Zowerengeka Zochepa Pambuyo pa Chipatala cha CAP Ndi Zopewedwa - ZhongXing

Kuwunika kwa kuwerengedwa kwa zipatala za chibayo chotengedwa ndi anthu ammudzi (CAP) ku France kunapeza kuti zowerengeka zochepa zomwe zingalephereke, kuchirikiza kutsutsidwa kuti muyesowu ungayambitse zilango zopanda chilungamo pamachitidwe olipira.
Zowerengeka zochepa zomwe zimalephereka pambuyo pogonekedwa m'chipatala chifukwa cha chibayo chopezeka ndi anthu ammudzi, kafukufuku watsopano ku France wapeza, akuwonetsa kuti chizindikirochi sichingakhale muyeso woyenera pamapulogalamu olipira chipatala.
Kafukufuku wobwerezabwereza wa gulu la anthu omwe adasindikizidwa mu JAMA Network Open adaphatikiza odwala 1150 omwe anali ndi chibayo chopezeka ndi anthu ammudzi omwe adagonekedwa ku Grenoble University Hospital ndi Annecy General Hospital ku France mu 2014.
Bastien Boussat, MD, wa dipatimenti ya Epidemiology pachipatala cha Grenoble University ku Grenoble, France, adauza Contagion kuti: "Ochepa chabe mwa anthu omwe abwereranso pambuyo pogonekedwa m'chipatala chifukwa cha chibayo amatha kupewedwa (osachepera m'modzi mwa 10 omwe adawerengedwanso).
Phunziroli linaphatikizapo amuna a 651 (56.6%) omwe ali ndi zaka zapakati pa zaka 77.8, odwala 98 (8.5%) adamwalira m'chipatala, odwala 184 adalandiridwanso mkati mwa masiku 30, ndipo 108 (9.4%) adalandiridwa mosayembekezereka.
Deta yosonkhanitsidwa imaphatikizapo comorbidities, kalasi ya chiopsezo cha chibayo, kufufuza kwa thupi ndi zotsatira za labotale, X-ray kapena CT scan scan ndi zotsatira za microbiological, komanso chithandizo ndi zovuta.
Phunziroli linaphatikizapo kubwereza zolemba zachipatala ndi akatswiri a zachipatala omwe adayesa chikhalidwe chosakonzekera, chikhalidwe chopeŵeka ndi zifukwa zowerengera.Mlandu uliwonse udawunikiridwa ndi akatswiri a 4 kuchokera ku gulu la madokotala ovomerezeka a board 9, kuphatikizapo akatswiri a matenda opatsirana a 3, 3 pulmonologists, ndi 3 epidemiologists yachipatala.Mwayi wa kupeŵeka, kusanthula kwapamwamba kwapamwamba ndi kusanthula kwa Bayerian classibility ndi kusanthula kwapamwamba kwa Bayerian wamkulu kuposa 50% amaonedwa kuti ndi otetezeka.
Zolemba khumi ndi zisanu za 108 zosakonzekera zowerengera zinali ndi chiwerengero cham'mbuyo chowonjezereka kuposa 50% (13.9% ya 108 yowerengedwa yosakonzekera; 95% CI, 8.0% -21.9%).Odwala omwe amapewa kuwerengedwa kwa masiku a 4 anali ndi nthawi yochepa kwambiri pakati pa kutulutsidwa ndi kuwerengedwa poyerekeza ndi masiku 12 (p = 12).
Boussat adati adadabwa ndi zovuta zomwe akatswiri adakumana nazo povomereza ngati kubwezeredwa kungathe kupewedwa komanso kuchepa kwa kubwezeredwa komwe kungapeweke.
Pa zowerengera zosakonzekera za 108, 51 okha (47.2%) anali ogwirizana kwathunthu pakati pa owunikira anayi odziyimira pawokha, kuphatikiza wodwala m'modzi yemwe amadziwika kuti ndi wopeŵeka.
"Kugwiritsa ntchito kuwerengedwa kwa masiku a 30 pambuyo pa chipatala cha CAP kuti mudziwe malipiro ofulumira komanso malipoti a anthu akhoza kulanga zipatala mopanda chilungamo," adatero Boussat, akugogomezera kuti "pamene ndondomeko yoweruza imaphatikizapo kumvera kwa obwereza, Kubwereza kodziimira kosiyanasiyana.
Centers for Medicaid and Medicare Services inayambitsa ndondomeko yolipira malipiro ku 2008, kugwirizanitsa kubwezera kwa Medicare ku chipatala chachipatala. ndondomeko zoyendetsera ntchito, olembawo amati, pozindikira kuti adatsutsidwa chifukwa chosaganizira mokwanira zovuta zachipatala komanso kusapeŵeka kwa kuwerengedwa kwina.
"Opanga ndondomeko atha kupanga malipoti a dziko molingana ndi njira yomwe yagwiritsidwa ntchito mu kafukufukuyu, kuwunikiranso kwa akatswiri omwe awerengedwa," adatero Boussat."