Kuchinja kwezvoutano kunogara panzvimbo yenharo dzezvamatongerwe enyika nedzenzanga munyika yose. Zvisarudzo zvinoitwa navanogadzira mitemo navakuru vakuru vanoumba upenyu hwavagari vemo, vanopesvedzera upfumi, uye vanosarudza utano hwose hwevagari vemo. Chinjo imwe neimwe inokarakadzwa inobatanidza kutengesa(no kushandura kunogona kuwedzera muuyo uri wose unodikanwa. Vagadziri vemitengo vanofanira kuyera zvinhu zvinokosha zvinokwikwikwidzana zvakadai sokuwana, kunaka, mutengo, uye kuchengeteka. Kunzwisisa uku kushambadza kunokosha nokuda kwezvisarudzo zvokuziva zvinotungamirira kukubudirira, kukwaneka, uye gadziriro dzoutano dzakasimba. Nyaya ino inonzvera bhizimisi guru revo revo revo revo revo, rinonzvera mipimo yavo, uye rinopa mamiriro ezvinhu okuongorora mitoo yokusarudza chaiyoiyo yenyika.

Kunzwisisa Kutengeswa Kwemitemo Yoruzhinji

Kushambadza kwemitemo kwavose kunoitika apo vagadziri vemitemo vanofanira kusarudza pakati pezvinonyanya kukwikwidzana. Mukuchinja kwezvoutano, uku kutengeswa kunogona kupesvedzera kusvika, kunaka, uye mutengo wekutarisira. Kuziva izvi kunobatsira kuongorora kushanda kwemagadzirisi anokarakadzwa. Trandoffs hadzisi dzokuda kukanganisa mararamiro adzo; panzvimbo pezvo, dzinomiririra zvinhu chaizvoizvo kuti zvinhu (jenacial , munhu, uye sangano) zvine parino. Chisarudzo icho chinobetsera boka rimwe kana kuti chinangwa chinowanzoisa mari pane chimwe. Somuenzaniso, kukwidziridza kushambadza kwehurumende kungawedzera kushandwa kwemitero kana kuti kuderedzwa kubhadhara mari nokuda kwemamwe mabasa avose. Nenzira yakafanana, kuderedza mutengo wemari kungaganhurnisa migove yemabasa akafukidzwa kana kuti kutakura varwere.

Kuchinja Kweutano Hwevatengesi

  • wekupinda.
  • Mutengo w.
  • Zv. Sarudzo dzapachivande
  • Tsika pfupi. Betsero Dzenhambo refu
  • Kugutsikana

Chimwe nechimwe cheizvi zvirongwa chinopa denho dzakasiyana. Somuenzaniso, kuwedzera kusvika kunzvimbo dzinotarisirwa dzoutano kungatungamirira kukumirira nguva refu uye kuderera kwekutarisira. Ukurukuriranisa pamipimo kungaganhurira kusvika kwavamwe vanhu. Kubatanidza pakati pezvinhu izvi kunoda kusanoongororwa nokudisa kubvumirana pane zvisina kufanira. Vagadziri vemitengo vanofanirawo kurangarira kusakwanisa kwezvamatongerwe enyika kwechinjo uye mipimo yenzanga yavanomirira. Kudyidzana kunogamuchirwa mutsika imwe kana kuti mamiriro ezvemari kungasafanira kutendwa mune imwe.

wekupinda.

Kuwana nzvimbo kumabasa okutarisira utano ivavariro inokosha yokuchinja. Zvisinei, kuwedzera kwokuwana kunogona kukanganisa kunaka kwetarisiro. Kunzwisisa uku kunokosha kuvagadziri vemitemo. Access COM (Induration) inowanika yemabasa, mari, nzvimbo, uye kugamuchirwa kwetsika. Uku kubatana kwekushanda zvakanaka, kune rumwe rutivi, kunobatanidza kushanda zvakanaka, kuchengeteka kwomwoyo, ruzivo rwokushivirira, uye nguva. Uku kukura hakuwirirani nguva dzose.

Kuoma Kwokuwedzera

Kana paine zvawakaronga, zvinovapo zvinoti:

  • vhoriyamu yokushivirira yakawedzerwa muzvipatara, zvinogona kukurira zvinhu zviripo.
  • [ Nhamo dzine chokuita navanopa varapi vezvoutano, kuchitungamirira kukuneta nokuderedza ngwariro pamurwere mumwe nomumwe.
  • Nguva refu dzinomirira kugadzwa, zvikurukuru nokuda kwamabasa asingafambiki.
  • [[[NHAU]] Chinoparira kuneta pakati penyanzvi dzezvoutano, uko kunogona kubvisazve vara.

Zvinhu izvi zvinogona kutungamirira kukuderera kwekutarisirwa. Somuenzaniso, fundo inobudiswa ne National Institutes of Health yakawana kuti mirau yakakwirira yemurwere kuinoita kuti pave nenzvimbo dzoutano dzenzanga yakabatana nokuderera kwekudzivirira uye kutarisirwa kwehosha dzisingaperi. Zvisinei, kuwedzera kwekuwana kwapakarepo hakudzikisi kana kukabatanidzwa nokutevedzerwa kwemari mumabasa, ruzivo rwokugadzirwa kwezvinhu, uye kutarisirwa. Nyika dzakafanana neUnited Kingdom dzakakwanisa kutambanurira pedyo nokuwanda kwezvokuwana zvinhu padzinochengeta kunaka kune mufungo kupfurikidza neNational Health Service, kunyange zvazvo nguva dzakamirira dzichiri nguva dzinova nhau inopfuurira.

Nenzira inopesana, kunyanyonangidzira ngwariro pavara kunogona kuganhurira kusvika. Ndyiko dzakakwirira, tarisiro yakakwirira ingagona bedzi kuwanika kune avo vanogona kuitenga kana kuti kugara pedyo nenzvimbo dzinoshandiswa. Vagadziri vemitemo vanofanira kudzikamisa chishuvo chokuwana masvingo makuru nokudikanwa kwokuchengeta mipimo yakakwirira yetarisiro. Imwe nzira ndeyokushandisa mabhii akanaka netsinhano yetsinhano kuti ishandiswe, sezvinoonekwa mumifanikiso yezvipo zvokutarisira zvinokosha.

Fundo Yenhau: Chirongwa Choutano cheOregon

Oregon Health Plan yakawedzera kufukidzwa kweMedicaid kuvakura vaiwana mari shoma muma1990. Nzvero dzakaratidza kuti kubhadharwa kwakavandudza kusvika kutarisiro nedziviriro yemari, asi miuyo yokutanga yakaratidzira kuvandudzika kukuru mumiuyo yomuviri pashure pamakore maviri. Ikoku kunoratidzira kukura pakati pokuwedzera kusvika nokuwana vara revara mukati menguva pfupi. Nzvero dzenguva refu gare gare dzakakarakadza betsero nokuda kwoutano hwendangariro nendyiko dzine ngwavaira, kusimbisa kudikanwa kwokurangarira zvose zviri zviviri nguva pfupi nemavara akareba.

Mutengo w.

Kumwe kushambadza kukuru mukugadziridza zvoutano kuri pakati pendyiko nebhadharo. Kuwedzera kunoda mari yakawedzerwa, uko kunogona kukwidza ndyiko nokuda kwemitero nehurumende. Nhamburiko dzokuva nendyiko dzinowanzobatanidza kuganhurirwa, kusimudzwa kwezvisingashandiswi, kana kuti mibatanidzwa yezvokuchengetera mari. Uku kunetseka kuri pakati penharo dzakawanda dzezvoutano, kubva paAffordable Care Act muUnited States kusvikira kuzvikarakadzo zvose zvezvoutano muCanada nomuEurope.

Vatapi Vane Basa Rokutarisira Utano Vachitsigira Mari

Nhungamiro dzokutarisira utano dzinoshandiswa pakushandisa dzinogona kubva mumanyuko akasiana - siana:

  • [ Mitero yakawedzerwa[ [somuenzaniso, kubhadhara mitero yemitero yemitero kana kuti mari inobhadharwa inoshandiswa kubhadhara kufutunurwa kweinishuwarenzi yavose.
  • Kuiswa chaikoiko kwezviwanikwa zvemari yemari zviripo(] kubvisa mari mudziviriro, dzidzo, kana kuti dzimwe nharaunda mutarisiro youtano.
  • [ Kuisa mari yechikamu [](kubatanidza zvikumbiro zvomushandirwi, mitero yeinishuwarenzi, uye mari yemari inobhadharwa.
  • Hurumende yokukwereta []

Manyuko okupa mari ane revo nokuda kwemibato yavose neteramo yemari. Vagadziri vemitemo vanofanira kurangarira nzira yokudzikamisa nayo kudikanwa kwokufukidza mutoro wemari unoiswa kuvagari vemo. Somuenzaniso, gadziriro yomubhadharo mumwe inogona kuderedza ndyiko dzehurumende uye kukurukura mitengo yakaderera yemirimo, ingaderedza mari yose. Zvisinei, kuchinja kungada mitero mitsva nedzokudzongonyedzwa kwemisika yeinishuwarenzi iripo. Mukuwirirana ne Lialysis in Health Affats, kutamira kugadziriro yokubhadhara mari imwe yemirimo muU.S.

Zvinhu Zvinoshandiswa Pakubhadhara

Hurumende nevarendi vanoshandisa mazano akasiyana - siyana kuti vave nemari inodhura pasina kuisa mari yavo:

  • [[[NHAU] , mutengo uchitenga uye kurukurirano
  • Reference princing
  • [ tarisiro yeManied
  • [[FT:0] Ndyiko-yakati (mue., muripo, zvinoshaikwa) kudzivisa kushandiswa kusiri madikanwa.

Zvisinei, kudhura kunovhiringidza: zvinhu zvinodhura zvingatadzisa vanhu kutsvaka kutarisirwa zvakafanira, zvichiita kuti vazorwara zvakanyanya uye vazorasikirwa neyakawanda.

Zv. Sarudzo dzapachivande

Gakava riri pakati pezvisarudzo zvezvoutano zvavose nezvinoitwa nomunhu oga rutivi rwakatanhamara rwekurukurirano dzechinjo. Nzira imwe neimwe ine betsero dzakajeka nedzisingabetseri, uye nyika zhinji dzinoshandisa gadziriro dzakavhengana nezvose zviri zviviri mativi avose naavanhu.

Betsero Dzokutarisirwa Kwoutano Hwavose

Gadziriro dzokutarisira utano dzavose dzinogona kugovera:

  • Kubhadharwa kusingawirirani [ nokuda kwavagari vemo vose, kuva nechokwadi chokuti hapana munhu anonyimwa tarisiro nemhaka yokusakwanisa kubhadhara.
  • Kurapa kwose kunodya mari [ kupfurikidza nokutarisira kwapakati nesimba rokukurukura.
  • Mitengo yakachekererwa [ nokuda kwemishonga namabasa, kazhinji kazhinji ichiwana ndyiko dzakaderera dzeboka rinoenzaniswa nemisika yapachivande.

Zvisinei, gadziriro dzavose dzingatarisanawo nedenho dzakadai sokuperevedza kwemari, mirangariro yehurumende inotonga yokushivirira, uye chisarudzo chakaganhurirwa. Nguva dzokumirira miitiro yokusarudza inogona kuva refu, uye kuvandudza kungava kushoma nemhaka yokuronga mari kusingadzorwi uye kushaikwa kwekurudziro dzezvokutengeserana.

Betsero Dzokutarisirwa Kwoutano Kwavoga

Gadziriro dzokutarisira utano dzapachivande dzinogona kugovera:

  • [ Chisarudzo chikuru zvikuru [ nokuda kwavarwere pamusoro pezvirongwa zvokugovera zvokudya, zvokurapa, uye inishuwarenzi.
  • [ Nguva pfupi zvikuru dzokumirira [ nokuda kweminamari, zvikurukuru nokuda kwaavo vane inishuwarenzi yakakwana kana kuti mano okubhadhara kunze kwechipo.
  • [ Tsitsi dzekuvandudza [ uye kuvandudzika kunosundwa namakwikwi nevavariro dzemhindu.

Zvisinei, iyi gadziriro inogona kutungamirira kukupesana mukuwana uye ndyiko dzakakwirira nokuda kwavanhu vasina kubhadharwa. Dzingaputsawo tarisiro, kuwedzera shoo yepamusoro, uye kuisa mabasa ane mhindu panzvimbo yeutano hwechiverengero chavagari vemo. Somuenzaniso, United States inopedza inenge 8% yendyiko dzose dzoutano pakudzora, ichienzaniswa ne 2-4% munyika dzine gadziriro dzemari shomanene, mukuwirirana nefundo ye Commonweal FF] Fution

Mienzaniso Yakavhengana: Ndeipi Yakanakisisa Munyika Dzose Dziri Dzose?

Nyika zhinji, dzakadai seGermany, Netherlands, uye Switzerland, dzinoshandisa gadziriro yavanhu yakadzorwa yeinishuwarenzi inodzorwa netarisiro yavose. Iyi mienzaniso inoedza kubatanidza kushanda zvakanaka nechisarudzo chemisika yavanhu netsika dzavanhu vose nedzokudzora kwendyiko. Dzinoda kuti mainshuwarenzi ave asingabetseri purofiti kana kuti anodzorwa zvikuru, tsikidzwa nehana, uye kushandisa gadziridzo yengozi kudzivisa kusarudzwa kwevanyoreswa vane utano hwakanaka. Kutengeswa kuno kuno kwakaoma: tsika yakavhengana inogona kuva yakaoma kudzora uye ingasiyazve mikata nokuda kwezviverengero zvakati zvavagari vemo.

Tsika pfupi. Betsero Dzenhambo refu

Vagadziri vemiitiro kazhinji kazhinji vanotarisana nechinetso chokuisa betsero dzenguva pfupi mberi kurutsuta rwapanhambo refu. Kugadziridza kwokukurumidza kungagovera nyaradzo yekurumidziro asi kunogona kutungamirira kunhau huru zvikuru mumugwagwa. Zvezvamatongerwe enyika (kazhinji kazhinji makore maviri kusvikira kumana) zvinokurudzira zvisarudzo zvinoparira miuyo inooneka pamberi pesarudzo inotevera, kunyange kana vakachengeta zvinetso nokuda kwenguva yemberi.

Mienzaniso Yezvigadzikiso Zvenguva Pfupi

Mimwe mienzaniso yezvinogadziriswa zvenguva pfupi inobatanidza:

  • [[[NHAU] Mari inowedzera [ nokuda kweMedicaid kana kuti zvipatara zvavose zvisingarangariri painenge iri mubato.
  • [ Kurapa kusingadzoreki kunofanira kudzorwa, zvakadai semari inobhadharwa mukati medenda, iyo inofanira kuchinjwa gare gare.
  • chinjo dzetsika dzinogara kwenguva refu, kufanana nedzoreso dzemitengo paboka rakati remirimo, idzo dzingashatisa misika pasina kuchinja gadziriro.

Somuenzaniso, kakawanda kushandisa mashoko okuwedzera kuti vana varambe vachishandisa purogiramu youtano yevana pasina kutsigira mari kwenguva refu kungaita kuti vasava nechokwadi uye vasakwanisa kutarisira.

Kuedza Kuchinja Kwenguva Refu

Nzira dzenguva refu dzingabatanidza:

  • Gadziriro yokutarisira utano inopa mhaka yechinjo[[FLT: 1] iyo inorongazve kurudziro, mienzaniso inobhadharwa, uye gadziriro dzokupa.
  • [ Kushandiswa mukudzivirira nokuedza kurapa vanhu [ kunoderedza mutoro wehosha yomunguva yemberi uye ndyiko.
  • [ Kushandiswa kwemienzaniso inotsigirwa nemari [, yakadai semitero yakatsaurirwa kana kuti maakaundi emari youtano, anogona kukurira kuderera kweupfumi.
  • Chikamu chemamongi [ kudzivisa kudzongonyedzwa uye kubvumira nguva yokugadziridza.

Zvisinei, zvingada ushingi mune zvematongerwe enyika uye kutsigirwa nevanhu. Betsero dzacho dzingasanyatsowanikwa kwemakore gumi kana kupfuura, zvichiita kuti dzive nyore kusiyiwa kana njodzi dzapakarepo dzikamuka.

Kudzikamisa Nguva

Gadziriro inoshanda inobatanidza mubatanidzwa wemipimo mipfupi nenhambo refu. Somuenzaniso, mukati medenda reCOVID-19, hurumende dzakakudza nokukurumidza kufukidza kwetelehealth ndokurembedza mimwe mirau (nguva pfupi), nepo dzichivambawo kutsigira gadziriro dzoutano dzavanhu nokunzvera mukugadzirwa kwenhomba. Unyanzvi hwokuchinja zvinhu huri kuziva apo kugadziridza kwenguva pfupi kuri madikanwa kudzikamisa gadziriro uye apo kutsinhanisa nokuda kwokuchinja kwokuvaka kuchabhadhara kwamakumi amakore.

Kugutsikana

Kunyange zvazvo isina kurongwa zvakajeka munyaya yapakuvamba, kufambidzana pakati pekukwana nokushanda kukuru kunokosha kukugadziridzwa kwezvoutano.Equity inonongedzera kukururamisira mukuwana, kurapa, uye migumisiro mumapoka avanhu akasiyana - siyana.

Mitemo inodzorwa nedanho rakadai sokuwanira mari zvipatara zvekotsekano, kugovera tarisiro yapachena kuvanhu vanowana mari shoma, kana kuti kupfuudza mitauro (zvingada mari shoma zvikuru kupfuura mitoo yokushandisa. Zvingada mari yokudzora kuti itsive zvinhu, kana kuti vangagovera pfuma kumapoka anodhura zvikuru kuti ashande. Nenzira inopesana, mitemo yokubudirira yakadai segadziriro dzoutano dzinobudirira zvikuru kana kuti kubatana kwechipatara zvingakuvadza zvikuru vanhu vanotapurwa.

Somuenzaniso, fundo mu JAMA yakawana kuti kufutunuka kweMedicaid kwakaderedza paradzano yedzinza muhuwadzano asi kune miuyo yakavhengana pamhatsa mumiuyo youtano. Masangano anofanira kusarudza kuti ibasa rakadini ravanodisa kurega kuita nharidzano dzechinowirirana, kana kuti nzira yokuita nayo miitiro iyo inosvika kupfurikidza nezviito zvenguva itsva zvakafanana nemiripo yakarongwa yengozi nemiitiro yomunzanga yezvoutano.

mhedziso

Kunzwisisa mitoo yehurumende yokuchinja zvinhu mukugadziridza zvoutano kunokosha mukugadzira mitemo inobudirira. Nokuziva kuoma kwekuwana, kunaka, mutengo, kufukidza, kufambidzana, vapangi vanogona kushanda kumhinduro dzinowirirana nezvinotsiva. Nguva yemberi yezvoutano inotsamira pazvisarudzo zvine ruzivo izvo zvinorangarira zvose zvinodikanwa zvekurumidziro nezvinotsigirwa kwenguva refu. Hapana gadziriro yakakwana inotengesa inoratidzira mipimo nepfuma zvenzanga. Vagadziri vemitengo vanofanira kubatanidzwa noufakazi, kuteerera manzwi akasiyana - siyana, uye kuramba vanozvininipisa pamusoro pemiganhuro ipi neipi yokuchinja. Kuita kudaro, vanogona kutungamirira iyi zvisarudzo zvakaoma uye kuvaka gadziriro dzoutano dzinobatira zvakanaka vanhu vavo munguva yemberi.