Ya kamata a ba da taken wannan post ɗin binciken wanda aka buga a cikin 2022. Na rasa wannan littafin har kwanan nan, watakila saboda taken da ba shi da cikakken bayani: "Ingantacciyar gidan jinya, mutuwar COVID-19, da yawan mace-mace." Babu wani abu da ke nuna alamun girgizar ƙasa.
Bayanin daga doguwar takarda ya saba wa abin da mutane da yawa za su yi tunani: mafi girman yunƙurin ragewa a gidajen kula da tsofaffi na Amurka, mafi girma adadin wadanda suka mutu a lokacin barkewar cutar. Waɗannan yunƙurin ba wai kawai sun gaza rage yawan mace-macen Covid ba, har ma sun ƙara mutuwar wadanda ba na Covid ba. Ƙoƙarin da suka yi don ragewa, mafi munin sakamakon ya kasance.
An rarraba nau'in takarda mai aiki a cikin Oktoba 2020. An ƙaddamar da rubutun farko ga mujallar a cikin Maris 2021, kuma ya ɗauki mawallafin watanni goma don ƙaddamar da sigar ƙarshe, fiye da lokacin da aka saba. Ina tsammanin cewa marubutan ba su yi tsammanin sakamakon ba tukuna da ƙarfin hali sun yarda da su. Don tabbatar da ingancin su, sun ƙara ƙarin bayanai kuma sun yi “bincike mai ƙarfi” na ban mamaki. Da alama marubutan sun yi aiki tuƙuru don faranta wa masu bita rai (wataƙila ba a san su ba) waɗanda wataƙila sun gwammace a binne rubutun.
Na gina samfurori guda uku na mahimmin sakamako daga Tebura 3, lambobi masu haske, da ƙarin kibiyoyi.
Ba tare da shiga cikin bayanin fasaha ba, manyan lambobi da ke sama sun gaya mana cewa gabaɗayan mace-mace a cikin gidajen kula da tsofaffi na Amurka yana da alaƙa da ingancinsu: mafi girman inganci, mafi girma adadin wadanda suka mutu. Waɗannan sakamakon sun yi daidai cikin lokuta uku a jere: Mayu zuwa Satumba 2020, Satumba zuwa Disamba 2020, da Disamba 2020 zuwa Afrilu 2021. Bugu da ƙari, dangantakar da ke tsakanin matsayi mai inganci da mace-mace ta ƙara ƙarfi akan lokaci. Yana kuma "monotonic;" wato, ana lura da su a cikin kowane nau'i mai inganci a jere. (Rukunin matsayi na tauraro 1 ya ɓace saboda yana aiki azaman nuni ga wasu.)
Me yasa ingancin martabar gidan reno ya kasance da alaƙa kai tsaye, maimakon sabani, ga duk- sanadin mace-mace yayin bala'in? Ana kuma nuna amsar a cikin Tebur 3: mafi girman matsayi, mafi girman adadin ba Covid mutuwar.
Shin ingancin martabar gidan kula da tsofaffi yana da alaƙa da mutuwar Covid?
Sai kawai a cikin lokacin farko muna lura da ƙungiyar da ba ta dace ba (lambobi mara kyau guda uku a jere). Kuma bai isa ba don watsi da alaƙar kai tsaye tare da mace-mace marasa Covid.
Me yasa mace-mace marasa Covid ya karu yayin da ingancin gidan kula da tsofaffi ya fi girma?
Marubutan sun ba da shawarar mafi kusantar bayanin dalilin. Matsayi mai inganci shine madogara don bin ƙa'idodin ragewa. Mafi girman ingancin gidan jinya, ana bin ƙa'idodin hukuma sosai. Kuma waɗancan jagororin sun sami sakamako mai yawa, waɗanda marubutan suka bayyana a matsayin "rashin rashin sa'a ga waɗannan manufofin farko waɗanda zasu iya yin mummunar tasiri ga lafiyar mazaunin gida."
Da yake ambaton binciken da ya dace, sun ƙayyade wasu hanyoyin: matsanancin keɓewa, wanda zai iya zama mai kisa a cikin Alzheimer's; abincin da ba a kula da shi ba yana haifar da asarar nauyi; rashin ayyukan haɗin gwiwa, wanda ya rage yawan motsa jiki da kuma ƙara lokacin da aka kashe a gado; da kuma babban raguwa a cikin kula da lafiya na yau da kullum na marasa ƙarfi, tsofaffi mazauna. Waɗannan hanyoyin da za a iya ɗauka an rubuta su cikin ban tsoro labarun sirri.
Na bambanta daga marubuta akan manyan abubuwa guda biyu. Na farko, ba sa faɗin kalma ɗaya game da ƙarancin rarraba mace-mace ga Covid. Na biyu, kuma mafi mahimmanci, sun yi imanin cewa allurar rigakafin mazauna gidajen jinya ta taka muhimmiyar rawa a farkon 2021.
Na sadaukar da kasidu da dama ga wannan batu (Cutar Kwayar cuta ta Covid: Maƙasudin Nazari marasa Al'ada). Tasirin allurar rigakafin Covid akan mutuwar Covid ya kasance na ɗan lokaci kuma matsakaici a mafi kyau. Mai yiwuwa, ya kasance kusa da sifili or korau a cikin tsofaffi marasa ƙarfi.
Ya zuwa yanzu, an yarda cewa allurar rigakafin Covid ba su rage haɗarin kamuwa da cuta ba, amma har yanzu jami'ai sun ce sun rage haɗarin mutuwa idan kamuwa da cuta. Yin amfani da bayanai daga Tebu 1 a cikin labarin, zan nuna cewa yawan mace-mace (CFR) bai ragu ba yayin yakin neman rigakafin. Haka kuma allurar rigakafin Covid ba su rage Covid da duk- sanadin mace-mace a cikin wannan jama'a masu rauni ba. A ƙarshe, zan yi amfani da bayanan takardar don ƙididdige ƙididdiga masu ƙima na yawan mace-mace a cikin gidajen kula da tsofaffi na Amurka da kuma rabon da ya kamata a dangana ga ƙoƙarin ragewa.
Marubutan sun ba da rahoton adadin jimlar kawai a maki huɗu, ba daidai ba. Lokaci na ƙarshe ya ƙunshi kamfen ɗin rigakafin (kamar na Janairu 2021). Tebur na da ke ƙasa yana nuna ƙimar shari'ar Covid da mace-mace a kowane lokaci da gabaɗaya (kusan shekara ɗaya).
CFR, kamar yadda aka lissafta daga bayanan takarda, bai ragu ba a cikin lokaci na ƙarshe, duk da yawan alurar riga kafi a gidajen kulawa. Ya kasance kusan kama da CFR a farkon lokaci kuma sama da CFR a cikin lokaci na biyu.
Dangane da bayanan CDC, kusan kashi 25% na mutuwar Covid a Amurka sun kasance rashin rarraba a cikin watanni biyar na farkon 2021. Wadannan mutuwar wasu yanayi ne suka haifar da su kuma da sun faru ko da babu annoba. Ba su taimaka wajen yawan mace-mace ba. Idan muka yi amfani da gyara zuwa lokacin ƙarshe (hunturu/ bazara), adadin mutuwar Covid na gaskiya ya kasance 2.3 (maimakon 3.1), kuma CFR ya kasance 16.2% (2.3/14.22), kama da CFR a cikin lokacin riga-kafin nan da nan.
Duk lissafin biyu suna kaiwa ga ƙarshe ɗaya. CFR a lokacin alurar riga kafi yayi kama da CFR a farkon lokaci, ko dai na farko ko na biyu.
Tebu na gaba yana nuna adadin mutuwar wata-wata (Covid, non-Covid, da duk-dalilai) a cikin lokaci guda. An ƙididdige waɗannan ƙimar (kowane gadaje 100) ta hanyar rarraba adadin kwanakin da adadin kwanakin da ke cikin lokacin da ninka da 30.
A cikin layi na ƙarshe, na ƙididdige adadin duk abin da ke haifar da mutuwar kowane mazaunin 100 (%) ta la'akari kimanta zama a kowane lokaci.
Idan muka yi amfani da gyaran da ya gabata zuwa lokaci na uku (hunturu/ bazara), adadin mutuwar Covid na gaskiya ya kasance 0.49 maimakon 0.66, kuma adadin wadanda ba na COVID-1.81 ba ya kasance 1.64 maimakon 100. Waɗannan ƙimar (a kowane gadaje 0.46) sun yi kama da daidaitattun ƙimar a farkon lokacin (1.76 da XNUMX). Suna da ɗan girma yayin ɗaukar ƙananan zama cikin lissafi. Ko ta yaya, adadin mutuwar Covid na wata-wata a lokacin rigakafin bai yi ƙasa da adadin a farkon lokacin ba tare da allurar rigakafi ba.
Lokacin wucin gadi shine mafi guntu. Kamar yadda ake tsammani kowace shekara, duk wata mace-mace na kowane wata ya kasance mafi girma a cikin bazara fiye da lokacin bazara, amma da alama ya kasance saboda yawan mace-macen Covid kadai. Wannan na iya zama ba haka lamarin yake ba, kodayake, saboda rashin rarrabawar mutuwar ga Covid da alama ya ci gaba da kasancewa cikin bala'in cutar a cikin nau'i daban-daban. Bambance-bambancen dogaro da lokaci a cikin rashin rarrabawa, wanda ke da wahalar ƙididdigewa, yana ƙara wasu rashin tabbas ga kowane binciken abubuwan da ke faruwa a cikin mace-macen Covid.
Ko ta yaya, yawan mace-mace na kowane mazaunin 100 bai bambanta ta zahiri tsakanin hunturu/ bazara da faɗuwa (jeri na ƙarshe). Babu fa'idar rigakafin Covid, idan akwai, ko kuma mutuwarsu (babu shakka) na ɗan gajeren lokaci da ke bayyana a cikin mace-macen duka. Mitoci sun yi ƙasa kaɗan.
Gabaɗaya, kusan kashi 3.2% na mazaunan sun mutu kowane wata. Wannan kusan kashi 40 ne cikin shekara guda. Shin za mu iya ƙididdige yawan mace-mace a cikin wannan jama'a masu rauni?
M lissafin kasa, tare da heuristic gardama.
Yawan mace-macen mutanen da aka kwantar da su a gidan jinya sananne ne, amma bayanai ba su da yawa. Nazarin Amurka tun daga 2012-2013 ya ba da rahoton mutuwar kashi 35% na kowace shekara sabon shigar mazauna. Koyaya, mazaunan da aka lura a cikin shekara guda an shigar dasu a lokuta daban-daban na farko. Wasu daga cikinsu sun tsufa amma watakila sun fi koshin lafiya (masu tsira). Nazarin Norwegian Sabbin mazaunan da aka shigar sun sami kwanciyar hankali na mace-mace na rukunin masu rai sama da shekaru uku na bin diddigin. Kusan kashi ɗaya bisa uku na ragowar ƙungiyar sun mutu kowace shekara.
Idan yawan mace-mace ("na al'ada") a cikin gidajen kula da tsofaffi na Amurka ya kasance kashi 33% yayin bala'in cutar, yawan mace-mace sama da watanni 12 ya kusan kashi 20%. Kuma idan yawan mace-macen da ake sa ran ya kasance 30% kawai, yawan mace-mace ya kusan kashi 30%.
Duk da cewa adadin wadanda suka mutu ya yi yawa, amma watakila an takaita rayuka da watanni, ba shekaru ba.
Nawa ne yawan mace-macen da ake iya dangantawa da ƙoƙarin rage rashin amfani da cutarwa, kamar yadda aka bayyana a cikin takarda? Ina bayar da ƙididdiga masu yawa.
Tebu na 3 yana nuna ƙididdiga na yawan mace-mace a cikin kowane lokaci don ƙimar ingancin tauraro 2 ko mafi girma, dangane da gidajen kulawa da matsayi na tauraro 1. Haɗa waɗannan lambobi ta hanyar samar da lissafi mai sauƙi kusan kashi 10% na mace-mace a cikin gidaje masu tauraro 2-5 a cikin kusan shekara guda..
Idan gidajen kula da marasa lafiya mafi ƙanƙanta (tauraro 1) sun ƙididdige yawan mace-macen da ake tsammani ba tare da rage komai ba, adadin ƙoƙarce-ƙoƙarce (10%) ya kai kashi ɗaya bisa uku (10/30) zuwa rabin (10/20) na yawan mace-mace a cikin watanni 12.
Shin kewayon ƙididdiga na yana da kyau? Shin za mu iya danganta aƙalla kashi ɗaya bisa uku na yawan mace-mace a gidajen kulawa da ƙoƙarin ragewa? Zai iya zama ma mafi girma?
Ina tsammanin cewa marubutan labarin ba za su yi mamaki ba. Misali, sun rubuta (shafi na 14):
A karshen wadannan lokuta uku (jere na 21), gidaje masu tauraro biyar sun sami kashi 17.5 cikin dari fiye da adadin wadanda suka mutu fiye da gidajen tauraro daya… Bisa kididdigar da muka yi, duk wadannan yawan mace-mace na faruwa ne saboda abubuwan da ba na Covid-XNUMX ba.
Wani kwararre a gidan jinya da ba a bayyana sunansa ba, wanda ya yi nazarin bayanai daga wurare 15,000 na kasar. a cikin Nuwamba 2020: "... ga kowane mutum biyu da aka samu COVID-19 a cikin kulawa na dogon lokaci, akwai wani wanda ya mutu da wuri saboda wasu dalilai." Kuma al'amura sun tsananta a lokacin sanyi.
Na yi karatu Rabon yawan mace-mace marasa Covid a cikin Amurka, a Arizona, a cikin gundumar Arizona, da kuma a cikin Isra'ila. Sakamakon ya yi daidai. Aƙalla kashi 15%, kuma har zuwa kashi ɗaya bisa uku, na yawan mace-mace ana iya danganta shi da martanin firgita ta kowane nau'i, gami da ƙoƙarin rage rashin amfani. Wannan rabon tabbas ya kasance mafi girma a cikin marasa ƙarfi na gidajen kulawa. Tabbas bai kasance ƙasa ba.
Ya kamata a ce binciken da na yi magana a nan ya kasance a cikin kafofin watsa labarai na yau da kullun. Abubuwan da aka gano suna da ƙarfi kuma suna ɓarna. Ina tsammanin 'yan kaɗan ne suka ji labarin. Wannan ba abin mamaki bane, duk da haka.
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Dokta Eyal Shahar farfesa ne a fannin kiwon lafiyar jama'a a fannin cututtukan cututtuka da kididdiga. Binciken nasa yana mayar da hankali ne akan ilimin cututtuka da kuma hanyoyin. A cikin 'yan shekarun nan, Dr. Shahar ya ba da gudummawa sosai ga hanyoyin bincike, musamman a fannin zane-zane da kuma son zuciya.
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