqondo nokwandisa izinsiza zomphakathi ezigxile ekuvimbeleni, ukuhlonzwa kusenesikhathi kwezidingo zempilo yengqondo kanye nokwelashwa kusenesikhathi,” esho.
“Lokhu kuzovimbela intsha ekubeni nezinkinga eziholela ekuvakasheni komnyango wezimo eziphuthumayo.”
E-US, kunodokotela bengqondo yezingane nentsha abayi-14 kuphela ezinganeni eziyi-100,000.
Njengesibonelo esisodwa, Uhlelo Lokufinyelela Kwezempilo Yengqondo Yezingane lusebenzela ukuxhuma odokotela bokunakekelwa okuyisisekelo nodokotela bengqondo yezingane ukuze kuboniswane ngocingo, ukuze izingane zithole ukunakekelwa ezikudingayo endaweni evamile futhi elula.
Ezinye izibhedlela zithatha izinyathelo ezintsha
Ezinye izibhedlela zithatha izinyathelo zokwandisa futhi zithuthukise ukunikezwa kwazo kokunakekelwa kwezempilo yengqondo.
Ngo-2020, Isibhedlela Sezingane i-New Orleans savula ama-Behavioral Health Pods emnyangweni wawo wezimo eziphuthumayo, esizinikezele ekuhloleni. izingane kanye nentsha ngezidingo zokuziphatha kanye nempilo yengqondo.
Ama-pods afana “namagumbi aphephile” anokufinyelela okuyimfihlo okuvikelekile, ifenisha ekhethekile nezinye izici zokuhlinzeka ngokunakekelwa okungcono kakhulu kweziguli.
Isibhedlela Sezingane Sikazwelonke e-Columbus, e-Ohio, siphinde savula umnyango wezimo eziphuthumayo ozinikele, kanti i-Connecticut Children’s – enezindawo eziningi esifundeni sase-Connecticut – inophiko lokubheka impilo yokuziphatha ngaphakathi kwe-ER yayo.
Ucwaningo olusha luthole ukuthi ucwaningo olwengeziwe luyadingeka ukuze kuqondwe ikhwalithi yokunakekelwa kwezempilo yengqondo izingane ezikutholayo ekunakekelweni okuphuthumayo kanye nokunakekelwa kokulandelela. (iStock)
Isibhedlela Sezingane sase-Lurie e-Chicago naso sihlela ukuvula iyunithi yokubheka impilo yokuziphatha enemibhede emihlanu.
Nakuba uDkt. Hoffmann ekholelwa ukuthi ukuba nendawo ethile ngaphakathi esibhedlela ukubhekana nezidingo zempilo yengqondo ngokushesha kuyisinyathelo esihle, uthe ngeke kuyixazulule inkinga yokufinyelela okulinganiselwe kwezinsiza zempilo yengqondo yomphakathi.
Ucwaningo lwakhe luphinde lwathola ukuthi ucwaningo olwengeziwe luyadingeka ukuze kuqondwe izinga lokunakekelwa ngokwengqondo izingane ezikutholayo ekunakekelweni okuphuthumayo kanye nokunakekelwa kokulandelela.
CHOFOZA LAPHA UKUZE UTHOLA UHLELO LOKUSEBENZA IZINDABA
“Izingane eziphephile uma zingaphuma kwa-ER zidinga ukunakekelwa okuqhubekayo emphakathini,” kusho yena.
Wengeze ngokuthi ngokombono wakhe, “Kufanele sinxuse abenzi benqubomgomo ukuthi banyuse uxhaso lwenhlangano ukuze baqinisekise ukuthi zonke izingane ziyakwazi ukuthola usizo lwezempilo yengqondo.”
I-Fox News Digital ifinyelele ku-ACEP, i-American College of Emergency Physicians, ekomkhulu e-Irving, eTexas, ukuze iphawule.
CHOFOZA LAPHA UKUZE Ubhalisele IPHEPHA LETHU LEZEMPILO
“Odokotela bezimo eziphuthumayo bangasiza enkingeni yezempilo yengqondo, kodwa sivame ukukhungatheka ngoba siyazi ukuthi kuningi okungenziwa,” kusho umongameli we-ACEP uChristopher S. Kang, MD, umlingani we-American College of Emergency Physicians.
“Amathuba okunakekelwa kokulandelela kanye nezinsizakalo ngokuvamile ayingxenye elahlekile ye-equation,” engeza. “Ukwandisa izinsiza zokunakekelwa kwezempilo yengqondo kungavimbela izimo eziphuthumayo futhi kuvale izikhala eziyingozi ekunakekeleni iziguli ezisengozini.”
