Iko kambani yveshuwarisi yehutano yakakopa iwe maneja wechikwata? Iwe uri kuonekwa nemhosva yemhosva mune imwe chipatara kana yehutano yekambani? Iwe uri mukoti anoda kuve mutariri wemhosva here? Hauna chokwadi chaizvoizvo kuti maneja wechiitiko akadini, sei iwe uchida imwe, kana kuti chii chaungave uchiita kana iwe ukava mutariri wemhosva? Hezvino izvo zvaunoda kuziva.
Case Management Inogona Kureva Zvinhu Zvakasiyana Munzvimbo dzakasiyana
Kutanga, iwe unofanirwa kuziva kuti chii chinotarirwa nemutungamiriri chinoenderana nemamiriro ezvinhu aanoita.
Semuenzaniso, mumiririri wemhosva ari kushanda nekambani yehutano hwemusha achapa hutano hwakasiyana zvikuru pane mutariri wemhosva mukambani yehutano yehutano, kambani yevashandi yemari yveshuwarenzi, kana chipatara.
Zvisinei, pane zvimwe zvinhu zvinogara zvichienderana nezvose zvinotarisirwa kuita basa. Nenzira iyo, vatongi vemhosva vanoongorora zvinodiwa nemurwere uye zviripo zviripo. Mhosva mameneja anoedza kuwana nzira yakanakisisa, yakanakisisa, yepamusoro yehupfumi inokwanisa kusangana nezvido zvevarwere nemari inowanikwa.
Uye kunyanya nokuda kwechirwere chisingaperi, chirwere chakakomba, chirwere chekuita chinogona kuguma nemigumisiro yepamusoro yevarwere, kuwirirana kwakanaka nemazano ezvehutano, uye nani zviri nani kuzviraramisa-kunyange zvazvo kune mhedzisiro yemigumisiro iyo maitiro ehutano angave nawo. Heano mimwe mimwe mienzaniso yenyaya iyo mumiririri akaita sei pane zvakasiyana-siyana.
Chipatara Chekuita Mutariri
Chiremba wechipatara chechipatara kazhinji ari mukoti anoita zvose zviri zviviri kugadziriswa nekugadzirisa zvirongwa .
Kudzokorora kushandiswa kunosanganisira kuve nechokwadi chokuti murwere ari kuwana kutarisirwa kunotarisirwa uye kunowanikwa munzvimbo yakakodzera. Kugadziriswa kwekubuda kwezvirwere ndiyo nzira yekufanotaurira varwere vanopfuurira zvido zvekurapa mushure mokunge zvipatara uye vachiisa chirongwa chekuzadzisa zvido izvi. Vatapi venhau vezvipatara vanoita masters pakurongedza zvinetso zvakanyanya zvakanyanya kune nguva nevanopa .
Somuenzaniso, ndicho chipatara chemhosva mabiko inoita kuti hurumende yehutano inshuwarano yehutano inzwisise chii chiri kuitika munguva yekurapa kwechiremba. Anovimbisa kuti inshuwarisi ine ruzivo rune ruzivo rwunoda kubvumidza kubhadharwa kwechipatara uye rinoshandiswa kudzivirira inishuwarenzi kubvuma. Anotaurirana nehutano wechipatimendi rejeri mumiriri wezuva rimwe nerimwe kana mazuva mashomanana.
Ndiye iye anoronga kuti murwere ave nekushanyira kumusha kubva mukoti anomushanyira mushure mokunge asunungurwa kubva kuchipatara, kana kuti awane chirwere chakasimba chokugadziriswa kubva kune imwe nzvimbo yezvekugadzirisa zvirwere. Ndiye anobatsira murwere kutsvaga kambani yehutano yeimba kana nzvimbo yekurapa inpatient iri mu-network pamwe neye insurer uye inogamuchira iye somurwere.
Uyezve, chipatara chemhosva mhenari inogona kutaurirana nezvekugoverana kwezvipo pakati pehutano wehutano, mupi, uye murwere. Heano muenzaniso: Zvichida murwere ane utachiona husingaperi hwepfupa ane utano hwakakwana hwokuenda kumba achibva kuchipatara uye kuwana ma antibiotic ake kumba kumba kwevhiki nhatu dzinotevera. Zvisinei, hutano hwehutano hwehutano hahufukidze mishonga yeVV kana kuti midziyo yakadai seAV tubing uye mapampu ayo murwere anoda kupiwa mushonga kumba.
Mishonga yemisha yeimba IV inoda murwere kuribhadhara $ 5,000 kubva muhomwe yake yezvinodhaka nemichina.
Muchengeti wemhosva anogona kutaurirana nemishonga yeimba yeimba yeimba, kambani yekuchengetedza vana vehutano, yehutano insurer, uye murwere. Zvichida anoita kuti murwere arambe achibvumirana kubhadhara mari inodhura $ 1 000 pamutengo wezvinodhaka nemichina saka haafaniri kugara muchipatara kune mamwe mavhiki matatu.
Anowanikwawo mishonga yemisha yeimba IV kuderedza mari yezvinodhaka nemidziyo ne $ 1 000. Anowana kambani yekuchengetedza hutano yekambani inobvumirana kutora tabu yeVIV inoputika pamapombi pamutengo we $ 500.
Anowana kambani yveshuwarenzi yehutano kubvumirana kubhadhara ma pharmacy mari inosara $ 2 500 kunyange zvazvo isingakodzeri nokuti haisi kubatsiridzirwa kwepurogiramu yemurwere.
Iyo inshurensi inoda kubhadhara $ 2,500 kuitira kuti irege kuenderera mberi kuripa chipatara kune mabasa ekurapa. Kambani yehutano yemusha inoda kubhadhara $ 500 pamapombi nokuti kana ikasaiti, murwere haangadzoki kumusha uye haazodi kutarisirwa kwehutano hwemusha pamusha. Mishonga yemapurisa inoda kuderedza mutengo wemishonga nemidziyo ne $ 1 000 nokuti kuita zvishoma zvingabatsiri pane kuisa mari zvachose kana murwere asina kubviswa.
Musha Utano Care Case Manager
Mutariri wekodzero yehutano hwemusha akasiyana kubva kuchipatara chejaja mune zvekuti anowanzopa maoko-pamutano weutano. Mukuwedzera, anorongedza humwe humwe nhengo dzeboka rehutano hwehutano uye vatarisi, vanotaurirana nekambani yehutano inshuwarhu, anotaurirana nachiremba wemurwere, uye anotarisira vamwe vanamukoti vanoshanyira kana kuti vashandi vehutano hwemusha vanotarisirawo murwere.
Nekupihwa kubva kumurwere nemhuri, maneja wekuchengetedza hutano hwekumba anoudza urongwa hwehutano hwemurwere uye anohupa kune chiremba werapa kuti agamuchire kwekupedzisira. Anobatanidza kushandiswa kwechirongwa ichi pamwe nemurwere, vanoita basa rinodiwa, uye tweaks chirongwa ichi kana zvichidikanwa.
Health Insurance Company Muchengeti Wenyaya
Kambani yehutano inshuwarisi yemhosva muteja inowana mashoko kubva kune vatapi venhau vechipatara, makambani ekuchengetedza hutano hwepamusha, mahofisi echiremba, vashandi vezvemagariro evanhu nevamwe vanopa utano hweutano Zvichienderana nehutarisiki uye nzvimbo, angatoshanyira murwere kuchipatara.
Chinangwa chake ndechekuti ave nechokwadi kuti murwere ari kutarisira kurapwa mune zvemishonga, kutarisirwa kwepamusoro, uye kuti kutarisirwa kuri kuendeswa sekubudirira uye mune zvehupfumi sezvinobvira. Anofungidzira zvinodiwa nehutano hwemurwere mune ramangwana uye anoedza kuisa nzira dzekugadzirisa zvido izvi nenzira yakanakisisa sezvinobvira.
Mune mamwe makambani ehutano inshuwarhu, anogona kuisa mamiriro ekushanda kwebasa kune varwere vane chirwere chisingaperi chinorwara. Semuenzaniso, kana achishanda chete nehutatoid arthritis varwere, iye nyanzvi yekugadzirisa kutarisira varwere veR RA uye vanogona kutarisira kutarisira kwavanoda uye nekunyatsogadzirisa kuisa nzira dzekuzadzisa zvido izvi. Anokwanisa kudarika nepepuru tsvuku uye angave nekwaniso yekusvika kunze kwezvakabatsirika zvehutano inshuwarisi yehutano uye kubvumira zvinhu kana mabasa asina kunyatsogadziriswa nehutano hwehutano asi iyo inobvumira kutarisirwa kuendeswa zvakajeka uye kuchengetedza mari munguva refu. Anoshanda kuti asangane nezvinodiwa nemurwere paanenge akatarira ziso uye nguva refu.
Ndiani Anoita Case Management?
Maitiro ekutungamirira anowanzoitwa nevanamukoti, asi kwete nguva dzose. Zvichienderana nemamiriro ezvinhu, rumwe ruzivo rwenyanzvi runogona kupa nyaya yekuchengetedza mabasa. Semuenzaniso, munhu anopa nyaya yekuchengetedza nyaya munharaunda yekushandisa zvinodhaka zvekushandisa zvinodhaka angave ane ruzivo rwekushandisa kushandisa zvinodhaka zvisina kunaka. Hazvisi zvisingazivikanwi kuti nyaya yekugadzirisa inofanira kuitwa nehutano hwevashandi vehutano.
Kuti uwane mamwe ruzivo pamusoro pemhosva yemhosva yemhosva, ona Komisheni ye Case Case Certification.
> Sources:
> Vanachiremba veAmerica Credentialling Center (Subsidiary yeAmerican Nurses Association), Nursing Case Management.
> Dhipatimendi reUnited Health yeHurumende neHuman Services, Sangano reUnited Healthcare Research uye Unhu, Zvipo zvehutano hwechirwere chisingaperi, February 2013.