Sh\u00ebrbimi Kujdesit Sh\u00ebndetsor nuk mund t\u00eb jet\u00eb i efektsh\u00ebm pa kontributin e Sh\u00ebndetit Publik. Dihet q\u00eb shumica e vdekjeve t\u00eb hershme dhe s\u00ebmundjet kronike i atribohen stilit t\u00eb jet\u00ebs, shprehive t\u00eb gabuara, ambientit t\u00eb pap\u00ebrshtatsh\u00ebm, apo rrethanave sociale. Dihet q\u00eb promocioni i sh\u00ebndetit dhe parandalimi i s\u00ebmundjeve, p\u00ebrmir\u00ebsojn\u00eb cil\u00ebsin\u00eb e jet\u00ebs dhe e zgjasin at\u00eb. Dihet q\u00eb shum\u00eb nga s\u00ebmundjet e shekullit, t\u00eb pamundura p\u00ebr t\u2019u trajtuar, jan\u00eb krejt\u00ebsisht t\u00eb parandalueshme. Madje, disa lloje tumoresh, aksidentet automobilistike, vdekje t\u00eb parakohshme nga duhan-pirja, konsumi i tep\u00ebrt i alkoolit, p\u00ebrdorimi i drogave, “mjekim” t\u00eb vet\u00ebm kan\u00eb parandalimin. <\/p>\n
Sh\u00ebndeti publik Vs. Kujdesi mjeksor<\/p>\n
P\u00ebr ilustrim le t\u00eb ndalemi te dy problemet m\u00eb t\u00eb m\u00ebdha sh\u00ebndetsore t\u00eb shekullit : diabetin dhe obezitetin. N\u00eb rastin e diabetit, Kujdesi Mjeksor ndoshta \u00ebsht\u00eb duke e fituar betej\u00ebn p\u00ebr kontrollin e nivelit t\u00eb sheqerit n\u00eb gjak, por \u00ebsht\u00eb duke humbur luft\u00ebn p\u00ebr frenimin e epidemis\u00eb s\u00eb diabetit q\u00eb po p\u00ebrhapet pa u ndalur. E njejta gj\u00eb me obezitetin. Ndon\u00ebse nj\u00eb progres shkencor \u00ebsht\u00eb b\u00ebr\u00eb n\u00eb zbulimin e hallkave me t\u00eb imta t\u00eb fizillogjis\u00eb se tij, asnj\u00eb rrezultat n\u00eb zbutjen e epidemis\u00eb. Me t\u00eb drejt\u00eb lindin pyetje : a \u00ebsht\u00eb racionale t\u00eb vazhdohet m\u00eb tej me p\u00ebrsosjen e antidod\u00ebve farmaceutik\u00eb kund\u00ebr obezitetit, apo duhet t\u00eb p\u00ebrpiqemi me t\u00eb gjitha forcat p\u00ebr t\u00eb ndryshuar mjedisin q\u00eb e shkakton !? A \u00ebsht\u00eb rritja e shpenzimeve p\u00ebr medikamente zgjidhja e problemit ? Dhe kjo vlen p\u00ebr shumic\u00ebn e s\u00ebmundjeve kronike q\u00eb tashm\u00eb po dominojn\u00eb sken\u00ebn e s\u00ebmundshm\u00ebris\u00eb. Pra, n\u00eb nj\u00eb k\u00ebndv\u00ebshtrim m\u00eb t\u00eb gjer\u00eb, nuk jan\u00eb zgjidhjet klinike ato q\u00eb do t\u00eb frenojn\u00eb shtimin e pandalsh\u00ebm t\u00eb s\u00ebmundjeve kronike . E vetmja mund\u00ebsi \u00ebsht\u00eb q\u00eb investimi t\u00eb b\u00ebhen n\u00eb nivelin komb\u00ebtar t\u00eb parandalimit n\u00ebp\u00ebrmjet programeve t\u00eb Sh\u00ebndetit Publik. Rr\u00ebnj\u00ebt q\u00eb ushqejn\u00eb k\u00ebto epidemi jan\u00eb faktor\u00ebt social\u00eb, faktor\u00eb q\u00eb kan\u00eb t\u00eb b\u00ebjn\u00eb me stilin e jet\u00ebs, faktor\u00eb q\u00eb p\u00ebr fat t\u00eb mir\u00eb mund t\u00eb ndryshohen. Kujdesi Mjeksor, pak mund t\u00eb b\u00ebj\u00eb p\u00ebr nj\u00eb mushk\u00ebri t\u00eb shkat\u00ebrruar nga duhani, nj\u00eb m\u00ebl\u00e7i t\u00eb shkat\u00ebruar nga alkooli, nj\u00eb kafk\u00eb t\u00eb thyer n\u00eb aksident rrugor, p\u00ebr pasojat e nj\u00eb diete t\u00eb pap\u00ebrshtashme apo aktivitetit fizik t\u00eb munguar. \u00cbsht\u00eb Sh\u00ebndeti Publik ai q\u00eb p\u00ebrpiqet t\u2019i frenoj\u00eb k\u00ebto t\u00eb k\u00ebqia t\u00eb mos ndodhin. Sh\u00ebndeti Publik \u00ebsht\u00eb m\u00eb tep\u00ebr se kaq. Sh\u00ebndeti dhe s\u00ebmundja nuk jan\u00eb vet\u00ebm rezultat i zgjedhjes individuale, apo nj\u00eb llotari gjenetike \u2026 n\u00eb rradh\u00eb t\u00eb par\u00eb jan\u00eb rezultat i srukturave sociale dhe interesave ekonomike q\u00eb na rrethojn\u00eb. Sh\u00ebndeti Publik operon n\u00eb pika ku psikologjia, sociologjia, ekonomia, politika, gjeografia dhe mjeksia nd\u00ebrpriten, kryq\u00ebzohen, mbivendosen. Faktor\u00eb si strehimi, t\u00eb ardhurat, pun\u00ebsimi, etj, \u00e7eshtje q\u00eb dominon\u00eb jet\u00ebn publike, jan\u00eb p\u00ebrcaktues t\u00eb r\u00ebnd\u00ebsish\u00ebm t\u00eb sh\u00ebndetit dhe mir\u00ebqenies. N\u00eb m\u00ebnyr\u00eb t\u00eb ngjashme, shum\u00eb nga p\u00ebrcaktuesit madhor\u00eb t\u00eb pabarazis\u00eb n\u00eb sh\u00ebndet shtrihen jasht\u00eb sektorit sh\u00ebndetsor, prandaj dhe p\u00ebr t\u2019i shmangur, nuk k\u00ebrkohen politikat e Kujdesit Mjeksor. <\/p>\n
Por \u00e7\u2019ndodh n\u00eb t\u00eb v\u00ebrtet\u00eb ? <\/p>\n
N\u00eb vend q\u00eb t’i adresohen shkaqeve q\u00eb shkaktojn\u00eb s\u00ebmundjen, eleminimit t\u00eb tyre, njer\u00ebzit vazhdojn\u00eb t\u00eb kujdesen p\u00ebr sh\u00ebndetin vet\u00ebm pasi jan\u00eb goditur nga s\u00ebmundja. \u00cbsht\u00eb fakt se shumica e resurseve p\u00ebr sh\u00ebndetin p\u00ebrdoren p\u00ebr kurim, mbasi njer\u00ebzit jan\u00eb s\u00ebmur\u00eb, apo p\u00ebr menaxhimin e s\u00ebmundjet kronike, mbasi ato jan\u00eb shfaqur. Sh\u00ebndeti Publik, ndon\u00ebse kaq i r\u00ebnd\u00ebsish\u00ebm, vazhdon t\u00eb konsiderohet si “kush\u00ebri i varf\u00ebr” i Kujdesit Mjeksor. Edhe n\u00eb vendet m\u00eb t\u00eb zhvilluara si SHBA, rreth 95% e gjith\u00eb shpenzimeve p\u00ebr sh\u00ebndetin alokohen p\u00ebr Kujdesin Mjeksor, dhe vet\u00ebm 5% p\u00ebr Sh\u00ebndetin Publik.<\/p>\n
Pse ky n\u00ebnvler\u00ebsim ?<\/p>\n
Arsyet jan\u00eb disa. Nj\u00eb nga zgjedhjet m\u00eb t\u00eb r\u00ebnd\u00ebsishme q\u00eb \u00e7do individ apo shoq\u00ebri duhet t\u00eb b\u00ebj\u00eb, \u00ebsht\u00eb: t’i p\u00ebrdor\u00eb resurset q\u00eb ka p\u00ebr t\u00eb k\u00ebnaqur d\u00ebshirat e momentit p\u00ebr Kujdes Mjeksor (konsum n\u00eb terma ekonomike), apo t\u00eb krijoj\u00eb nj\u00eb kapital, q\u00eb do t\u00eb sh\u00ebrbej\u00eb p\u00ebr t\u00eb ardhmen n\u00eb Sh\u00ebndetin Publik (investim n\u00eb terma ekonomike) ? Truri yn\u00eb, pjes\u00ebt e korteksit q\u00eb kan\u00eb t\u00eb b\u00ebjn\u00eb me k\u00ebnaq\u00ebsin\u00eb imediate, padurimin, jan\u00eb m\u00eb t\u00eb hershme, m\u00eb t\u00eb gjera, m\u00eb t\u00eb fuqishme. \u00cbsht\u00eb kjo ar\u00ebsyeja pse investimet, t\u00eb cilat k\u00ebrkojn\u00eb vullnet dhe durim p\u00ebr ta shtyr\u00eb k\u00ebnaq\u00ebsin\u00eb p\u00ebr t\u00eb ardhmen, preferohen m\u00eb pak. Politikan\u00ebt kan\u00eb edhe nj\u00eb arsye m\u00eb shum\u00eb. Ata duan q\u00eb p\u00ebrfitimet e investimit t’i korrin brenda mandatit t\u00eb tyre. Dhe nd\u00ebrsa p\u00ebrfitimet nga investimet n\u00eb Sh\u00ebndetin Publik shpesh duan vite, e kund\u00ebrta ndodh me Kujdesin Mjeksor ku p\u00ebrfitimet jan\u00eb m\u00eb t\u00eb shpejta, mbasi i sigurojn\u00eb njer\u00ebzve k\u00ebnaq\u00ebsi t\u00eb menj\u00ebher\u00ebshme n\u00ebp\u00ebrmjet leht\u00ebsimit t\u00eb shpejt\u00eb nga s\u00ebmundja. Arsye p\u00ebrb\u00ebn dhe fakti se arritjet e Sh\u00ebndetit Publik nuk krijojn\u00eb emocione publike t\u00eb forta. Kur dikush p\u00ebrballet me vdekjen, individi, familja, dhe shoq\u00ebria jan\u00eb t\u00eb gatsh\u00ebm t\u00eb paguajn\u00eb (pavar\u00ebsisht kostos) p\u00ebr \u00e7do kurim q\u00eb premton sadopak shp\u00ebtimin e jet\u00ebs. N\u00eb t\u00eb kund\u00ebrt\u00ebn, njer\u00ebzit e sh\u00ebndetsh\u00ebm nuk jan\u00eb gjithmon\u00eb t\u00eb gatsh\u00ebm t\u00eb paguajn\u00eb p\u00ebr investime parandaluese q\u00eb do t\u00eb shp\u00ebtonin shum\u00eb m\u00eb tep\u00ebr jet\u00eb, p\u00ebr t\u00eb njejt\u00ebn sasi parash t\u00eb shpenzuara. P\u00ebr ilustrim : n\u00eb vitin 1988, n\u00eb Teksas ra n\u00eb nj\u00eb pus f\u00ebmija 18-muajshe, Jessica. E gjith\u00eb Amerika mbeti pa frym\u00eb. N\u00eb at\u00eb moment emocional njer\u00ebzit ishin t\u00eb gatsh\u00ebm t\u00eb shpenzonim miliona p\u00ebr t\u00eb shp\u00ebtuar beben, nd\u00ebrkoh\u00eb q\u00eb nuk do t\u00eb ishin t\u00eb gatsh\u00ebm t\u00eb b\u00ebnin t\u00eb nj\u00ebjt\u00ebn gj\u00eb p\u00ebr t\u00eb parandaluar vdekje statistikisht t\u00eb sigurta t\u00eb shum\u00eb bebeve. Njer\u00ebzit jan\u00eb t\u00eb gatsh\u00ebm t\u00eb sigurojm\u00eb resurse p\u00ebr t\u00eb let\u00ebsuar katastrofat, (p\u00ebrmbytje, etj), por jan\u00eb m\u00eb pak t\u00eb gatsh\u00ebm ta b\u00ebjn\u00eb k\u00ebt\u00eb p\u00ebr t’i parandaluar ato. P\u00ebr t\u00eb njejtat arsye emocionale, shum\u00eb m\u00eb t\u00eb d\u00ebgjuar jan\u00eb mjek\u00eb, q\u00eb me nd\u00ebrhyrje spektakolare shp\u00ebtojn\u00eb jet\u00eb, ndon\u00ebse m\u00eb t\u00eb pakta n\u00eb num\u00ebr. Kujtoni sa i njohur u b\u00eb kardio-kirurgu Christian Barnard, autori i transplantit t\u00eb par\u00eb t\u00eb zemr\u00ebs, nd\u00ebrkoh\u00eb q\u00eb fare pak njihet bashk\u00ebkoh\u00ebsi i tij, Hilleman, i cili me 30 vaksinat e tij, ka shp\u00ebtuar m\u00eb shum\u00eb jet\u00eb njer\u00ebzore se \u00e7do shkenctar tjet\u00ebr i shekullit 20 ! Por n\u00ebnvler\u00ebsimi i Sh\u00ebndetit Publik ka dhe shkaqe t\u00eb tjera. Ndryshimet sociale q\u00eb p\u00ebrb\u00ebjn\u00eb baz\u00ebn e programeve t\u00eb sh\u00ebndetit publik, jo rrall\u00eb frenohen, mbasi prekin interesat e lobeve t\u00eb fuqishme ekonomike (si n\u00eb rastin e industrive t\u00eb alkoolit, duhanit, ushqimeve, automobilave, qymyrit, naft\u00ebs, arm\u00ebve, etj). Mjafton t\u00eb p\u00ebrmendin faktin q\u00eb n\u00eb koh\u00ebn kur obeziteti dhe diabeti p\u00ebrb\u00ebjn\u00eb problemin sh\u00ebndetsor t\u00eb shekullit, n\u00eb qershor 2010, si pasoj\u00eb e lobimit intensiv t\u00eb korporatave nd\u00ebrkomb\u00ebtare t\u00eb ushqimit, Parlamenti Europian, hodhi posht\u00eb planin p\u00ebr nj\u00eb sistem informacioni q\u00eb n\u00ebp\u00ebrmjet etiketimit t\u00eb ushqimeve t\u00eb sh\u00ebndetshme do ndihmonte konsumator\u00ebt. Nd\u00ebrkoh\u00eb, e kund\u00ebrta ndodh me shpezimet p\u00ebr Kujdesin Mjeksor, t\u00eb cilat nxiten fuqimisht nga interesat e kompanive farmaceutike, t\u00eb sigurimeve, etj.<\/p>\n
N\u00eb vend t\u00eb mbylljes<\/p>\n
Profili i sot\u00ebm epidemiologjik i Shqip\u00ebris\u00eb ka disa ve\u00e7ori. S\u00ebmundshm\u00ebria \u00ebsht\u00eb n\u00eb tranzicion: s\u00ebmundjet infektive jan\u00eb n\u00eb r\u00ebnie nd\u00ebrsa ato kronike n\u00eb rritje t\u00eb shpejt\u00eb, madje po dominojn\u00eb sken\u00ebn. Nd\u00ebrsa, vdekshm\u00ebria \u00ebsht\u00eb e ngjashme me at\u00eb t\u00eb vendeve per\u00ebndimore. Kjo situat\u00eb k\u00ebrkon ndryshime jo vet\u00ebm n\u00eb nentalitet. I r\u00ebnd\u00ebsish\u00ebm \u00ebsht\u00eb edukimi mjeksor, sigurimi i informacionit q\u00eb mund\u00ebson marrjen e vendimeve t\u00eb duhura p\u00ebr sh\u00ebndetin, ndryshimin e shprehive q\u00eb ndikojn\u00eb drejtp\u00ebrdrejt n\u00eb faktor\u00ebt e riskut p\u00ebr s\u00ebmundje. Por vet\u00ebm p\u00ebrmir\u00ebsimi i dijeve nuk mjafton. T\u00eb domosdoshme jan\u00eb nismat politike – publike, programet komb\u00ebtare p\u00ebr kontrollin e s\u00ebmundjeve t\u00eb zemr\u00ebs, obezitetit, diabetit, kancerit, aksidenteve rrugore apo atyre me arm\u00eb zjarri, n\u00eb t\u00eb cilat Sh\u00ebndeti Publik luan rol thelb\u00ebsor. Ndon\u00ebse Sh\u00ebrbimi Mjeksor dhe Sh\u00ebndeti Publik ecin n\u00eb linja t\u00eb ndara, integrimi i tyre \u00ebsht\u00eb tejet i r\u00ebnd\u00ebsish\u00ebm. Por kjo k\u00ebrkon edhe ndryshimin e raporteve t\u00eb financimit. Vet\u00ebm 2% e shpenzimeve t\u00eb sh\u00ebndetsis\u00eb p\u00ebr Sh\u00ebndetin Publik, krahasuar me 52% p\u00ebr sh\u00ebrbimin spitalor dhe 42% p\u00ebr sh\u00ebrbimin par\u00ebsor, jan\u00eb t\u00eb pamjaftueshme. V\u00ebrtet\u00eb larja e duarve ndikoi n\u00eb mos-p\u00ebrhapjen e s\u00ebmundjeve infektive, por epidemit\u00eb infektive n\u00eb bot\u00ebn e zhvilluar nuk u eleminuan duke inkurajuar \u00e7do njeri t\u00eb laj\u00eb duart me sapun, por n\u00ebp\u00ebrmjet politikave t\u00eb nd\u00ebrtimit t\u00eb kanalizimeve, furnizimit me uj\u00eb t\u00eb past\u00ebr t\u00eb gjith\u00eb popullat\u00ebs, si dhe t\u00eb tjera masa t\u00eb sh\u00ebndetit publik. Sh\u00ebndeti i publikut ndikon mbi t\u00eb gjith\u00eb. N\u00eb fund t\u00eb fundit, publiku jemi Ne dhe Ai \u00ebsht\u00eb sh\u00ebndeti yn\u00eb. Sot, m\u00eb shum\u00eb se kurr\u00eb, \u00ebsht\u00eb koha e ri-vlersimit t\u00eb vlerave t\u00eb Sh\u00ebndetit Publik.<\/p>\n","protected":false},"excerpt":{"rendered":"
Sh\u00ebrbimi Kujdesit Sh\u00ebndetsor nuk mund t\u00eb jet\u00eb i efektsh\u00ebm pa kontributin e Sh\u00ebndetit Publik. Dihet q\u00eb shumica e vdekjeve t\u00eb hershme dhe s\u00ebmundjet kronike i atribohen stilit t\u00eb jet\u00ebs, shprehive t\u00eb gabuara, ambientit t\u00eb pap\u00ebrshtatsh\u00ebm, apo rrethanave sociale. Dihet q\u00eb promocioni i sh\u00ebndetit dhe parandalimi i s\u00ebmundjeve, p\u00ebrmir\u00ebsojn\u00eb cil\u00ebsin\u00eb e jet\u00ebs dhe e zgjasin at\u00eb. […]<\/p>\n","protected":false},"author":2,"featured_media":33664,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":{"0":"post-33663","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-te-tjera"},"_links":{"self":[{"href":"https:\/\/neutrale.al\/index.php\/wp-json\/wp\/v2\/posts\/33663","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/neutrale.al\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/neutrale.al\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/neutrale.al\/index.php\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/neutrale.al\/index.php\/wp-json\/wp\/v2\/comments?post=33663"}],"version-history":[{"count":1,"href":"https:\/\/neutrale.al\/index.php\/wp-json\/wp\/v2\/posts\/33663\/revisions"}],"predecessor-version":[{"id":33665,"href":"https:\/\/neutrale.al\/index.php\/wp-json\/wp\/v2\/posts\/33663\/revisions\/33665"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/neutrale.al\/index.php\/wp-json\/wp\/v2\/media\/33664"}],"wp:attachment":[{"href":"https:\/\/neutrale.al\/index.php\/wp-json\/wp\/v2\/media?parent=33663"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/neutrale.al\/index.php\/wp-json\/wp\/v2\/categories?post=33663"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/neutrale.al\/index.php\/wp-json\/wp\/v2\/tags?post=33663"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}