urgentcare: recovering from the urban hospital addiction

7/30/2019 UrgentCare: Recovering from the Urban Hospital Addiction

1/16

Xsl{q kqMNJF KBVO@N[SAbbvxs{nsalg kq @[F@ YA]]LBA DL[FD[LGS

AXXVF

986

[fhltf{ag` {lo sef V{kng Elxyasnb Nccahsalg

V{`fgs Hn{f


2/16

Tlbvof >" Axxvf 86'

;9>; GfUS Nof[AHNG HASQ

D{d{gs ax yvkbaxefc pffjbq kq

Gfus Nof{ahng Hasq" n 69>h8 glgy{ls

sens hlggfhsx hasafx ngc sef yflybfpl{jag` sl aoy{ltf sefo'

Gfus Nof{ahng Hasq'

;5>4 Pfxs @a{n{c Ntf'

Yeabncfbyean" YN >1>89

Dl{ xvkxh{aysalgx" ybfnxf taxas

ppp'nof{ahnghasq'l{`,xvkxh{akf'

Peabf Gfus Nof{ahng Hasq pfbhlofx sef xvkoaxxalg

l vgxlbahasfc pl{j" pf vgl{svgnsfbq onq gls kf

nkbf sl {fxylgc sl fnhe xvkoaxxalg agcatacvnbbq'

Ybfnxf xfgc pl{j sl n{afbbnInof{ahnghasq'l{`'

Dl{ nccasalgnb agl{onsalg" ybfnxf

taxas ppp'nof{ahnghasq'l{`'
http://www.americancity.org/subscribe.mailto:ariella%40americancity.org?subject=Forefront%20Submissionshttp://www.nextamericancity.org/http://www.nextamericancity.org/mailto:ariella%40americancity.org?subject=Forefront%20Submissionshttp://www.americancity.org/subscribe.


3/16

V{`fgs Hn{f , Mnjf Kbvo`n{s

>

DL[FD[LGS

C{atag` n{gc S{gsg pase C{' @{`{q Paan" q `s se ay{ag e

jgp y{ssq he t{q g d se hasq gn{q 56"999 {acgs' Ltf{ sef hlv{xf

l oq cnq pase eao" Pabbanox {ffsfc nbolxs n cl}fg yflybf" ltf{gofgs foyblqffx

ngc elofbfxx nbajf" {lo sef pagclp l eax hn{ l{ xs{lbbag` clpg sef xs{ffs' Asx n `llc

seag`" sll' Kfag` ag slvhe ax y{fssq ovhe eax mlk'

Pabbanox ax n hloovgasq l{`nga}f{ l{ sef {fgslg Efnbse fno" n glg/y{lshlbbnkl{nsatf sens ax s{qag`" lgf {fbnsalgxeay ns n saof" sl s{ngxl{o sef pnq efnbse hn{f

ax cfbatf{fc ag Gfp Mf{xfqx xs{v``bag` hnyasnb' Nbbafc pase sef {fgslg Cfyn{sofgs

l Yvkbah Efnbse ngc efnbse hn{f y{ltacf{x" aghbvcag` spl elxyasnbx ngc sef hasqx

blgf fcf{nbbq ~vnbafc efnbse hfgsf{" sef sfnox pl{j ax yn{s l n pntf l v{kng

y{l`{nox sens xen{f n oaxxalg l {fonjag` sef pnq sef pnq Nof{ahngx" fxyfhanbbq

sef aoyltf{axefc" {fhfatf efnbse hn{f'

Pabbanox ax snbb ngc pfn{x n gfnsbq s{aoofc xnbs/ngc/yfyyf{ kfn{c' Ef xyfnjx

pase ~vafs cfsf{oagnsalg nklvs eax c{atf sl jffy sef blp/aghlof yflybf ef pl{jx

pase lvs l sef elxyasnb'Ovhe l pens A cl glp ax {fnbbq mvxs xff sef pnbjag` cfnc" xnac Pabbanox" pel

oltfc sl {fgslg ag ;990 pase n {fxe cf`{ff ag V{kng Oagaxs{q {lo sef Gfp

K{vgxpahj Sflblàhnb Xfoagn{q" nf{ xyfgcag` cfhncfx ag hl{yl{nsf Nof{ahn'

Yflybf pel n{f mvxs lgf can`glxax npnq {lo c{lyyag` lvs pase eaè kbllc y{fxxv{f"

ngc xs{ljf" ngc cankfsfx" ngc hnghf{'

Bajf ongq Gfp Mf{xfq hasafx" {fgslg ax n taxalg l vghefhjfc oac/;9se hfgsv{q

v{kng cfhbagf' As gftf{ vgcf{pfgs sef l/enabfc {ftasnba}nsalg fuyf{afghfc ag

hasafx bajf Gfp Ql{j" Yeabncfbyean ngc Heahn`l' Pnbj se{lvè sef xsnsf hnyaslbx

clpgslpg ngc xff hefhj/hnxeag` mlagsx ngc {aoq Heagfxf snjflvsx nh{lxx sef xs{ffs{lo Hasq Enbb' Kln{cfc/vy xsl{f{lgsx xas hnssqhl{gf{ sl sef xsnsfx Cfyn{sofgs l

Fgta{lgofgsnb Y{lsfhsalg' Sf{f n{f fp `{lhf{q xsl{fx paseag sef hasqx 0'0 x~vn{f

oabfx' {fgslgx {nsfx l{ ftf{q sqyf l he{lgah abbgfxx s{voy sef ntf{n`f" pase >4

yf{hfgs l sef ylyvbnsalg xvf{ag` {lo cankfsfx ngc 8> yf{hfgs {lo eqyf{sfgxalg'

Gfn{bq 39 yf{hfgs l sef ylyvbnsalg ax lkfxf'

Sf efnbse h{axax ax gls en{c sl xff ns sef Jag`xkv{q nyn{sofgs slpf{x" n yvkbah

elvxag` cftfblyofgs ltf{blljag` sef Cfbnpn{f [atf{' Sf spl eaè {axfx" peahe n{f

lyfg sl blp/ ngc olcf{nsf/aghlof yflybf 66 ngc lbcf{" xsngc kfspffg sef xsnsf

Cfyn{sofgs l Efnbse" sef Evèfx Mvxsahf Hloybfu ngc sef tfgf{nkbf Xnh{fc Efn{s

Hev{he' Peabf sefxf xqoklbx l efnbse" nase ngc mvxsahf bllo ag sef knhj`{lvgc" sef

ongq fbcf{bq ngc blp/aghlof Jag`xkv{q {fxacfgsx" pel n{f y{fcloagngsbq N{ahng

Nof{ahng %{fgslg asxfb ax 6; yf{hfgs kbnhj! clgs fgmlq fnxq nhhfxx sl {fxe llc'

Ba~vl{ xsl{fx ngc ltf{y{ahfc hlgtfgafghf xelyx n{f nhhfxxakbf kq lls' D{fxe y{lcvhf"

gls xl ovhe'
http://trentonhealthteam.org/tht/http://trentonhealthteam.org/tht/


4/16


;

DL[FD[LGS

Lg n {fhfgs pffjcnq nf{gllg" n `{lvy l nklvs n cl}fg Jag`xkv{q {fxacfgsx

ofs ag lgf l sef kvabcag`x hloolg n{fnx' Sfq pf{f sef{f sl caxhvxx k{fnxs hnghf{

pase gv{xf y{nhsasalgf{ Yf` Gvhf{l" n ofokf{ l sef {fgslg Efnbse fno %E!'

Sf `{lvy hloy{axfc olxsbq oaccbf/n`fc ngc fbcf{bq plofg" nbselv`e n qlvg`

ong eltf{fc n{lvgc sef fc`fx ~vafsbq lkxf{tag` sef y{fxfgsnsalg' %Sf{f n{f blp/

{axf nyn{sofgs kvabcag`x ag sef xenclp l Jag`xkv{q" peahe elvxf ongq qlvg`noabafx'! Sf `nsef{ag`" cvkkfc sef Jag`xkv{q Efnbse fno" ax yn{s l n xf{afx l

pffjbq offsag`x efbc kq E' [fxacfgsx helxf sef slyahx" peahe {ng`f {lo clofxsah

nkvxf sl cankfsfx ongn`fofgs' Sf olxs cfcahnsfc ofokf{x l sef sfno yn{sahaynsf

ag s{nag/sef/s{nagf{ xfxxalgx" {vg kq Gvhf{l" peahe ftfgsvnbbq pabb fgnkbf sefo sl

fcvhnsf sefa{ fbblp {fxacfgsx'

Ag seax yn{sahvbn{ offsag`" Gvhf{l" ef{ kblgcf ena{ ag n hlgxf{tnsatf kvs xsqbaxe

klk" `ntf n hnxvnbbq l{se{a`es agsf{nhsatf y{fxfgsnsalg lg sef cng`f{x" {axj nhsl{x

ngc pn{gag` xa`gx l k{fnxs hnghf{' Xef nbxl xs{fxxfc sef aoyl{snghf l nggvnb

onool`{nox' A pabb p{asf qlv n xh{ays Zl{ n onool`{nyeq_ a qlv clgs entfy{aon{q hn{f" xef xnac' Ao cvf l{ lgf" sll' Abb `l pase qlv'

Gvhf{l sllj ~vfxsalgx cv{ag` ngc nf{ sef y{fxfgsnsalg" gls baoasag` caxhvxxalg

sl sef slyah ns engc' Lgf plong nxjfc nklvs kbllc y{fxxv{f ofcahnsalgx ngc pnx

nctaxfc lg kfxs y{nhsahfx %nbpnqx snjf as pase llc!' Nf{pn{cx Gvhf{l slbc of

sens sef nctaxl{q fbfofgsx l sef offsag`x n{f h{vhanb' Ongq cankfsah {fxacfgsx" l{

funoybf" cacgs jglp elp sl vxf n `bvhlofsf{ y{al{ sl sefa{ fg`n`fofgs pase E"

cfxyasf {f~vfgs F[ taxasx l{ hloybahnsalgx' Elp cl qlv fuyfhs yflybf sl hn{f l{

sefoxfbtfx paselvs knxah s{nagag`


5/16


8

DL[FD[LGS

Sf l{`nga}nsalg pl{jx kq hll{cagnsag` pase sef hasqx efnbse hn{f xsnjfelbcf{x

sl yllb cnsn ngc acfgsaq sef >8 yf{hfgs l Hnocfgx ylyvbnsalg {fxylgxakbf l{ 59

yf{hfgs l sef hasqx efnbse hn{f hlxsx' Lghf sefxf {fxacfgsx n{f acfgsafc" sef hlnbasalg

hll{cagnsfx sefa{ hn{f nh{lxx agxsasvsalgx ngc pl{jx pase sefo" xlofsaofx se{lvè

elof taxasx" sl gc lvs peq sefq sefa{ efnbse hlgsagvfx sl nab %{fxvbsag` ag fuyfgxatf

ngc vgybfnxngs {fyfns elxyasnba}nsalgx!' Hnbbfc els xylssag`" seax xqxsfo ax fxxfgsanbbqn ynsafgs/hfgsf{fc l{o l efnbse hn{f sens vxfx cnsn sl kfssf{ hlggfhs pase yflybf

ngc y{ltacf kfssf{ y{ftfgsnsatf hn{f' As lhvxfx lg yflybf pel" ag sef ynxs" entf nbbfg

se{lvè sef h{nhjx l sef efnbse hn{f xqxsfo vgsab sens xqxsfo enx sl {fhfatf sefo

ag ng nokvbnghf'

Pase n xsn l 38 ngc n baoasfc kvc`fs xvyyl{sfc kq fcf{nb {ngsx" sef glg/y{ls

enx nheaftfc xyfhsnhvbn{ xvhhfxxfx ag asx sasvbn{ hasq" klnxsag` n 64 yf{hfgs cfhbagf ag

sn{`fsfc ynsafgsx elxyasnb kabbx'Sf pl{j kfag` clgf ag Hnocfg ngc {fgslg ax xl xvhhfxxvb kfhnvxf efnbse hn{f

y{ltacf{x n{f pl{jag` sl`fsef{ sl s{fns sef pelbf ynsafgs ngc sl efnc l ofcahnb

hlgcasalgx kfl{f sefq {fnhe n h{axax ylags' Sax hlgs{nxsx xen{ybq pase sef xsngcn{c

pnq l clag` seag`x ag sef gnsalgx hv{{fgs efnbse hn{f xqxsfo' Vgcf{ sef eaxsl{ah

gl{o" y{ltacf{x n{f ynac l{ sef gvokf{ l y{lhfcv{fx yf{l{ofc" gls kq efnbse

lvshlofx' Y{ltacf{x {fonag pnbbfc l {lo hloyfsasl{x" fn{vb l xen{ag` pens

nolvgsx sl sefa{ kvxagfxx cnsn' Asx n xs{nsf`q sens pl{jx gf l{ nonxxag` y{ls ngc

s{fnsag` agmv{afx" kvs gls xl `{fns l{ s{fnsag` he{lgah abbgfxx l{ sef fbcf{bq'

Nof{ahng efnbse hn{f ax bajf ng agh{fcakbf l{hefxs{n pase sef olxs snbfgsfc

ovxahangx" kvs pf entfgs n`{ffc sl ybnq ag sef xnof jfq l{ ag sef xnof {eqseo ngc

pf n{f kfag` ynac yf{ glsf" K{fggf{ xnac'

A sef efnbsehn{f xqxsfo `fsx ol{f fhafgs" penspf{f snbjag` nklvs ax xblpag` sef {nsf l `{lpse" efxnac' Gls hvssag` efnbsehn{f" {fn{{ngàg` as'


6/16


3

DL[FD[LGS

Sf hlnbasalgx nheaftfofgsx ag Hnocfg entfgs fxhnyfc glsahf' Sax qfn{" sef

Lknon ncoagaxs{nsalg npn{cfc sef glg/y{ls #>0'; oabbalg ag `{ngsx sl xhnbf vy

sef y{l`{no sl s{fns nbb l Hnocfg ngc {fybahnsf as ag lv{ lsef{ hasafx = Xng Caf`l"

Nbbfgslpg" Yn'" Nv{l{n" Hlbl' ngc Jngxnx Hasq" Ol' %As nbxl {fhfatfc gnsalgnb nssfgsalg

pefg Nsvb @npngcf y{lbfc asx pl{j ag sef Gfp Ql{jf{ag Mngvn{q ;9>>'!

F}fjafb Fongvfb" Y{fxacfgs Lknonx l{of{ efnbse hn{f ylbahq nctaxl{" seagjxas pnx lgbq n onssf{ l saof vgsab lsef{ hasafx hnvès lgsl Hnocfgx xs{nsf`q' fg

yf{hfgs l sef ylyvbnsalg hlgxvofx nbolxs 40 yf{hfgs l sef efnbse hn{f hlxsx" xnac

Fongvfb" n tahf y{ltlxs ns sef Vgatf{xasq l Yfggxqbtngan ngc k{lsef{ sl [neo

Fongvfb" Lknonx l{of{ heaf l xsn ngc onql{ l Heahn`l'

K{fggf{x nyy{lnhe" ef xnac" ax sef jagc l els xylssag` pf gffc= Acfgsaqag`

yflybf bajfbq sl Zaghv{_ eaè hlxsx ngc `fssag` sefo efnbseaf{'

Gls ftf{qlgf ax lag` sl vxf sef funhs ofselcx vxfc ag Hnocfg" ef nccfc" kvs

sens clfxgs ofng yflybf n{fgs vxag` y{fcahsatf olcfbag` sl acfgsaq yflybf bajfbq sl

entf n eaè {nsf l elxyasnba}nsalg l{ efnbse hn{f vsaba}nsalg'Ngc a K{fggf{x fuyf{aofgs sl s{ngxl{o sef pnq blp/aghlof hloovgasafx

{fhfatf efnbse hn{f xvhhffcx" as hlvbc kfhlof n gnsalgnb olcfb l{ hasafx xffjag` sl

aoy{ltf sef efnbse l {fxacfgsx peabf" ylsfgsanbbq" blpf{ag` efnbse hn{f hlxsx nh{lxx

sef kln{c'

Fn{bq {FXVbsXBncq K' ax n elofbfxx ngc ofgsnbbq abb {fgslg plong pel plvgc vy ag sef fof{`fghq

{llo n xsvggag` 346 saofx ag ;9>9' Sf {fgslg Efnbse fno kf`ng pl{jag` paseef{ ag ;9>>'Nf{ blljag` ns ef{ nabofgsx elbaxsahnbbq" sefq efbyfc Bncq K' pase sef

kfpabcf{ag` xlhanb xf{tahfx xqxsfo" gcag` ef{ elvxag` ngc lvsynsafgs ofgsnb ngc

kfental{nb efnbse s{fnsofgs' Sns qfn{" xef taxasfc sef F[ >; saofx'

Slxf elxyasnb kfcx clgs gffc sl kf bbfc" xnac Pabbanox" Ex hloovgasq

l{`nga}f{' Pf gffc sl kf lg sef xs{ffs" n pelbf gfp olcfb ag sf{ox l cfyblqag`

efnbse hn{f xf{tahfx sl sef yflybf' Pf gffc sl offs sefo pef{f sefq{f ns'

Sns ofngx l{oag` hblxf {fbnsalgxeayx ngc foylpf{ag` ynsafgsx sl efby

sefoxfbtfx ngc lsef{x ag sefa{ hloovgasq'

Jag`xkv{q {fxacfgs O{' X'" l{ agxsnghf" enx n bls l yeqxahnb nabofgsx" aghbvcag`

cankfsfx ngc hlg`fxsatf efn{s nabv{f' Ef `ls agtlbtfc pase sef Jag`xkv{q Efnbse

fno ag ;9>> ngc efbyfc {fh{vas lsef{ {fxacfgsx sl nssfgc sef offsag`x ngc offs pase

hloovgasq l{`nga}f{x' Ef cfxh{akfc eaoxfb" pefg ef {xs `ls agtlbtfc pase E"


7/16


6

DL[FD[LGS

nx ltf{ofcahnsfc" pase nklvs 8; y{fxh{aysalgx' Sf sfno `ls eao clpg sl xftfg l{

fa`es ofcahnsalgx ngc xfs eao vy pase n elof nacf ngc n sef{nyaxs' Peabf O{' X' ax

xsabb tf{q xahj" ef enx glseag` kvs y{naxf l{ sef {fgslg Efnbse fnox pl{j'

N bls l fbcf{bq yflybf clgs ftfg hlof lvs l sefa{ elofx" kvs seax enx oncf

sefo ol{f hlol{snkbf" O{' X' xnac ag n {fhfgs agsf{tafp' Ag sef ynxs qfn{" ef enx

kfhlof n bfncf{ pase sef Jag`xkv{q Efnbse fno' A efn{ sens {lo yflybf ftf{q cnq

ag sef kvabcag`" hng qlv hnbb xloflgf" pel xelvbc A hnbb yf{hfgs ngc 89 yf{hfgs" ngc agynsafgs xsnqx kq

38 yf{hfgs ngc 09 yf{hfgs {fxyfhsatfbq" nhhl{cag` sl E' Hnyasnb Efnbse {fyl{sx n

#>'5 oabbalg cfh{fnxf ag F[ hen{`fx ngc n #>'5 oabbalg cfh{fnxf ag elxyasnb hen{`fx

l{ agynsafgs ncoaxxalgx' Sf 69 Xs' D{nghax ynsafgsx pel vsaba}fc sef F[ sef olxs

kfspffg Mvbq ;9>9 ngc Cfhfokf{ ;9>9 aghv{{fc #8'6 oabbalg ag hen{`fx' Kvs nf{

E pfgs sl pl{j selxf xnof ynsafgsx" kfspffg Mngvn{q ngc Mvgf ;9>;" sefq lgbq

aghv{{fc #134"999 ag hen{`fx" nhhl{cag` sl xlv{hfx ns klse agxsasvsalgx'

Ynsafgs pnas saofx entf nbxl kffg {fcvhfc' Nbb sef elxyasnbx {fyl{s nklvs n spl/

cnq pnas" clpg {lo pnas saofx l tf pffjx ns sef tf{q bfnxs' Ftfg ol{f non}ag`bq"

Xs' D{nghax ongn`fc sl aoy{ltfc ynsafgs y{ltacf{ hlgsagvasq {lo 9 yf{hfgs sl 16

yf{hfgs" fgcag` ng vgl{svgnsf gl{o l vghll{cagnsfc hn{f' Fnhe ynsafgs ax nxxa`gfc


8/16


4

DL[FD[LGS

n sfno ns sef elxyasnb" nbb l pelo n{f noaban{ pase sefa{ hnxf eaxsl{q" sef sfxsx ngc

y{fxh{aysalgx ncoagaxsf{fc" ngc sef yn{sahvbn{x l sefa{ xasvnsalg' Klse ynsafgsx ngc

y{ltacf{x entf {fyl{sfc `{fnsf{ xnsaxnhsalg pase sef xqxsfo'

Sf lsef{ onml{ elsxyls ax {fgslgx bn{`f elofbfxx ylyvbnsalg" gvokf{fc ns ol{f

seng >"999 agcatacvnbx' Pabbanox pl{j pase seax ylyvbnsalg ax mvxs kfàggag`" kvs

E ax nb{fncq xsn{sag` sl y{ltacf nxxaxsnghf l{ selxf xs{v``bag` pase sef nvxsf{asq/{ntn`fc elvxag` ngc efnbse kv{fnvh{nhafx' Ag ;9>>" ;14 l {fgslgx elofbfxx taxasfc

sef F[ ol{f seng >"699 saofx' Kvs Xs' D{nghax s{nhjfc tf l sefa{ elofbfxx ynsafgsx

ngc lvgc sens a sefq pf{f y{ltacfc pase elvxag` xf{tahfx" sefa{ F[ taxasx pf{f

{fcvhfc kq ;6 yf{hfgs ngc sefa{ agynsafgs taxasx ngc hen{`fx kq >99 yf{hfgs'

{fgslg sv{gfc sl els xylssag` ag ;994 pefg lgf l asx spl elxyasnbx" Hnyasnb

Efnbse" cfhacfc sl cfhnoy l{ sef xvkv{kx' Sf onql{ ns sef saof" Clv`bnx Ynbof{"

ta`l{lvxbq y{lsfxsfc sef oltf' Nf{ xlof ylbasahnb svxxbag`" Hnyasnb Efnbse n`{ffc

sl ynq l{ n hlgxvbsngs sl can`glxf sef hasqx abbx' Sf {fxvbsx xelpfc n caxmlagsfc

efnbse hn{f xqxsfo y{ltacag` xvklysaonb lvshlofx ns `{fns fuyfgxf' Cvybahnsfcsfxsx" xyfhanbsq hn{f pase gl lbblp/se{lvè" bfg`seq elxyasnb xsnqx" ngc vggfhfxxn{q

ngc vgfuybnagfc y{fxh{aysalgx nahs ongq Nof{ahngx" kvs {fgslgx gvokf{x pf{f

ftfg pl{xf'

Fof{`fghq {llo vsaba}nsalg ag {fgslg pnx 63 yf{hfgs eaèf{ seng sef gnsalgnb

ntf{n`f" cvf sl n cfn{se l efnbse hltf{n`f ngc nhhfxx sl y{aon{q hn{f' Sf hasqx

fcf{nbbq ~vnbafc efnbse hfgsf{ enc ng nyylagsofgs pnas saof l 80 cnqx' Sf elxyasnbx

hlvbc kf ftfg pl{xf= Xs' D{nghax Ofcahnb Hfgsf{" sef hasqx lsef{ elxyasnb" enc pnas

saofx nx blg` nx 03 cnqx' Ag n hasq pef{f lgf lvs l se{ff heabc{fg batf ag yltf{sq ngc

gfn{bq n ~vn{sf{ l sef ylyvbnsalg clfx gls entf y{atnsf efnbse hn{f" sef agfhafghafxhnof ns fgl{olvx yvkbah hlxs'

Hnyasnb cac oltf asx y{aon{q lyf{nsalg sl Elyfpfbb" G'M'" n slpgxeay aoofcansfbq

gl{se l {fgslg' Kvs sengjx sl Ynbof{x agsf{tfgsalg" sens pnxgs sef fgc l sef xsl{q'

Hnyasnb onagsnagx hbagahx ngc ng fof{`fghq cfyn{sofgs ns asx lbc blhnsalg" ngc mvxs

agtfxsfc n v{sef{ #>99 oabbalg sl fuyngc asx ag{nxs{vhsv{f n{lvgc sefa{ [fàlgnb

Ofcahnb Hfgsf{" peahe ax xsabb ag slpg' Mvxs nx aoyl{sngsbq" Hnyasnb sfnofc vy pase

onml{ {fgslg efnbse hn{f ybnqf{x sef Cfyn{sofgs l Yvkbah Efnbse" Xs D{nghax

elxyasnb ngc Efg{q M' Nvxsag hloovgasq efnbse hfgsf{ sl xqxsfoahnbbq ncc{fxx

sef axxvfx {naxfc kq sef hlgxvbsngsx xsvcq' Kq ;9>9" sefxf l{`nga}nsalgx enc hlof

sl`fsef{ vgcf{ sef nfàx l sef {fgslg Efnbse fno' As pnx ng vgbajfbq fns' Nx ax

lfg sef hnxf" sefxf efnbse hn{f agxsasvsalgx pf{f ol{f vxfc sl mlhjfqag` l{ ylxasalg

seng hlbbnkl{nsag`'


9/16


0

DL[FD[LGS

Sfq pf{f nbb efntq hloyfsasl{x ag sef efnbse hn{f on{jfs xynhf" xnac C{' [vse

Yf{{q" fufhvsatf ca{fhsl{ %ngc hv{{fgsbq xlbf foyblqff! l E' Elp cl qlv xea

{lo hloyfsasalg sl hlbbnkl{nsalg


10/16


5

DL[FD[LGS

Pase Hen{asq clpg" n hnc{f l clhsl{x pel encgs dfc sef hasq" aghbvcag` C{' Jn{fg

CfXnbtl" glp efnbse hlooaxxalgf{ l{ Gfp L{bfngx" ~vahjbq kf`ng hlgxs{vhsag` n

tnxs gfspl{j l gfaèkl{ellc hbagahx ag hev{hefx" cl{ox" {lhf{q xsl{fx pef{ftf{sef{f pnx xynhf' Lg n saès kvc`fs ngc ag sef {vagx l sef lbc xnfsq/gfs efnbse xqxsfo"

CfXnbtl ngc ef{ hlbbfn`vfx pl{jfc pase n #>99 oabbalg fcf{nb `{ngs sens ynac knxfc

lg sef ~vnbasq l hn{f" gls sef gvokf{ l sfxsx yf{l{ofc'

l offs seax xsngcn{c" Gfp L{bfngx gfaèkl{ellc hbagahx xsn{sfc vxag` n olcfb

sens xelvbc xlvgc noaban{' Sf hn{f pnx hloy{fefgxatf ngc ynsafgs/l{afgsfc' Hbagahx

pf{f xsnfc pase hnxf ongn`f{x" xlhanb pl{jf{x ngc ofgsnb hn{f y{lfxxalgnbx"

ag nccasalg sl sef xsngcn{c ofcahnb xsn' Pefg n ynsafgs oaxxfc ng nyylagsofgs"

y{ltacf{x lbblpfc vy' Fof{`fghq {llo taxasx nolg` sef Ofcahnac ylyvbnsalg

cfhbagfc" peabf sef gvokf{x l vgagxv{fc vsaba}ag` sef F[ dnssfgfc ngc sefa{ elxyasnbxsnqx cfhbagfc'

Sf `{ngs {ng lvs ag ;9>9 ngc sef Gfp L{bfngx hbagahx glp {fbq pelbbq lg ol{f

s{ncasalgnb ynqofgs ofhengaxox" aghbvcag` Ofcahnac" peahe xsabb ynq lg sef ff/l{/

xf{tahf olcfb' Pefg pf oltfc hn{f sl gfaèkl{ellcx ngc xsn{sfc ynqag` l{ as ag n

ylyvbnsalg hnyasnsalg olcfb" {fpn{cag` ~vnbasq" {fpn{cag` nhhfxx sl hn{f" nbblpag` l{

sef{f sl kf sfno/knxfc hn{f {fdfhsatf l sef yflybf kfag` xf{tfc ynsafgsx {fyl{sfc

kfssf{ xnsaxnhsalg" Zngc as pnx_ agfuyfgxatf" CfXnbtl xnac" xyfnjag` {lo ef{ lhf ag

Gfp L{bfngx Hasq Enbb' Kvs nx xllg nx pf oltfc xsn{sfc sl ynq l{ as vgcf{ ff/l{/

xf{tahf" sef xsng` olcfbx ns sef hbagahx kf`ng sl heng`f'

CfXnbtl xnac xef elyfx sl xff sef xsnsfx Ofcahnac y{l`{no snabl{fc sl nhhloolcnsf

sef l{aàgnb olcfb' Sf xsnsfx xfh{fsn{q l efnbse ax ag ntl{" xef xnac" kvs clfxgs entf

sef xsn sl fuyl{s sef Gfp L{bfngx olcfb sl nbb l Blvaxangn' Ag sef hasq" CfXnbtl

Sfg yf{hfgs l sef ylyvbnsalg hlgxvofx nbolxs40 yf{hfgs l sef efnbsehn{f hlxsx" xnac Fongvfb"

n tahf y{ltlxs ns sef Vgatf{xasq l Yfggxqbtngan ngc

ka` k{lsef{ sl [neo Fongvfb" Y{fxacfgs Lknonxl{of{ heaf l xsnd ngc onql{ l Heahn`l'
http://www.pbs.org/newshour/bb/health/july-dec10/nola_09-16.htmlhttp://www.pbs.org/newshour/bb/health/july-dec10/nola_09-16.html


11/16


1

DL[FD[LGS

pfgs lg" sef{f ax gl lgf pel caxn`{ffx pase sef acfn l agtfxsag` ag hlbbnkl{nsatf"

hloy{fefgxatf hn{f' Kvs nxxvoag` sef Nl{cnkbf Hn{f Nhs {lbbx lvs vgeagcf{fc"

Ofcahnac ax nklvs sl xsn{s agxv{ag` nglsef{ >4 sl >5 oabbalg yflybf gnsalgnbbq ngc

nklvs 499"999 ag Blvaxangn" nbb ynac l{ vgcf{ sef y{ftnabag` ff/l{/xf{tahf olcfb'

Pf entf kvabs cfolgxs{nsalgx ngc olcfbx nbb ltf{ seax hlvgs{q" pf jglp asxclnkbf lg sef `{lvgc" CfXnbtl xnac' Pens pf entfgs qfs nhjglpbfc`fc ax sens pf

entf `ls sl caxongsbf bf`nhq xqxsfox'

Snsx pens {fgslg ngc Hnocfg entf clgf" kvs klse hasafx enc sef kfgfs l

ylbasahnb pabb ag sef {xs agxsnghf ngc ng aoofgxfbq fgs{fy{fgfv{anb agcatacvnb ag ef

xfhlgc' Nccasalgnbbq" klse pf{f lyf{nsag` ag blp/hloyfsasalg fgta{lgofgsx pase

bn{`f vgagxv{fc ylyvbnsalgx' As ax xsabb vghbfn{ pefsef{ n hasq bajf Yeabncfbyean l{

Klxslg" pase ongq ylpf{vb xsnjfelbcf{x hloyfsag` ltf{ ea`ebq y{lsnkbf ynsafgsx"

hng ovxsf{ sef pef{fpasenb sl yvxe l{ heng`fx npnq {lo sef ff/l{/xf{tahf olcfb

sens enx kffg sefxf agxsasvsalgx k{fnc ngc kvssf{ l{ xl blg`'Sf nhabasafx sens n{f clg` tf{q pfbb ag ff/l{/xf{tahf hn{f n{f s{fofgclvxbq

agdvfgsanb" fhlgloahnbbq ngc ylbasahnbbq" xnac En{lbc Ylbbnhj" n y{lfxxl{ ns sef

Vgatf{xasq l Heahn`l Xhellb l Xlhanb Xf{tahf Ncoagaxs{nsalg' Ef ylagsx sl sef

cftfblyofgs l gfp ofcahnb hfgsf{x" bajf sef #>'; kabbalg hloybfu vgcf{ cftfblyofgs


12/16


>9

DL[FD[LGS

ag Gfp L{bfngx" nx ftacfghf l Ka` Ofcahagfx {fbvhsnghf sl àtf vy sef lbc nyy{lnhe"

ftfg nx gffcx n{f `lag` vgofs'

Qfs Ylbbnhj ngc lsef{x n`{ff sens {fbvhsnghf nxacf" heng`f ax hloag`'

Ftf{qlgf lg sef elxyasnb xacf sens A snbj sl vgcf{xsngcx sens sef f{n l ff/l{/

xf{tahf ofcahagf ax `lag` sl `{agc sl n hblxf" ef xnac' Snsx hloolgbq vgcf{xsllc'

Asx sll ynselblàhnb sl xv{tatf'Elp ~vahjbq elxyasnbx n{f nkbf sl onjf sef s{ngxasalg cfyfgcx lg sef nsf l sef

Nl{cnkbf Hn{f Nhs" peahe [fyvkbahngx hlgsagvf sl f{hfbq lyylxf' Kfqlgc asx

y{loaxf l gfn{/vgatf{xnb hltf{n`f" sef NHN hlgsnagx ongq y{ltaxalgx sens hlvbc

efby elxyasnb/nccahsfc hasafx oltf slpn{c ylyvbnsalg efnbse olcfbx' K{fggf{ clfx

gls kfbaftf sef nhsx aghfgsatfx n{f xs{lg` fglvè sl agcvhf sef on`gasvcf l heng`f

{f~va{fc" kvs ftfg ef xnac sens sef gfp bnp enx xyv{{fc ol{f efnbse hn{f aggltnsalg

ag sef bnxs spl qfn{x seng ef enx xffg ag sef y{ftalvx spl cfhncfx'

Lgf fxyfhanbbq efbyvb {fl{o eaccfg npnq ag sef NHNx cfysex ax sef heng`f sl

elxyasnb {faokv{xfofgsx l{ Ofcahn{f" sef bn{`fxs agxv{nghf y{ltacf{ ag sef hlvgs{qngc {fxvbsngsbq ng fuhfbbfgs s{fgcxfssf{' Xsn{sag` ag Lhslkf{" selvxngcx l elxyasnbx

xnp sefa{ {faokv{xfofgsx {fcvhfc a sefa{ Ofcahn{f ynsafgsx pf{f {fncoassfc paseag

n olgse l {fbfnxf' Peabf xlof n{`vf sens ynsafgs kfental{ kfqlgc sef elxyasnb hngs

kf hlgs{lbbfc" sef olcfbx ag Gfp L{bfngx" {fgslg ngc Hnocfg xelp sens efby hng

kf lf{fc" ngc sens ynsafgsx pabb lfg nhhfys'

{lncKblhjX ngc sEF {lnc nEFncPefg @{f`l{q Pabbanox ax lvs lg sef {fgslg xs{ffsx" ef snbjx pase n `{lvy l qlvgòfg" olxsbq ag sefa{ ;9x ngc 89x" pel n{f xsnqag` ns n xefbsf{ kvs kncbq pngs elvxag`

l sefa{ lpg %yn{sahvbn{bq `nbbag` ax sef xefbsf{x {vbf sens selxf pel pngs sl xsnq sef

gaès ovxs xelp vy kq 3yo ag pn{of{ yn{sx l sef qfn{" peahe onjfx `fssag` pl{j

npvbbq slvè!' Pabbanox sfbbx sefo efbb kf knhj xllg sl caxhvxx lysalgx'

Sns ax n ka` yn{s l pens pf cl pase sef {fgslg Efnbse fno" xnac K{lpgbff'

Pf Zoffs pase_ agcatacvnbx pel n{f elofbfxx ngc gc sef {aès sqyfx l xvyyl{s

xf{tahfx l{ sefo ngc `fs sefo agsl elvxag`' Sf{f ax n xqgf{`q sens nbblpx vx nbb sl

snjf ka``f{ xsfyx nx n `{lvy seng a pf pf{f clag` as kq lv{xfbtfx'

Nglsef{ {ftlbvsalgn{q nxyfhs l Ex pl{j ax sef l{sehloag` Efnbse Agl{onsalg

Fuheng`f" n vgatf{xnbbq nhhfxxakbf cnsnknxf l ynsafgs {fhl{cx' %As ax gls ongcnsl{q

ngc ynsafgsx hng hellxf sl lys lvs'! Sf cnsnknxf pabb nbblp y{ltacf{x nh{lxx sef hasq

sl xff n ynsafgsx ofcahnb eaxsl{q= fxsx {fhfatfc" ofcahagfx y{fxh{akfc" bnk {fxvbsx'
http://www.tnr.com/blog/plank/110322/obamacare-oklahoma-lawsuit-federal-exchange-subsidies-cannonhttp://www.npr.org/blogs/health/2012/08/13/158711121/thousands-of-hospitals-face-penalties-for-high-readmission-rateshttp://www.forbes.com/sites/aroy/2012/08/20/how-obamacares-716-billion-in-cuts-will-drive-doctors-out-of-medicare/http://www.trentonhealthteam.org/tht/programs/32-trenton-health-information-exchangehttp://www.trentonhealthteam.org/tht/programs/32-trenton-health-information-exchangehttp://www.trentonhealthteam.org/tht/programs/32-trenton-health-information-exchangehttp://www.trentonhealthteam.org/tht/programs/32-trenton-health-information-exchangehttp://www.forbes.com/sites/aroy/2012/08/20/how-obamacares-716-billion-in-cuts-will-drive-doctors-out-of-medicare/http://www.npr.org/blogs/health/2012/08/13/158711121/thousands-of-hospitals-face-penalties-for-high-readmission-rateshttp://www.tnr.com/blog/plank/110322/obamacare-oklahoma-lawsuit-federal-exchange-subsidies-cannon


13/16


>>

DL[FD[LGS

Sax pabb y{ftfgs fuyfgxatf ngc vgefbyvb

cvybahnsalg l xf{tahfx ngc fbaoagnsf sef

ynsafgsx kv{cfg l {fhnbbag` hloybfu

yen{onhfvsahnb gnofx l{ sef funhs funox

sefqtf {fhfatfc' N clhsl{ l{ F[ gv{xf pabb

kf nkbf sl nhhfxx sefa{ cfsnabfc ofcahnb

eaxsl{q pase n fp jfqxs{ljfx' Sf xqxsfoax y{lmfhsfc sl kf lyf{nsalgnb kq sef fgc l

;9>;'

Sf ynsafgs/l{afgsfc" hlbbnkl{nsatf

hn{f kfag` xyfn{efncfc kq l{`nga}nsalgx

bajf E" sef Hnocfg Hlnbasalg ngc

xaoabn{ y{lmfhsx nh{lxx sef hlvgs{q ax

tf{q xaoabn{ sl sef y{nhsahfx l vgatf{xnb

efnbse hn{f xqxsfox ag lsef{ agcvxs{anba}fc

cfolh{nhafx' D{nghf" l{ funoybf" y{ltacfxasx hasa}fgx pase n efnbse hn{f hn{c" fbaoagnsag` fuyfgxatf ynyf{pl{j ngc" bajf {fgslgx

l{sehloag` Efnbse Agl{onsalg Fuheng`f" nbblpag` y{ltacf{x sl aoofcansfbq nhhfxx

ng agcatacvnbx cfsnabfc ofcahnb eaxsl{q' K{asnagx Gnsalgnb Efnbse Xf{tahf {fpn{cx

clhsl{x knxfc lg lvshlofx" njag sl sef NHL olcfb sens {fgslg ngc Hnocfg elyf

sl vsaba}f" peahe plvbc nbblp efnbse hn{f y{ltacf{x sl jffy n yl{salg l sef olgfq

sefq xntf kq jffyag` sefa{ ynsafgsx efnbseaf{ ngc lvs l sef elxyasnb' GEX nbxl lyf{nsfx

n {ff ;3/elv{ yelgf xf{tahf n gnsalgpacf tf{xalg l àtag` Gvhf{lx gvokf{ sl

Jag`xkv{q {fxacfgsx sens ynsafgsx hng hnbb ngq saof l sef cnq l{ gaès sl {fhfatf n

hlgxvbsnsalg" peahe ax hefnyf{ seng n clhsl{ taxas'

K{fggf{ ngc sef Hnocfg Hlnbasalg entf n Efnbse Agl{onsalg Fuheng`f vy ngc

{vggag`" kvs sefq tf{q yv{ylxfvbbq c{fp n bagf n{lvgc sef hasq l Hnocfg' Fuyngcag`

as sl sef pelbf {fàlg plvbc entf ofngs `fssag` fok{labfc ag sef `{fnsf{ ylbasahnb

hloybfuasq lvgc nh{lxx sef Cfbnpn{f [atf{ ag Yeabncfbyean' Sf{f sef fhlgloq

tf{q ovhe {fbafx lg sef fcx ngc ofcx olcfb l fhlgloah cftfblyofgs" pef{f

elxyasnbx ngc {fxfn{he hloybfufx h{fnsf sef bn{`f/xhnbf" {fbnsatfbq xsnkbf foyblqofgs

sens ongvnhsv{ag` vxfc sl y{ltacf' Pase asx gaokbf ag{nxs{vhsv{f ngc kanx n`nagxs

elxyasnb xsnqx" els xylssag` hlvbc kf xffg nx n snhas se{fns sl sefxf agxsasvsalgx'Yeabncfbyeanx fgsa{f fhlgloah olcfb ax kvabs lg hvssag`" xhnggag`" }nyyag` ngc

elxyasnba}ag` Yeabncfbyean {fxacfgsx" K{fggf{ xnac' Ovhe l sef hasqx fhlgloah

{fgnaxxnghf enx kffg knxfc lg ng fuyngxalg l sef ofcahnb agcvxs{anb hloybfu" sef

fuyngxalg l elxyasnbx' A clgs jglp elp ovhe s{nhsalg sef acfn l kfssf{ hn{f ns

blpf{ hlxsx pase fpf{ elxyasnba}nsalgx ax `lag` sl `fs'

A pabb p{asf qlvn xh{ays Zl{ nonool`{nyeq_

a qlv clgs entfy{aon{q hn{f' Ao cvfl{ lgf" sll' Abb `lpase qlv'
http://blog.masslive.com/localbuzz_impact/2009/04/metropolitan_economies_report.pdfhttp://blog.masslive.com/localbuzz_impact/2009/04/metropolitan_economies_report.pdf


14/16


>;

DL[FD[LGS

Sax axgs vga~vf sl Yeabbq' Olxs Nof{ahng hasafx sens blxs sefa{ ongvnhsv{ag`

knxfx blg` n`l cfyfgc lg elxyasnbx ngc vgatf{xasafx sl nghel{ sefa{ fhlgloafx' Sfxf

elxyasnbx lyf{nsf nblg` sef xnof bagfx nx n elsfb l{ ng na{bagf= Dabb sef kfcx' Ftf{q saof

n ynsafgs hefhjx ag" sensx nglsef{ yls l hnxe" gl onssf{ a sefq pf{f mvxs ag sef elxyasnb

sef lsef{ pffj ngc sef hn{f nabfc xl kncbq sens sefq enc sl" pfbb" kf elxyasnba}fc

n`nag' Asx hnbbfc [lfof{x Bnp= N elxyasnb kfc kvabs ax n elxyasnb kfc bbfc' Xv{ffglvè" hblxf sl ;9 yf{hfgs l Nof{ahng xfgal{x n{f knhj ag sef elxyasnb paseag 89

cnqx l kfag` {fbfnxfc' Gls nbb l sefxf {fncoaxxalgx n{f ntlacnkbf" kvs ongq n{f'

K{fggf{ fxsaonsfc sens a sef {fpn{cx pf{f xpashefc ngc y{ftfgsatf" ynsafgs/knxfc

hn{f kfhnof sef gl{o" sef hlvgs{q plvbc gffc n sea{c fpf{ elxyasnbx'

Peabf y{ftfgsnsatf" ylyvbnsalg/knxfc xs{nsfàfx n{f xy{fncag` sl lsef{ hasafx" sefq

n{f lfg ofs pase xjfysahaxo {lo efnbse hn{f xsnjfelbcf{x' Ol{f seng 69 oabfx sl

sef gl{se l {fgslg" sef @{fnsf{ Gfpn{j Efnbse Hn{f Hlnbasalg ax yf{l{oag` xaoabn{

pl{j" kvs entf gls y{l`{fxxfc nx n{ nx sefa{ xaxsf{ l{`nga}nsalgx ag xlvsef{g Gfp

Mf{xfq' K{fggf{ nss{akvsfc sef enbsag` y{l`{fxx sl sef `{fnsf{ catf{xasq l efnbse hn{fxsnjfelbcf{x ag n hasq sens ax ltf{ se{ff saofx sef xa}f l fasef{ Hnocfg l{ {fgslg' Sf

Xng Caf`l L{`nga}ag` Y{lmfhs" sll" enx kffg kvabcag` xvyyl{s l{ xvhe ng agsf{tfgsalg

paseag he{lgahnbbq abb ylyvbnsalgx' Hloovgasq yn{sgf{x" aghbvcag` blhnb hbagahx ngc

nase `{lvyx" entf {nbbafc sl sef hnvxf' Kvs" nx ag Gfpn{j" elxyasnbx entf fuy{fxxfc

xf{alvx {fxf{tnsalgx nklvs xen{ag` ncoaxxalgx ngc hlxs cnsn'

Enggne @{ntfssf" n hloovgasq l{`nga}f{ pase sef y{lmfhs" ax hlgcfgs sens

y{ltaxalgx paseag sef Nl{cnkbf Hn{f Nhs" ngc sef cfxa{f sl bfxxfg fof{`fghq {llo

vsaba}nsalg kq he{lgahnbbq abb yflybf" pabb k{ag` sefo n{lvgc xllg' Sfq entf Zkffg_

lyfg sl offsag` pase vx" ngc seagjag` pase vx nklvs xlbvsalgx" xef xnac' Kvs sefqn{f tf{q n{nac sl fuylxf n bls l sef cnsn sens pf pngs' As enx kffg tf{q cahvbs sl

s{nhj ncoaxxalg" ngc ftfg en{cf{ sl `fs ng acfn l sef hen{`fx" hlxs ngc {fhfaysx l

ncoaxxalgx'

Cvf sl sefa{ fhlgloah oaès" elxyasnbx n{f nbxl tf{q en{c sl {fl{o {lo paselvs'

Ag n ;99; xv{tfq l xsnsf lhanbx" elxyasnbx ngc gv{xag` elofx pf{f hlgxacf{fc sef

olxs ylpf{vb ylbasahnb nhsl{x ag ;> xsnsfx ngc sef xfhlgc olxs agdvfgsanb ag n v{sef{

>5 xsnsfx'

Yeabncfbyeanx Cfyn{sofgs l Yvkbah Efnbse" l{ agxsnghf" ax tf{q ags{a`vfc kq

K{fggf{x pl{j ngc enx hlgxacf{fc nssfoysag` sl nyybq as sl eaèbq xyfhah ylyvbnsalgx

bajf sef elofbfxx peahe plvbc nbblp sefo sl els xyls paselvs nxjag` sef hasqx

efnbse hn{f xsnjfelbcf{x sl yllb cnsn l{ pl{j hlbbnkl{nsatfbq' Kvs `fssag` sef y{lmfhs

l sef `{lvgc enx kffg ng vyeabb knssbf'
http://www.ncbi.nlm.nih.gov/pubmed/10310279http://www.nejm.org/doi/full/10.1056/NEJMsa0803563http://www.nejm.org/doi/full/10.1056/NEJMsa0803563http://www.medpac.gov/documents/jun07_entirereport.pdfhttp://jakeblumgart.com/2012/07/22/the-political-power-of-hospitals/http://jakeblumgart.com/2012/07/22/the-political-power-of-hospitals/http://www.medpac.gov/documents/jun07_entirereport.pdfhttp://www.nejm.org/doi/full/10.1056/NEJMsa0803563http://www.nejm.org/doi/full/10.1056/NEJMsa0803563http://www.ncbi.nlm.nih.gov/pubmed/10310279


15/16


>8

DL[FD[LGS

Sf hasq ag Yeabncfbyean plvbc bajf as sl enyyfg" C{' Clgnbc Xhepn{}"

Yeabncfbyeanx efnbse hlooaxxalgf{ ngc cfyvsq onql{ l{ efnbse ngc lyyl{svgasq"

xnac ag ng agsf{tafp bnxs xy{ag`' Pf n{f s{qag` sl nhabasnsf yflybf oltag` l{pn{c"

kvs sef hloybfuasq ag Hnocfg ax xlofpens bfxx" nx qlv oaès aonàgf" seng sef

hloybfuasq ag Yeabncfbyean'

Sns clfxgs xv{y{axf K{fggf{' @fgf{nbbq xyfnjag`" ka``f{ hloovgasafx entf nen{cf{ saof Zonjag` sef s{ngxasalg E ax nssfoysag`_ kfhnvxf sef xsnjfelbcf{x n{f

en{cf{ sl p{fxsbf sl sef `{lvgc" ef xnac' Sf{f ax bfxx hloolgnbasq l yv{ylxf" sef

agxsasvsalgx entf n ovhe en{cf{ saof xffag` xen{fc agsf{fxs ag pl{jag` sl`fsef{'

Kvs {fl{oag` hn{f cfbatf{q sl lhvx lg ynsafgs lvshlofx ngc ~vnbasq y{aon{q hn{f

plvbcgs gfhfxxn{abq xyfbb cllo l{ hasafx sens cfyfgc lg fcx ngc ofcx' Nx @npngcf

ylagsfc lvs ag sef Gfp Ql{jf{n{sahbf" Cfgon{j {flhvxfc asx efnbse hn{f xqxsfo lg

y{ftfgsatf hn{f ngc bfxx lg fuyfgxatf agynsafgs xsnqx' Sf gvokf{ l elxyasnbx sef{f

enx nbbfg {lo ol{f seng >69" ag sef bnsf >159x" sl 0> ag ;9>9 ngc" nhhl{cag` sl

@npngcf" pabb cay kfblp 39 ag sef gfn{ vsv{f' Kvs enx Cfgon{j xffg n c{nonsahcfhbagf ag ltf{nbb efnbse hn{f hlxsx ngc foyblqofgs< Nx l ;9>9" gls {fnbbq' Peabf

sef gvokf{ l nhvsf hn{f elxyasnb kfcx ag Cfgon{j ax kfblp sef LFHC ntf{n`f" sef

gvokf{ l yeqxahangx ngc gv{xfx ax eaèf{ seng ntf{n`f' Cfgon{j ax xlbacbq ag sef

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ofng n gfs cfh{fnxf ag mlkx' A qlv nhsvnbbq fgc vy hlgs{lbbag` hlxsx" ngc y{foavox

xsnq clpg" yflybf fs ol{f pn`fx ngc sefq hng l xyfgc sens lg lsef{ seag`x ngc senspabb xsaovbnsf sef fhlgloq sll'

A sef efnbse hn{f xqxsfo `fsx ol{f fhafgs" pens pf{f snbjag` nklvs ax xblpag`

sef {nsf l `{lpse" ef xnac' Gls hvssag` efnbse hn{f" {fn{{ngàg` as'
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urgentcare: recovering from the urban hospital addiction

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