Kafukufuku wokhutitsidwa ndi odwala amanyalanyaza mtundu ndi mitundu ina ya tsankho: kuwombera

Pambuyo pogonekedwa m’chipatala, odwala ambiri amafufuzidwa kuti awone mmene moyo wawo unalili bwino. Zotsatira za kafukufuku zingakhudze kuchuluka kwa zipatala zomwe zimalipira. Komabe, nkhani za tsankho lamtundu kapena mitundu ina ya tsankho sizinayankhidwe m’mafukufukuwo.

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Zithunzi za David Sacks / Getty

Pambuyo pogonekedwa m’chipatala, odwala ambiri amafufuzidwa kuti awone mmene moyo wawo unalili bwino. Zotsatira za kafukufuku zingakhudze kuchuluka kwa zipatala zomwe zimalipira. Komabe, nkhani za tsankho lamtundu kapena mitundu ina ya tsankho sizinayankhidwe m’mafukufukuwo.

Zithunzi za David Sacks / Getty

Tsiku lililonse, odwala masauzande ambiri amalandira foni kapena kalata atatulutsidwa m’zipatala zaku US. Kodi kukhala kwawo kunayenda bwanji? Kodi chipindacho chinali chaukhondo komanso mwabata bwanji? Kodi ndi kangati anamwino ndi madokotala amawachitira zinthu mokoma mtima ndi mwaulemu?

Mafunsowo akuyang’ana pa zomwe zingatchedwe kuti ndizomwe zimakhutitsidwa ndi makasitomala nthawi zonse zachipatala, chifukwa zipatala zimawona odwala monga ogula omwe angasamutsire malonda awo kwinakwake.

Koma mafunso ena ofunikira sakupezeka pa kafukufuku wopezeka paliponse, zotsatira zake zomwe zimakhudza kuchuluka kwa zipatala zomwe zimalipira ma inshuwaransi: Safunsa odwala ngati adasalidwa panthawi ya chithandizo chawo, dandaulo lofala pakati pamagulu osiyanasiyana a odwala.

Momwemonso, adalephera kufunsa magulu osiyanasiyana a odwala ngati adalandira chisamaliro choyenera pachikhalidwe.

Ofufuza ena amati uku ndi kulakwitsa kwakukulu.

Kevin Nguyen, wofufuza zaumoyo ku Brown University’s School of Public Health yemwe adasanthula deta yomwe inasonkhanitsidwa kuchokera ku kafukufuku wadziko lonse woyendetsedwa ndi boma m’njira zatsopano, adapeza kuti – pansi pa nthaka – adalankhula za kusiyana pakati pa mitundu ndi mafuko mu chisamaliro.

Pakufufuza mozama, Nguyen adaphunzira ngati odwala omwe ali mu dongosolo la chisamaliro loyang’aniridwa ndi Medicaid ochokera m’mitundu yaying’ono adalandira chisamaliro chofanana ndi anzawo oyera. Anapenda mbali zinayi: kupeza chithandizo chofunikira, kupeza dokotala waumwini, kupeza nthawi yake yopimidwa kapena chisamaliro chachizolowezi, ndi kupeza chithandizo chapadera panthawi yake.

“Izi zinali zapadziko lonse lapansi m’mitundu yonse. Choncho olandira akuda; Amwenye a ku Asia, Amwenye Achihawai, ndi Pacific Islanders; ndi anthu a ku Puerto Rico, Hispanic, kapena Hispanic / Latino omwe adalandira malipoti akuwonetsa zochitika zoipitsitsa pamiyeso yonse inayi, “adatero.

Nguyen adati kafukufuku omwe amagwiritsidwa ntchito kwambiri ndi zipatala (otchedwa Consumer Assessments of Healthcare Providers and Systems, kapena CAHPS) atha kukhala othandiza ngati adatha kulowa mozama mugawo limodzi – mwachitsanzo, funso. Chifukwa chiyani? Zinali zovuta kupeza chisamaliro chanthawi yake, kapena Chifukwa chiyani? Alibe dokotala wawo.

Zingakhalenso zothandiza ngati CMS ifalitsa poyera osati zotsatira zonse za wodwala, komanso kuwonetsa momwe mawerengerowa amasiyanirana ndi mtundu wa oyankha, fuko, ndi chinenero chomwe amakonda.

Izi zitha kuthandiza kudziwa ngati chipatala kapena inshuwaransi yaumoyo ikukwaniritsa zosowa za aliyense motsutsana ndi odwala ochepa. Nguyen sanaphunzire mayankho a LGBTI kapena, mwachitsanzo, ngati anthu amalandira chisamaliro choipitsitsa chifukwa ndi onenepa.

Kafukufuku wakuchipatala – ndi momwe angawasewere – akhala bizinesi yayikulu

Boma la federal likufuna kufufuza kwa opereka chithandizo chamankhwala m’zipatala zambiri zachipatala, ndipo mtundu wake wa zipatala umafunika kuzipatala zambiri zachipatala. Kutsika pang’ono kungayambitse zilango zandalama, ndipo zipatala zimapeza phindu lazachuma chifukwa chowongolera kapena kupitilira za anzawo.

Kafukufuku wa Chipatala cha CAHPS, wodziwika bwino kuti HCAHPS, wakhalapo kwa zaka zopitilira 15. Zotsatira zimanenedwa poyera ndi Centers for Medicare ndi Medicaid Services kuti apatse odwala njira yofananizira zipatala, komanso kupatsa zipatala chilimbikitso chowongolera chisamaliro ndi ntchito. Kukumana ndi odwala ndi chinthu chimodzi chomwe boma la federal limayesa poyera; Kulandiranso ndi kufa ndi matenda kuphatikizapo matenda a mtima ndi zovuta zochizira za opaleshoni ndi zina mwa matenda.

Dr. Mina Sechamani, mkulu wa bungwe la Medicare, ananena kuti odwala ku United States akuwoneka kuti akukhutira ndi chisamaliro chawo:

“Tawona kusintha kwakukulu kwa kuchuluka kwa HCAHPS pakapita nthawi,” adatero m’mawu olembedwa, ndikuzindikira, mwachitsanzo, kuti kuchuluka kwa odwala omwe amati anamwino awo “nthawi zonse” amalumikizana bwino adachoka pa 74% mu 2009 mpaka 81%. m’chaka cha 2020.

Koma malinga ngati kafukufukuyu analipo, kukayikira kunalibe pa zomwe zinagwidwa. Kafukufuku wokhudzana ndi odwala akhala bizinesi yayikulu, ndi njira zotsatsira makampani kuti akweze zotsatira. Ofufuzawo adadabwa ngati kuyang’ana pa kukhutitsidwa kwa odwala – ndi kaloti ndi ndodo yachuma yomwe imagwirizana nawo – idatsogolera kusamalidwa bwino. Ndipo ali ndi mabungwe amthunzi wautali omwe amatha “kuphunzitsa ku mayesero” mwa kuphunzitsa ogwira ntchito kuti alangize odwala kuyankha mwanjira inayake.

Kafukufuku wadziko lonse apeza kuti mgwirizano pakati pa kukhutira kwa odwala ndi zotsatira za thanzi ndi wofooka kwambiri. Kafukufuku wina wofunika kwambiri watsimikizira kuti “kuwerengera kwabwino kumadalira kwambiri malingaliro a odwala osinthika kusiyana ndi mankhwala abwino,” akutchula umboni wakuti akatswiri a zaumoyo adalimbikitsidwa kuyankha zopempha za odwala m’malo moika patsogolo zomwe zinali zabwino kwambiri pa chisamaliro. , pamene Iwo anali mkangano.

Zipatala zalembanso momwe anamwino ayenera kuyankhula ndi odwala kuti awonjezere kukhutira kwawo. Mwachitsanzo, ena adafunsidwa kuti apereke chizindikiro kwa odwala kuti chipinda chawo chili chete poonetsetsa kuti akunena mokweza kuti, “Ndimatseka chitseko ndikuzimitsa magetsi kuti chipatala chikhale chete usiku.”

Gulu latsopano lofufuza zipatala za tsankho

Pafupifupi zaka khumi zapitazo, Robert Witch Maldonado, wofufuza zaumoyo ku yunivesite ya Alabama-Birmingham, anathandiza kupanga gawo latsopano kuti awonjezere ku kafukufuku wa HCAHPS “Kulimbana ndi zinthu monga zochitika ndi tsankho, ndi nkhani zodalirika.” Mwachindunji, ndinafunsa odwala kuti kaŵirikaŵiri amachitiridwa zinthu mopanda chilungamo chifukwa cha makhalidwe monga mtundu kapena fuko, mtundu wanji wa dongosolo laumoyo umene anali nawo (kapena ngati analibe inshuwaransi), kapena mmene amalankhulira bwino Chingelezi.

Anafunsanso odwala ngati akuwona kuti angadalire othandizira awo azachipatala. Cholinga, adati, ndikupangitsa kuti izi zitheke, kuti odwala athe kuzigwiritsa ntchito.

Ena mwa mafunsowa adapangitsa kuti ikhale gawo losankha la kafukufuku wa HCAHPS – kuphatikizapo mafunso okhudza kangati ogwira ntchito amanyazitsa kapena amwano, komanso kangati odwala amamva kuti ogwira ntchito amawasamalira ngati munthu – koma CMS sichitsatira kuchuluka kwa zipatala zomwe zikugwiritsa ntchito kapena momwe amagwiritsira ntchito zotsatira. Ndipo ngakhale kuti HCAHPS imafunsa oyankha kuti mtundu wawo, fuko, ndi chinenero chawo amalankhula chiyani kunyumba, CMS sichifalitsa deta iyi pa webusaiti ya odwala ambiri, komanso sikuwonetsa momwe odwala amitundu yosiyanasiyana amachitira poyerekeza ndi ena.

Popanda kugwiritsa ntchito mafunso omveka bwino okhudza tsankho, Dr. Jose Figueroa, pulofesa wothandizira zaumoyo ndi kasamalidwe ku Harvard School of Public Health, akukayikira kuti deta ya HCAHPS yokha “idzakuuzani ngati muli ndi tsankho” – makamaka. chifukwa cha kuchepa kwa mayankho a kafukufukuyu.

Chitukuko chimodzi chochititsa chidwi, iye anati, chiri mu kuthekera kotulukira kusanthula mayankho otseguka (osati kusankha kangapo) kudzera muzomwe zimatchedwa kuti chinenero chachilengedwe, chomwe chimagwiritsa ntchito luntha lochita kupanga kuti lifufuze momwe anthu amawafotokozera m’mabuku olembedwa kapena olankhulidwa monga zowonjezera. Kwa kafukufuku wosankha angapo.

Kafukufuku wina wopenda ndemanga zachipatala pa Yelp anali makhalidwe enieni omwe odwala ankaganiza kuti ndi ofunika koma sanatengedwe ndi mafunso a HCAHPS – monga momwe ogwira ntchito amasamaliridwa bwino komanso omasuka, komanso chidziwitso cha kulipira. Kafukufuku wofalitsidwa chaka chino mu Health Affairs adagwiritsa ntchito njirayo kuti apeze kuti opereka chithandizo kuchipatala amatha kugwiritsa ntchito mawu oipa pofotokoza odwala akuda kusiyana ndi anzawo oyera.

“Ndizosavuta, koma ngati zitagwiritsidwa ntchito moyenera zingathandize kwambiri machitidwe azaumoyo ndi zipatala kudziwa ngati akufunika kugwira ntchito pa nkhani za tsankho mkati mwawo,” adatero Figueroa.

Press Ganey Associates, yomwe ikulipidwa ndi zipatala zambiri zaku US kuti izichita kafukufukuyu, ikuwunikanso lingaliro ili. Dr. Tegal Gandhi akutsogolera pulojekiti kumeneko yomwe ikufuna, mwa zina, kugwiritsa ntchito luntha lochita kupanga kufufuza ndemanga za odwala chifukwa cha zizindikiro za kusagwirizana.

“Akadali masiku oyambilira,” adatero Gandhi, ndikuwonjezera, “Ndi zomwe zachitika ndi mliriwu, pankhani zachilungamo, komanso zinthu zonsezi pazaka ziwiri zapitazi, pakhala chidwi chochulukirapo pamutuwu.”

Kuyankhulana kwachindunji kuti apititse patsogolo luso la chikhalidwe

Komabe, zipatala zina zatenga njira yoyesera-ndi-yoona kuti amvetsetse momwe angakwaniritsire bwino zosowa za odwala: kulankhula nawo.

Monica Federico, dokotala wa pulmonologist wa ana pa University of Colorado School of Medicine ndi Children’s Hospital of Colorado ku Denver, anayamba pulogalamu ya chipatala cha mphumu zaka zingapo zapitazo. Pafupifupi gawo limodzi mwa magawo asanu a osankhidwawo sanapezekepo. Gululo linkafunika china cholondola kuposa deta yokhutiritsa odwala kuti amvetse chifukwa chake.

“Tinazindikira odwala omwe anali m’chipatala omwe ali ndi mphumu, tinawaitana, ndi kuwafunsa, mukudziwa, ‘Hey, muli ndi chidziwitso cha chipatala cha mphumu. Kodi pali zolepheretsa kuti mulowemo?’ kumvetsetsa zomwe iwo anali, “adatero Federico.

Panthawiyo, anali amodzi mwa othandizira olankhula Chisipanishi m’dera lomwe mphumu yaubwana imakhudza kwambiri anthu a ku Spain. (Odwala adatchulanso zovuta zamayendedwe komanso nthawi zosasangalatsa zogwira ntchito kuchipatala.)

Pambuyo posintha kangapo, kuphatikizapo kuwonjezera maola achipatala mpaka madzulo, chiwerengero cha osawonetsa chatsala pang’ono kutsika.

Kafukufuku wokhutitsidwa ndi odwala ali mgulu lazachipatala ku America ndipo akuyembekezeka kukhalabe kuno. Koma CMS tsopano ikuyesetsa koyambirira pakufufuza kuti ithetse zovuta zomwe zidanyalanyazidwa kale: Pofika chilimwechi, ikuyesa funso la odwala azaka 65 kapena kuposerapo omwe angafunse mwatsatanetsatane ngati aliyense wochokera kuchipatala kapena kuchipinda mwadzidzidzi kapena ofesi ya dotolo. anawachitira “mopanda chilungamo kapena mopanda chifundo” chifukwa cha makhalidwe awo monga mtundu, fuko, chikhalidwe, kapena malingaliro ogonana.

KHN (Kaiser Health News) ndi chipinda chankhani cha dziko chomwe chimatulutsa utolankhani wozama pazaumoyo. Ndi dalaivala wodziyimira pawokha wa KFF (Caesar Family Foundation). KFF ndi bungwe lopanda phindu lomwe limapereka chidziwitso pazaumoyo kudziko lonse.

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