Nzanga dzomumaruwa muUnited States yose yakaparapatika nokuwana kwoutano kwave kuri kunonoka kumativi omumaguta nomumaruwa. Kuparadza kwenzvimbo yenzvimbo inogarwa, vashandi vezvoutano vari kuderera, uye kuganhurirwa mune zvemari kunoparira mhinganidzo dzakakwana nokuda kwamamirioni eAmerica vanogara kure nezvipatara, nyanzvi, uye mabasa anodzivisa. Gavhuna vehurumende, vamire pamitemo yemiitiro yehurumende uye mibato yomunzvimbomo, vakavamba sevagadziri vemishonga yemishonga yemitsva. Kupfurikidza nemirayiro yezvo, mitengo yemitemo, uye kuiswa kwemari inodzo, vadzori vezvoutano, zviri kudzosa zvinodzorwa nokuwana zvinangwa zvemibato zvinobudirira zvemitengo. Nyaya iyi inonzvera mhingani dzinotarisana noutano hwomumaruwa dzinovakidzani dzinoshandisa kubhiri, kuvandudza puro yeutano, uye kutsigira nzanga dzinosiyiwa shure kwenzanga.

Matambudziko Anopfuurira Okuwana Kurapa Mumaruwa

Zvinetso zvinotarisana nezviverengero zvavagari vomumaruwa hazvisi zvitsva, asi zvakawedzerwa nokuchinja kwechiverengero chavagari vemo, dzvinyiriro dzemari, uye njodzi dzoutano dzavose zvakadai sedenda reCOVID-19. Kunzwisisa izvi denho dzinokosha kukuonga mhinduro dzemiitiro yakaitwa navatongi.

Kuvharwa Kwoutano Nokusimbiswa

Chifo cha2010, zvipatara zvinopfuura 130 zvomumaruwa zvakavharwa muUnited States, maererano nemashoko anobva kuCecil G. Sheps Center for Health Services Research paUniversity of North Carolina. Uku kuvhara kunosiya vagari vasina mabasa ekurumidziro, mibhedha inotarirwa, kana kuti marabhoritari namano okushandisa. Kune avo vanoramba varipo, chipatara chiri pedyosa chingava awa kana kuti kupfuura, chinogona kuva chinouraya muchinoitika chedenho yemwoyo, sitiroko, kana kuti nhamo yakakomba. Gavhuna vakadavi rakapindura nokuita purogiramu dzinopa kuti zvirongwa zvinotamburira nokuongorora zvimwe zvipatara zvakadai se [[FLT:]] uye zvipataradzo zvokumaruwa zvinowana nguva yapanwa.

Kushaya Basa Mumaruwa

Kuperevedza kwenyanzvi dzezvoutano munharaunda dzomumaruwa kwakakomba. H. Health Resources and Service Administration (HRSA) inodudza zviuru zveMabasa ezveutano Hurefureations (HPSS) mumaruwa. Nzvimbo dzomumaruwa dzine vanachiremba 13.5 pavagari 10 000, zvichienzaniswa na30,9 vari mumataundi. Nhengo dzinotambanukira kudarika vanachiremba: vanhu vomumaruwa vanoshaiwawo vanachiremba, vanachiremba vepfungwa, vanachiremba vepfungwa, uye vadzidzi vezvikwereti zvinowirirana nedzidzo yemari, mari shoma, mikana yenyanzvi, uye mikana yakaganhurirwa nokuda kwokusarudza miitiro yokumaruwa. Vatongi vose vanodzivisa kubhadhara mari yemhindu yokubhadhara mari yemari seyamupirwa yehurumende inodzorwa neyamumapuranga anodiwa nevadzidzi vomunyika dzomumaruwa, izvo zvinogona kubhadhara mari inosvika $20 000 000 mumari inopfumba yezvipfuro zvitatu muzvikamu zvishanu zvinenge zvinenge zvinenge zvinenge zvichishandiswa kugadzira kugadzirawo. “Vana vana vose vanowana vamazvikoro vanodzidza kuti vazvikoro

Kufamba Nemhinganidzo Dzenzvimbo Inogarwa Nenyika

Kunyange apo mabasa anenge aripo, kuasvika kungava anodzivisa. Vagari vomumaruwa kazhinji kazhinji havana zvokufambisa zvakavimbika, uye madaro kunzvimbo yokutarisira iri pedyosa anogona kupfuura makiromita matatu imwe. Mutoro uyu unonyanya kuremera mhuri dzakwegura, dzinowana mari shoma, uye idzo dzine migariro isingaperi inoda shanyo dzenguva dzose. Somuenzaniso, murwere ane chirwere cheshuga munzvimbo iri kure angada kufamba makiromita 60 nenzira imwe neimwe nokuda kwenzvero yenguva dzose, kushaiwa basa uye kutora ndyiko dzamafuta. Vanamabhinanyi vakaisa mapurogiramu ezvokufambisa , semabhasiro anofamba bhasiro, mabasa okufambisa, asingafambiri mishonga, uye makambani okufambisa zvoutano anounza zvakananga kunzanga. Dzimwe nyika dzakaitawo zvikoro zvinofambidzanwa nokutenda uye masangano anofambidzana kugadzira mapurisa.

Mwero Wakakwirira Wehosha Yemakemikari Nemisiano Youtano

Vagari vomumaruwa vanowanzova vakura, varombo zvikuru, uye vane mwero yakakwirira yemigariro isingaperi yakadai sehosha yemwoyo, chirwere cheshuga, uye hosha yemapapu isingaperi inodzivisa kupopora. Mukuwedzera, vagari vomumaruwa vane bviro huru yokupinda mumufambiro woutano wakakwirira sesvuta uye vane dzidzo dzakaderera dzoutano. Zvinhu izvi zvinobatanidza kuparira migumisiro youtano yakashata nemwero yakakwirira yekufa kwezvirwere. Masangano eDziko anoona nezvehosha dzeDaselse Control neTreatting (CDC) anoshuma kuti vagari vomumaruwa vanofa nezvinoparira zvinodzivisikarirwa zvikuru kupfuura zvizvarwa zvavo zvomumaguta. Vatongi vakapindura nokutungamirira madhipati ezvo zvoutano kuti vadzorerwe nokudzivirira mamiriro ezvoutano, kubatanidza zvirongwa zvezvipatarati zvechikoro, uye purogiramu dzezvirongwa zvemari dzinodzorwa kupfurikidza nemitemo yezverongedzero yezvero yezvero yezvemari.

Vatungamiriri Vehurumende Vakanaka Vari Kushandisa Kuvandudza Kuwana Kwavanoita

Gavhuna vane mativi akawanda emiitiro yavanowana. Zvichitsamira pamamiriro avo enyika, simba remari, uye zvinhu zvinokosha, vakatsvaka nzira dzakasiyana- siyana dzinotevera.

Kukura Kwengarava Dzakagadzirwa Nengarava

Telehealth yakaputika mukati medenda reCOVID-19, uye vatungamiriri vazhinji vehurumende vakakurumidza kutama kuti vaite kuti zvinhu zvivepo zechigarire zechigarire. Telehealth inobvumira varwere kubvunza nyanzvi mazana amakiromita kure vasingasiyi misha yavo. Vatongi vakawedzera kusvika uku kupfurikidza:

  • Kuparadzira kusvika kwapaburi retsono paInternet kupfurikidza namahofisi ehurumende akafara, wirirano dzavanhu vose, uye mari dzehurumende dzinoshandiswa kubva kuInfrastructure Investicement and Jobs Act.
  • Mitemo yeMedicaid yokufukidza shanyo dzemari nokuda kwemhatsa yakasiyana- siyana yemibato, kubatanidza utano hwendangariro, kutarisirwa kwehosha dzisingaperi, uye tarisiro yokudzivirira.
  • [ Kuisa mutemo unoisa [ unoda vabhadhari vemibhadharo kuti vadzorere mari yemari pawirirano neshanyo dzapachivande.
  • Kubatanidza mumizinda yetrehealth [ iyo inobvumira kiriniki dzomumaruwa kubatanidza nenzvimbo dzedzidzo yezvokurapa nokuda kwenzvero dziri kure muminda yakadai secardiology, dermatology, uye tsinga.

Somuenzaniso, nharaunda yeArkansas, pasi paGavhuna Asa Hutchinson, yakatanga Arkansas Telehealth Network, iyo inobatanidza nzvimbo dzomumaruwa dzinopfuura 400 nenyanzvi paUniversity of Arkansas for Medical Sciences. Nenzira yakafanana, Gavhuna weVirginia Ralph Northam akasaina murairo wechiremera wokuita basa rokuwedzera renyika yose, kuchitungamirira kumutemo wechigarire wekubvumira. Nhano idzi dzakaderedza zvikuru mitoro yokufamba uye dzakamirira nguva nokuda kwavarwere vomumaruwa.

Vagoveri Vezvemari

Kuti vagadzirise kushaikwa kwevashandi, magavhuna akaisa zvinhu zvakawanda zvehurumende mumabasa uye mapurogiramu okuisa pfungwa panzvimbo imwe chete. Izvi zvinosanganisira:

  • Mari inobhadharwa uye mapurogiramu edzidzo anopiwa kupfurikidza namadhipatimendi ehurumende outano kana kuti dzidzo yakakwirira. Somuenzaniso, Texas Physician Education Loan Refunger Program inopa $660 000 nokuda kwavanachiremba vanoshanda mumaruwa HPSA.
  • Marobhu akarongeka enzvimbo dzokugara pazvipatara namakiriniki omumaruwa, vachikurudzira vanachiremba vatsva kuti varambe vari munharaunda pashure perovedzo.
  • Tsamba nebhonasi nokuda kwavatarisiri vanorovedza munharaunda dzomumaruwa kwechiverengero chiduku chamakore.
  • Ricenfirence compacts nepakati penyika zvinoita kuti zvive nyore zvikuru kuti vatarisiri vashandise mitsetse yehurumende, iyo inokosha munzanga dzemiganhu netelemedicine. Interstame Medical Licenfisse Convention Convention, inogamuchirwa nenyika dzakawanda, inobatanidza muitiro wokubvisa tsvina nokuda kwavanachiremba vanoda kurovedza munyika dzakawanda.

“ purogiramu yeMo HealthNet” yeMike Parson, mutungamiriri waGavhuna, mari yokudzorerwa yakawedzera nokuda kwevanotarisira zvikuru munharaunda dzomumaruwa, kuchikuita kuti kuve kunobudirira zvikuru mune zvemari kugamuchira varwere veMedicaid. North Dakota, pasi paGavhuna Doug Burgum, akatanga gadziriro yechikwereti chemari yebasa routano chinopa mari inobhadhara $50 000 yechikwereti nokuda kwenyanzvi dzezvoutano dzendangariro dzinoshandisa muzviverengero zvakaderera zvomumaruwa.

Kunzvera Mugadziriro Dzoutano Dzomumaruwa

Kupfuudzira kuchengeta zvipatara zviripo zvichizaruka, magavhuna ari kutsigira zvivako zvitsva uye zvinenge zvava nenguva yazvino uno. Ikoku kunobatanidza mari yokuvandudza nokuda kwezvishandiso, kufutunurwa kwezvivako, uye ruzivo rwokugadzira zvinhu. Hurumende yeCalifornia, pasi paGavhura pepanhau Gavin Newsom, yakabvumira mamirioni $200 000 “Chipatara chapabhedha Chomupatara Chomupatara Roan Program, kubetsera kutamburira zvipatara zvokudzivisa kuvhara. Mukuwedzera, magavhuvhura akawanda akatsigira chipatarati Emetertenment Hos Hospital [RE) muenzaniso, izvo zvinobvumira zvipatara mutengo zviduku kuti zvitendere kumabasa ekurumidziro, kugamuchira mari inowedzerwa yeMedicare.

Magavhuna akawanda akatsigirawo kutangwa kwenzvimbo dzokurapa dzokumaruwa, uko vaongorori nevanodzidza nezvemarapitsi vakabatana pakupedza zvinhu zvinoenderana nezvinodiwa munharaunda.

Kuparadzira Medicaid Nokuderedza Kusashanda Kwemari

Inishuwarenzi yezveutano inyika inodzorwa zvikuru kuti ipedze nhamba yokupinda. Mwero usina kuiswa pachena munharaunda dzomumaruwa kazhinji kazhinji wakakwirira kupfuura mumarobha, uye vagari vomumaruwa vane bviro zvikuru rokuva vanoshumwa. Vatongi mukukura nyika vakashuma kusimudzirwa kukuru kwemari yechipatara chemaruwa nokuwana kwokushivirira kuti vadzivirire. Somuenzaniso, pashure pokunge Montana Medicaid yafutunurwa mu2016 pasi paGavhurain Steve Bullock, zvipataratis zvomuruwa zvakaona kuderedzwa 25% mumari inopfuurirwa. Gavhuna rePuturopuko.

Kupfuura Medicaid, magavhuna akashandawo kunyoresa vagari vomumaruwa mumisika yeinishuwarenzi youtano uye kusimudzira zvirongwa zvokuda kubhadhara. Kuchinjana kwehurumende, kufanana neizvo zvomuColorado neMinnesota, kwakagadziridza nhimbe dzokusvika kuvagari vomumaruwa, vachigovera vafambi vengarava vemomberi uye mitoo yokunyoresa yakapfava.

Zvimiro Zvitsva Zvemiedzo Nezvikepe Zvehurumende

Vatongi havasi kuita vari voga, vari kushandira ukama nehurumende yehurumende uye chikamu chavanhu kuti vagadzirire mapurogiramu anotsigirwa uye anodzoreka.

Masangano Anozvidavirira Mumiganhu Yekirechi

Vamwe vatongi vakakurudzira kuumbwa kwe Kuzvidavirira kwe [Masangano eCalcure) ayo anobvumira makiriniki maduku nezvipatara kukumbanira mibatanidzwa inotuswa nokuda kwokuchengeta varwere vane utano panzvimbo pokungogovera kurapa. Ava ACOS vanoshandisa varongi vetarisiro, maidi eAnalytics, uye murwere kukurumidza kudzora kuti vatarisire hosha dzisingarapiki nokuderedza chipatara. Hurumende yeIowa, pasi paGavhuna Kim Reynolds, yakagovera betsero yemikoro yokumaruwa kuumba ACOs, kuchiguma nendyiko yemikoro yakaderera uye yakavandudzika nokuda kwokutora rutivi rwaMedicauvation.

Vashandi Voutano vomunzanga Nevezera Ravo

Vachiziva kuti kuvimba kunokosha munzanga duku, magavhuna akawanda akatsigira kurovedzwa nokushandiswa kwevashandi vezvoutano vomunzanga (CHWS) vanowanzova vagari vomunzanga imwe cheteyo dzavanoshandira. CHWs inogovera dzidzo youtano, inobetsera varwere kufamba, uye inobatanidza namabasa enzanga. Nyika dzakawanda, kubatanidza West Virginia neKentucky, dzakagadzira mapurogiramu okuvaka nokudzorera mari yezvirongwa zveCCHWS mukati memapurogiramu avo eMédicaid. Iyi nzira yakabvumikisa kuva inoshanda mukutarisira transfer, diabetes, uye utano hwamai mumaruwa.

Kushandira Pamwe Namarudzi Orudzi

Muhurumende dzine zviverengero zvavagari vemo veAmerica vakatanhamara, magavhuna akashanda nehurumende dzamadzinza kuronga mabasa ezvoutano mumiganhu yehurumende. Indian Health Service (IHS) inoshumira mitezo yakawanda yedzinza, asi pfuma yayo inowanzova isina kukwana. Gavhuna vakapinda muzvibvumirano zvokutenga, mapepa edata, uye mabasa ekiriniki akabatana kuti afukidzwe. Somuenzaniso, nyika yeAlaska, pasi paGavhurarain Mike Duneleavy, yakabatana nemasangano ezveutano hwedzinza kuti vawedzere teleheath kunyoresa uye maretarasi anokosha kugura nharaunda huru, dzisina mugwagwa.

Kushanda Kwakaita uye Zvinetso Zvasara

Mitemo yaishandiswa nemagavhuna yakabudisa kufambira mberi kunooneka, asi misiyano inokosha inoramba iripo.

Nyaya Dzevanhu Vakabudirira

  • Kushandiswa kwemari munharaunda dzomumaruwa kwakawedzera ne 3 000% mudzimwe nyika chifo cha 2020, nemwero yegutsikano yokushivirira inopfuura 90%. Varwere vomumaruwa mushumo wakachengeta nguva nemari, uye kunamatira kuri nani kutevera tarisiro.
  • [[NT:0] Chikwerete chemari yemari inobhadharwa paruwa chakaisa mazana ezvipo munzanga dzisina kuchengetwa. Somuenzaniso, Virginia State Loan Refunger Program yaisa vatarisiri vakuru vanopfuura 150 mumaruwa HPS Sezvifo zvayakatanga.
  • Recuruction mukuvakwa kwezvipatara zvinodzivisika munyika dzine gadziriro dzakasimba dzezvoutano dzenzanga uye ACOS.
  • Kuvharwa kwechipatara kwakaderedza mumashoko ayo akaisa mari yerashingidzo nokutendeutsirwa kumufananidzo weREH. Mukuwirirana neSheps Center, mwero wokuvhara wakaderera kubva paavhareji yegore negore ye 15 kusvikira ku 9 mumakore maviri anotevera kusumwa kwerouta yeREH.

Mhinganidzo Dzinoramba Dziripo

Pasinei zvapo neiyi miuyo, vagari vazhinji vomumaruwa vachiri kutarisana nezvinetso zvakakomba zvokuwana. Nzara dzebasa dzinopfuurira[; hurumende inofungidzira kuti mativi okutarisira makuru 20 000 anodikanwa kubvisa mazita eHPSA mumaruwa. [[FLT]] Broadbandband kusvika [[[FLT:]]] zvinongoringana: kunyange zvazvo Infractive Infactive Information Invementmentmentmentmental Invementalmentalmentalments [mabhiriyoni 20 000 000 000 000] echipo, nharaunda zhinji dzomumaruwa dzinoramba dzisingasarudzirwi kana kuti dziri pasi pechipfuri, dzinosvika pasi pezvikamu zvikuru. Zvikamu zvizhinjisariranwa zvemaruwa. [5], zvichipfuutsariranwa , zvisingashandurwi zvikuru, zvinopfuukwa namamirioni apasi pezvikamu]

Basa Remitemo Nezviwanikwa

Gavhuna havagoni kupedza kutarisirwa kwoutano hwomumaruwa voga. Mitemo yeFederal inosarudza zvisarudzo zvikuru zvehurumende.

  • Mitedhia neMedicaid mwero yemibayiro yemari [[[FLT: 1]: Mwero yakakwirira nokuda kwemigove yokumaruwa inovandudza dzikamo yezvemari. Centers for Medicare & Medicaid Services (CMS) yakatanga gadziridzo dzinoverengeka dzinoripirwa nokuda kwenharaunda dzomumaruwa, asi vatongi vakatsigira nokuda kwewedzero.
  • Zvirongwa nokuratidzira: Zvirongwa zvakafanana ne HRSA Federal Office yemapurogiramu outano hwemorural Policy inopa [ zvinogovera mari nokuda kwemari yemari, mabasa, uye kuvandudzwa kwenzvimbo. Magavhuna akawanda akashandisa idzi mhindu kuhurumende.
  • Kuchinjika kwemitemo: Miteve yetelehealth, vashandi vepachipatara, uye mutoo wetsika zvave zvave zvakaoma. Vatongi vakashanda neCMS nehurumende kuti vaite kuti zvirwere zvakawanda zvive zvechigarire.

Zvibvumirano zveHurumende, zvakadai se Kubatanidza 1115 Mdicaidrs , inobvumira nyika kuedza mitoo mitsva. Somuenzaniso, Ohio yakagamuchira murambidzi wokutyaira bhiza re “misha inochengeteka” muenzaniso wevarwere vane migariro isingaperi muruwa Appalchia, kubatanidza utano nohukuru hwetsika.

Kutarira Mberi: Nhungamiro Dzomunguva Yemberi Dzavanagavhuna

Muganhu unotevera wokuwana mishonga mumaruwa uchabatanidza kubatanidzwa kukuru kweruzivo rwokugadzira zvinhu, kushandiswa kwakawedzerwa kwevanopa zvokudya, uye kuramba vachiisa pfungwa pakudzivisa utano munzanga.Gavhuna angangoda kutsigira:

  • Kuwanda kwemiitiro yerovedzo nokuda kwemuitiro wakakwirira wavakoti vakanyoreswa (APRNS), vabetseri vachiremba (PAS), uye vagadziri vemishonga kuti varovedze panzvimbo yerezenisi ravo, uko kunogona kuwedzera kusvika mukushayikwa kwavanachiremba.
  • Kushandiswa kwokutarisira murwere kuri kure [[[FL:1] nemidziyo inoshata kubata migariro isingaperi, inotsigirwa nokuisa mari muhurumende mugadziriro dzoutano ID.
  • Nzvimbo dzoutano dzakasimba zvikuru dzakavakirwa pachikoro idzo dzinogovera tarisiro huru, utano hwendangariro, uye meno kuvana munharaunda dzomumaruwa, kazhinji kazhinji dzinowanira mari kupfurikidza nezvipo zvehurumende.
  • Kubhadhara mari inoripirwa yakavakirwa pakuchinja kunotusa muuyo panzvimbo pokuwanda, kuchibvumira vatarisiri vomumaruwa kuisa mari mukudzivirira nokutarisira.

Magavhuna anoverengeka ari kunzverawo mibatanidzwa yenzvimbo dzapakati dzetelehealth ntreasure, mishonga yokudzoserazve, uye kunyange kugoverana mashoko outano hwavanhu kuti azive zvinodikanwa zvinobuda munharaunda dzomumaruwa. mhoteredzo inodzorwa iri kugadzikiswa nguva dzose, uye vatongi vari kushandisa manzwi avo kuumba kutonga kwemubatanidzwa weNational Garvers Association uye kutungamirira Hurumende.

mhedziso

Kuwana kwoutano hwomumaruwa hakusati kuri chinetso chimwe asi muunganidzwa wenhau dzakabatanidzwa dzinobatanidza nzvimbo nenzvimbo, mari, uye muitiro. Gavhuna vakapinda mberi nemupimo mukuru wegadziriro dzoutano dzomunzvimbomo: kuwedzera mugwagwa, kupa kurudziro dzemari kugovera, kuisa mari mumitengi, kuwedzera bhadharo yeinishuwarenzi, uye kusimudzira kuvandudza mukupfuudzwa kwezvokutarisira. Nepo idzi nhamburiko dzakaita varavi vane revo ine revo nerevo, mitoo yezvoutano mishomanene yomunzvimbomo, mugwagwa wakasimba zvikuru unoramba uri mberi. [[FLT:]] Nhevedzo yezvero yezvemari yePunition Hub[FLT:] inosimbisa kuti vanhu vomumaruwa vapfuurireyi vapfuurire kuwana miuyo ine utano hwakashata, uye mukahanya pakati pemaruware ezvizvarwa nemaguta makuru, uye kubatanidzwa nenzanga yenzanga dzinova dzinova dzinova dzinopfuurira mberi pabasa nokuda kwoukuru, asi dzinopfuudzira kupfumisa kupfumisa kupfumisa.