Ukuqonda Ukutholakala Kwezempilo Kwendawo: Isisekelo Somphakathi

Ukukwazi ukunikeza isibhedlela sokwelapha endaweni kungukuhlakanipha kwabantu ukuthola izinkonzo zezempilo ezifike ngesikhathi, ezithengwayo, nezifanele emphakathini wabo. Akukona ukuba khona kwesibhedlela noma umthola-mpilo; kungumqondo onqumayo onqumayo ukuthi izakhamuzi zingathola ukunakekelwa uma zidinga. INhlangano Yezwe Yezempilo ichaza ukufinyelela “ithuba lokuthola nokuthola izinkonzo ezifanele zokunakekela impilo ezimweni zokudinga okuthile,” ezisekelwe ezingeni ezinhlanu: ukutholakala, ukutholakala, ukukholeka, ukukhokha, ukukhokha, ukukhokha, ukukhokha, nokukhokha, kanye nokwamukela – ngokuvamile okubizwa ngokuthi“ ukufinyelela kwempilo.”

Izindlela Ezinhlanu Zokunakekelwa Kwempilo

Ukutholakala Kwayo: Ukutholakala Kwanele Kwezinkonzo

Ukutholakala kwamazinyo kubhekisela ekutheni imithombo eyanele yezempilo ikhona yini endaweni ethile. Lokhu kuhlanganisa inani lezibhedlela, imitholampilo yokuqala, amahhovisi okunakekela, izikhungo zokunakekela eziphuthumayo, izikhungo zempilo yengqondo, kanye nezindlela zokusebenza kwamazinyo ezihlobene nezakhamuzi. IHealth Resources and Service Administration (HRSA) ichaza ukuthi i-Health Professional Shortge Areares (HPS) lapho isilinganiso sazonds abaphathi bezakhamuzi singaphansi kweminyango yombuso. Ngokwesibonelo, amaHPSA amagamende angaphezu kuka-7000 akhona e-inthanculthi eUnited States, athinta abantu abangaphezu kwezigidi eziyikhulu. Izakhamuzi ezilinganiselwe ezitholakalayo ukuze zihambe amabanga amade noma zinakekele ngokuphelele.

Ukutholakala: Indawo ezungezile Nezokuthutha

Ukutholakala kwezindawo kudlulela ngalé kokuba khona kwezezenhlalakahle; kuhlola ukuthi abantu bangafinyelela yini ngokoqobo kulezozinkonzo. Isithiyo sokuhamba siphakathi kwezithiyo ezikhonjiwe kakhulu, ikakhulukazi ezindaweni zasemaphandleni lapho kunamagebhudu ahlukene khona. Ukuhlolwa komphakathi wamashumi amabili anambili kuhlola i-National Institutes of Health[ kwathola ukuthi cishe izigidi ezingu-5,8 zamaMelika alibala ukunakekelwa kwezokwelapha minyaka yonke ngenxa yokuntula okunokwethenjelwa kokuhamba. Ukutholakala kuhlanganisa nesikhathi sokuhamba, izimo zomgwaqo, ukutholakala kwezimoto, nokusondela kwezinkonzo ezikoleni, emsebenzini, nasezindaweni zokuhlala.

Indawo Yokuhlala: Indlela Izinkonzo Ezifanelana Ngayo Nezidingo Zeziguli

I-accommodia icabangela indlela izinkonzo zokunakekela impilo ezihlelwe kahle ngayo ukuze zihlangabezane nezimiso zokwelapha namathemba. Lokhu kuhlanganisa amahora omtholampilo (umzk. kusihlwa nangezimpelasonto), ukumisa izikhathi zokulinda, ukuhamba ngezinyawo, izinkonzo zokuchaza ulimi, kanye nokuqondana kwezesiko lezisebenzi. Uma imitholampilo isebenza phakathi namahora ebhizinisi avamile, abantu abadala abasebenzayo bangase balwe kanzima ukuze baye ezindaweni zokuhlela ngaphandle kokuthatha ikhefu ngaphandle kokukhokhelwa. Ngokufanayo, iziguli ezikhuluma isiNgisi ngokulinganiselwe ngokuvamile zibhekana nomade noma zibonane nokungahambisani kahle uma izinkonzo zabatolikisi zingekho.

Ukuhhadla: Izindleko Nendawo Yomshuwalense

Ukukhululeka mhlawumbe kuyisithiyo esiqashelwa kakhulu. Ngisho noma izinkonzo zikhona eduze, izindleko ezinkulu ze-ocket, izindleko ezingakhokhiyo, imali ekhokhelwayo, nokuntula umshuwalense kungavimbela abantu ekufuneni ukunakekelwa. I-Censurebration Bureau imibiko yokuthi amaMelika ayizigidi ezingu-7,5 ayengenawo umshuwalense wempilo owengeziwe ngo-2021, futhi izigidi ezengeziwe zazingakhokhiswa. Ukuzi kuhlanganisa nezindleko ezingaqondile ezinjengaleyo ezilahlekile phakathi kokuhambela kwezokwelapha nezindleko zokuthutha. Inani eliphakeme lezakhamuzi ezingazinqikaziwe eU. I-Censureenius Bureaunions Bureaunions livame ukubona amazinga aphansi okunakekelwa kwempilo okuvikelwa isibhedlela futhi aphakeme kakhulu.

Ukuvunywa: Ukwethembana Nendlela Yokuphila

Ukwamukelwa kubonisa ukuthi izinkonzo zempilo zihlonipha futhi ziyasabela ezinkolelweni zesineke, ezithandwayo, nasezizindeni ezingokwesiko. Iziguli zithambekele kakhulu ekulandeleni iseluleko sezokwelapha futhi zilondoloze ukunakekela kwasikhathi sonke lapho abanikezeli bebonisa impumelelo engokwesiko. Ubandlululo, ubandlululo, noma ukuphathwa kabi okungokomlando (njengokuhlolwa kukagcukogcunsula) kungaqeda ukwethembana, ikakhulukazi phakathi kweqembu elincane lesizwe nesizwe. Ukuthambekela kwezempilo nohlobo umbiko oqhubekayo wokungahambisani nokuziphatha okuhle okungokwezinga lokunakekela amaBlabhu, amaSpani, nama-Ivanter, i-Ivantion, inyaka enyaka enyaka enyaka encikelelwayo.

Ukubaluleka Kokuthola Impilo Yasendaweni: Okwenza Kubaluleke Kubantu Nakubantu Basendaweni

Lapho imiphakathi ingathola ukunakekelwa kalula kwempilo yendawo ngokuqondile, ibhekana nemiphumela yempilo, umkhiqizo, nokungalingani komphakathi, ibhekana nezinga eliphansi lokufa, ukulawulwa okungcono kwezimo ezingamahlalakhona, nokuncishiswa kokunakekelwa kwempilo ngokuhamba kwesikhathi.

Ukuvimbela Izifo Nokusheshe Utholakale

Ukungena njalo ekunakekeleni okuyinhloko kuvumela izinkonzo zokuvimbela ukugoma, ukuxilonga umdlavuza, ukuhlola umfutho wegazi, nokuhlolwa kwecholesterol. ICenters for Disease Control and Prevention (CDC) ilinganisela ukuthi amaphesenti angu-60 abantu abadala baseMelika anesifo esisodwa esingamahlalakhona, futhi eziningi zalezi zimo zingavinjelwa noma zeqiswe ngokuhlola okuvamile. Ngokwesibonelo, amazinga omdlavuza wemibala okuhlolwa acishe abe ngu-20% ezindaweni ezinezinga lokunakekela eliphambili uma kuqhathaniswa nezindawo ezigciniwe. Ukuhlola kokuqala akugcini ngokusindisa ukuphila kodwa futhi kunciphisa umthwalo wezimali wokwelapha okuthuthukiswa kweqoko.

Ukulawulwa Kwezimo Ezingamahlalakhona

Izifo ezingapheli njengoshukela, umfutho wegazi ophakeme, isifo sofuba, kanye nesifo senhliziyo zidinga ukulawulwa njalo, ukunamatheliswa kwemithi, nokulandelwa njalo. Ukutholakala kochwepheshe bezifo, izinhlelo zokuphatha izifo, nemfundo yeziguli kusiza abantu ukuba balawule izimo. INhlangano ye-American Diabetes ibika ukuthi iziguli ezinesifo sikashukela ezikwazi njalo ukunakekelwa kwe - endoclegyology azinamathuba amancane kakhulu okuba zibe nezinkinga ezinjengokungasebenzi kwezinso noma ukunqunywa. Ngaphandle kokuba abagcini besizayo, iziguli zivame ukuthembela emagunjinini okuphuthumayo ukuze zibhekane nezenzakalo eziphuthumayo, ezibizayo futhi ezingasebenzi kakhulu kunendlela yokunakekela eyisisekelo.

Ukunakekelwa Okuphuthumayo Nokusabela Okubucayi

Izimo eziphuthumayo eziphuthumayo njengesifo senhliziyo, ukufa uhlangothi, ukulimala okukhulu, nokungezwani nomzimba kudinga ukwelashwa okusheshayo. Ukuvaleka komnyango wesimo esiphuthumayo noma esikhungweni sokushaqeka kuyisihluthulelo sokusinda. Iziguli ze-Stroke ezifika “ehoreni eliyigugu” (imizuzu yokuqala engu-60) zinemiphumela engcono kakhulu, kodwa izakhamuzi zasemaphandleni zivame ukubhekana nezikhathi ezidlula imizuzu engu-60 ngenxa yokuvalwa kwezakhiwo. Ukuvalwa kwezibhedlela zasemaphandleni ngaphesheya kwe-United States kuye kwashesha kakhulu eshumini leminyaka elidlule, izibhedlela zasemaphandleni ezingaphezu kuka-20 zivaleka kusukela ngo-201033, okuthinta ukunakekelwa okuphuthumayo.

Impilo Yengqondo Nezindlela Zokusetshenziswa Kwayo

Ukukwazi ukufinyelela ekunakekeleni impilo yengqondo kwendawo nakho kubalulekile. INational Institute of Mental Health ibonisa ukuthi cishe umuntu oyedwa kwabahlanu abantu abadala base-U.S. uphila ngokugula ngengqondo, kodwa abangaphezu kwengxenye abatholakali ukwelashwa ngokuphumelelayo ngenxa yokuthi akukho mnakekeli okhona. Ukusebenzisa kabi izifo zengqondo, kuhlanganise ne-opioids, kudinga ukwelashwa okuhlangene okuhlanganisa imithi, ukunikeza iseluleko, nokusekela komphakathi. Izindawo zomphakathi ezikwazi ukufinyelela ezifweni zempilo zengqondo zibona amazinga aphakeme okuzibulala, ukuhambela kwezehlakanizekile kakhulu kwezifo zengqondo, nokungabi namakhaya kakhulu. I-Telehealth ivela njengekhambiza eliyinxenye, kodwa iziguli eziningi azinakele izindawo zokuhambela ezivamile.

Umphumela Owaba Kubantu Abanobunzima

Amaqembu angenaluzwela − kuhlanganise nemikhaya yasebekhulile, ethola imali ephansi, abantu abakhubazekile, abafuduki abangabhaliwe, kanye nabantu abambalwa abavela emadolobheni − bathwala umthwalo onzima kakhulu wokuthola inhlalakahle engokwempilo. Lemiphakathi ivame ukubhekana nezithiyo ezinjengezezimali, ukungalingani kolimi, ukungafundi kahle kwempilo, nokucwasa. Ngokwesibonelo, amaMedicare angenela ezindaweni zasemaphandleni ayizi-60% asengozini yokuyeka ukunakekela okudingekayo kunalawo asemadolobheni. Ukukhuluma ngalezi zimo zokweqikelelo akuyona nje indaba yobulungisa; kuthuthukisa impilo yabantu bonke. Inhlangano yezempilo yezwe iye yagcizelela isikhathi eside ukuthi “ingumuntu onelungelo lokufinyelela abantu.”

Izinselele Eziyinhloko Ekutholeni Impilo Yasendaweni

Naphezu kokubaluleka kwayo, imiphakathi eminingi ibhekana nezithiyo ezinkulu ezivimbela ukuba umuntu akwazi ukunakekelwa kwempilo yendawo.

Ukuswelakala Kwamandla

I-United States ibhekene nokuntuleka okulinganiselwa ku-124 000 kodokotela ngo-2034, okunomphumela oyinhloko wokunakekelwa kanye nezindawo zasemaphandleni ezithinteke kakhulu. Odokotela abahlengikazi, abasizi, nochwepheshe bezempilo yengqondo nabo bambalwa. INhlangano ye-American Medical Colleges iphawula ukuthi cishe amaphesenti angu-60 eHPS asemaphandleni noma asemaphandleni. Ukuntula komsebenzi kuholela ekulindeni izikhathi ezinde, ukuncipha kokunakekelwa, nokutubeka isabalala phakathi kwasebe abasele. Kwezinye izingqhinga, izakhamuzi kumelwe zilinde izinyanga ezine kuya kweziyisithupha ukuze kufike ezindaweni eziyinhloko zokunakekela iziguli.

Ukwehluka Kwezindawo: Amadolobha Asemaphandleni Ahlukene Nezindawo Ezisedolobheni

Imiphakathi yasemaphandleni ibhekene nokufinyelela imingcele emibi kakhulu kunaleyo ekhona emadolobheni. Ihhovisi likahulumeni wase-U.S. libika ukuthi izakhamuzi zasemaphandleni zinezibhedlela ezimbalwa, odokotela, nezinkonzo eziphuthumayo eziphuthumayo. Kusukela ngo-2010, izibhedlela zasemaphandleni ezingaphezu kuka- 150 ziye zavalwa noma zashintshwa zaba izikhungo ezilinganiselwe, zishiya izindawo ezinkulu ezingenayo isineke. Imisebenzi ye-Obstetric inyamalala ngenani elishaqisayo; izibhedlela zasemaphandleni zintula isikhungo sokuzala esisekelwe esibhedlela, okuphumela “ekuhlanezelweni lokunakekela abantwana ” ezibangela ukuba ubumama kanye nokufa kwezinsana.

Amagebe Okukhokha Umshuwalense

Ngisho nane-Affordal Care Act, izigidi zihlala zingafakelwe noma zingangenisiwe. Amazwe angayandisanga iMedicaid anamazinga aphakeme kakhulu angenamali phakathi kwabantu abadala abaholayo abaphansi. Ngaphandle komshuwalense, abantu ngabanye ngokuvamile balibala kuze kube yilapho izimo ziba zimbi kakhulu, okuholela ekulahlekelweni okukhulu nemiphumela emibi kakhulu. Iziguli ezinezimo eziphansi zibhekene nezingakhokhwa kakhulu kanye nokukhokhwa okuzivimbela ekugcwaliseni imishado noma ukulandela ochwepheshe. INgxoxoxo yeSimali yeCommomomomoalfety ilinganisela ukuthi umuntu oyedwa kwabane abadala abasebenzayo uyalahlekelwa, okusho ukuthi bachitha imali engamaphesenti ayishumi ehholweni emalini yabo yempilo.

Ukufunda Ngemfundo Yezempilo Nesimiso Sokuhamba Ngemikhumbi

Ikhono lezempilo lokuthola, inqubo, nokuqonda ukwaziswa kwempilo, − kuyisici esibucayi kodwa esivame ukunganakwa. I-National Assessment of Adual Literance yathola ukuthi abantu abadala abaneminyaka engamashumi amabili kuphela abakwazi ukufunda ezempilo abakwazi ukufunda nokubhala. Iziguli eziningi zilwa kanzima ukuqonda imibandela yomshuwalense, imiyalo yemithi, noma indlela yokuhlela ukumiswa. Izimiso ze-xlextary, izimvume, namarekhodi empilo ahlukene awenziwe ngemishini yezobuchwepheshe zinezela ubunzima. Iziguli ezingakwazi ukufunda kahle zezempilo zivame ukulahlekelwa izinkonzo zokuvimbela, ukusetshenziswa kabi kwemithi, futhi zifakwe esibhedlela ngenxa yokugwema izimo ezifanele.

Izinselele Zokuqondisa

Izimiso zesilinganiso sikahulumeni zingavimbela izinga lokusebenza kodokotela, abasizi, nosokhemisi, zilinganisele ikhono labo lokunakekela izindawo ezigciniwe. Imithetho yesitifiketi edinga isidingo kwezinye izindawo idinga ukugunyazwa ngaphambi kokwakha izakhiwo ezintsha noma izinkonzo ezandayo, ezingavimbela ukusungulwa kwemithetho. Ngaphezu kwalokho, itelehealth ayikho ezifunekayo ekuvakasheni kwangaphakathi phambi kokuhlola iziguli ezithembele ekunakekelweni okukude. Inguquko ezithi zinciphise lemithetho imingcele iye yaboniswa ukuthuthukisa ukutholakala ngaphandle kokuhlehla kokuphepha.

Izinqubo Zokuthuthukisa Ukutholakala Kwendlela Yokwelapha Yasendaweni

Ukunqoba imingcele yokuthola izinto kudinga amasu amaningi ahlanganisa izimiso zezempilo, abakhi bezimiso, izinhlangano zomphakathi, kanye namasheya obuchwepheshe. Lezi zinqubo ezilandelayo ziye zabonisa ukuthi ziyasebenza ekutholeni indawo.

Ukunwetshwa Kwezinkonzo ZeTelehealth

ITelehealth yaqhuma phakathi nobhadane lwe-COVID-19 futhi iye yahlala isesimweni esihlala njalo. Inciphisa isikhathi sokuhamba, ivumela ochwepheshe ukuba bafike emaphandleni, futhi isekela ukulawulwa kwezifo ezingalapheki ekhaya. Umnyango wezempilo nezezinkonzo zobuntu wabika ukuthi ukuhambela kwe-telehealth kwanyukela ngokuphindwe ka-6 ngonyaka wokuqala walesifo esiwumqedazwe. Ukusekela intuthuko, izimiso kufanele ziqinisekise ukungena kwe-interbacbad, ukubuyisela i-telemedicine ngokunakekela okungalaphezi, futhi kunciphisa imishayo enqamula imigqa yombuso.

Izinhlelo Zomsebenzi Wezempilo Zomphakathi

Izisebenzi zezempilo zomphakathi (i-CHWs) zithenjwa kakhulu izisebenzi zezempilo zomphakathi ezixhumanisa izakhamuzi nezinkonzo, zinikeza imfundo yempilo, futhi zinikeza ukusekela komphakathi. I-CHWS iphumelela kakhulu kakhulu emiphakathini emincane nakubantu abavela kwamanye amazwe. I-2021 ukubukeza eMtatsheni wesizwe we-Medicine we-FLT wathola ukuthi ukungenela okuphawulekayo kwandisa amazinga omdlavuza, ukuthuthukisa ukulawulwa komfutho wegazi, nokuncishiswa kwesibhedlela. Ukukhokha i-mkhankampa e-mkhankasweni we-mfa e-mfashini ekhona esekela imingcele ye-bhulo phakathi kokunakekela nomphakathi.

Izimoto Ezihambayo Esibhedlela Nezikhungo Zezempilo Ezisekelwe Esikoleni

Imitholampilo ehambayo iletha ukunakekela okuyinhloko, izinkonzo zamazinyo, kanye nokuhlola ukuvikela ngokuqondile ezindaweni ezingenazo izakhiwo ezimisiwe. I-Mobile Healthcarety Association ilinganisela ukuthi kunamaqembu empilo emotweni angaphezu kuka-2 000 e-U.S., ngayinye ikhonza amakhulu ezinkulungwane zeziguli unyaka ngamunye. Ngokufanayo, izikhungo zezempilo zesikole zinikeza ukunakekela okungcono ezingabantwana nasentshani, ukusingatha yonke into kusukela ekugonyeni ukuvikela ezifweni ezifweni zempilo yengqondo. Lemiboniso-mfashini inciphisa imingcele yezokuhamba futhi ingathunyelwa ezindaweni ezishaywa yizinhlekelele zemvelo noma izingqwembe.

Ukuthuthuka Kwezisebenzi Nokuzigcina Usemsebenzini

Ukuqeda ukuswelakala kwabafundi kudinga izinhlelo zokuqashwa nokugcinwa. Izinhlelo zokukhokha intela, njenge-National Health Service Corps, i-centrives abaxhasi abasebenza eHPSA ngokukhokha imali ebolekiswa abafundi ukuze bakhokhele izibopho zenkonzo. Ukwandisa izinhlelo ze-payipiter eziqeqesha amadolobha asemaphandleni nabafundi abambalwa kungadala imisebenzi ehlukahlukene neyokwehla kwezwe. Izinhlelo zokulungisa izinhlelo ezifana ne-ECHO zivumela abanakekela abaholi abangaphansi kwezindawo ezigciniwe ukuba bathintane nochwepheshe bezemfundo, ukukhula kwekhono lendawo lokulawula izimo eziyinkimbinkimbi.

Ukufunda Nokuhamba Ngemikhumbi Okunempilo Nesineke

Ukuthuthukisa ukufunda nokubhala kwezempilo kunika iziguli amandla okwenza izinqumo zolwazi nokusebenzisa isimiso ngendlela ephumelelayo. Ukungenela okulula njengezinto zolimi olulula, ukufundisa izindlela ezibuya emuva, nezinkonzo zokuhamba ngezinyawo (lapho abantu abaqeqeshiwe beqondisa iziguli ngemishini, amafomu omshuwalense, kanye nama-athoralrator) kuye kwabonakala kuphumelela. I-Siguli sokuqeqesha i-Navigtator Training Colitinativation inikeza ubufakazi obusekelwe ezifundweni zesikole ezisezinzweni zemikhumbi-mikhumbi. Izimiso zezempilo zingafaka ulwazi lwempilo oluqinile emarekhodini empilo emishini, zisebenzisa iziqaphakaliso eziqalisi ukuze zisebenzise ulimi olulula noma izinsizaniso zemishini.

Ukuzivumelanisa Nomthetho Nezinguquko Zomshuwalense

Ukukhokha intela ephakeme kaMedicaid, izingcebiso ezisekelwe emalini, nokususwa kwemithetho evimbelayo esemthethweni kungathuthukisa ukutholakala ngokuphawulekayo. I-odola eyandisa iMedicaid yathola ukwehla okukhulu ekunakekeleni futhi kuncane kakhulu ekubekeni ukunakekela. Imizamo yomthetho kufanele igxile nasekuqiniseni izibhedlela zasemaphandleni ngokuthuthukisa amazinga entengo entengo kanye nokukhokha okungakhokhwa okuvuza okuvuza inzuzo enika isilinganiso sezempilo somphakathi kunokuba umthamo. Izikhungo zezempilo zomphakathi (Izikompathi Ezinezempilo Ezifanele) zithembele ezinkondlo yombuso futhi kumelwe zithole imali enele ukuze ziqhubeke zikhonza izakhamuzi ezinhlanu.

Isiphetho

Ukutholakala kwezempilo zendawo akuyona into yokunethezeka kodwa kuwukungalingani okuyisisekelo kwempilo yezakhamuzi, ukuhleleka kwezomnotho, nokungalingani kwezenhlalo. Njengoba imiphakathi ibhekene nezithiyo ezingapheli zemisebenzi (ukuswelakala kwemisebenzi), ukuhlukaniswa kwendawo, izikhala zomshuwalense, nezinselele zezempilo, kudingekile ukumisa izixazululo ezibanzi phakathi kwezinga ezinhlanu zokufinyelela. I-Telehealth, izisebenzi zezempilo, imithola mpilo, ukuthuthuka kwemisebenzi, kanye nezinguquko zezimiso zonke zinikeza izitebhisi eziya esimisweni lapho wonke umuntu angathola khona isikhathi, imali enele, futhi anakekelwa ngenhlonipho. Ngokufaka isisekelo sokufinyelela indawo yasekhaya namuhla, sibeka isisekelo sempilo, izizukulwane eziqinile ukuze kufike.