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Biomedical subjects

C L Raehl

Publications and source records attributed to C L Raehl.

At least 19 recordsLinked to original sources
PubMed2001

Medication errors in United States hospitals.

This study evaluated hospital demographics, staffing, pharmacy variables, health care outcomes measures (severity of illness-adjusted mortality rates, drug costs, total cost of care, and length of stay) and medication errors. A database was constructed from the 1992 American Hospital Association's Abridged Guide to the Health Care Field, the 1992 National Clinical Pharmacy Services database, and 1992 mortality data from the Health Care Financing Administration. Simple statistical tests and a severity of illness-adjusted multiple regression analysis were employed. The study population consisted of 1116 hospitals that reported information on medication errors and 913 hospitals that reported information on medication errors that adversely affected patient care outcomes. We evaluated factors associated with the 430,586 medication errors and 17,338 medication errors that adversely affected patient care outcomes. Medication errors occurred in 5.07% of the patients admitted each year to these hospitals. Each hospital experienced a medication error every 22.7 hours (every 19.73 admissions). Medication errors that adversely affected patient care outcomes occurred in 0.25% of all patients admitted to these hospitals/year. Each hospital experienced a medication error that adversely affected patient care outcomes every 19.23 days (or every 401 admissions). The following factors were associated with increased medication errors/occupied bed/year: lack of pharmacy teaching affiliation (slope = 0.8875, p=0.0416), centralized pharmacists (slope = 1.0942, p=0.0001), number of registered nurses/occupied bed (slope = 1.624, p=0.032), number of registered pharmacists/occupied bed (slope = 25.0573, p=0.0001), hospital mortality rate (slope = 2.8017, p=0.0192), and total cost of care/occupied bed/year (slope = 0.01432, p=0.0091). Factors associated with decreased medication errors were location in the Mid-Atlantic census region (slope = -1.5182, p=0.03), affiliation with a pharmacy teaching program (slope = -1.0252, p=0.0349), decentralized pharmacists (slope = -0.9843, p=0.0037), and number of medical residents/occupied bed (slope = -1.478, p=0.0014). There was a 45% decrease in medication errors (1.81-fold decrease) in hospitals that had decentralized pharmacists, compared with hospitals that had centralized pharmacists. In addition, there was a 94% decrease in medication errors that adversely affected patient care outcomes (16.88-fold decrease) in hospitals that had decentralized pharmacists compared with hospitals that had only centralized pharmacists. Based on previous field studies and our findings in 1116 hospitals, it appears that one of the most effective ways to prevent or reduce medication errors is to decentralize pharmacists to patient care areas. The results of this study should help hospitals reduce the number of medication errors that occur each year.

Education, Pharmacy↗
PubMed2001

Interrelationships among mortality rates, drug costs, total cost of care, and length of stay in United States hospitals: summary and recommendations for clinical pharmacy services and staffing.

We evaluated interrelationships and associations among mortality rates, drug costs, total cost of care, and length of stay in United States hospitals. Relationships between these variables and the presence of clinical pharmacy services and pharmacy staffing also were explored. A database was constructed from the 1992 American Hospital Association's Abridged Guide to the Health Care Field, the 1992 National Clinical Pharmacy Services database, and 1992 Health Care Finance Administration mortality data. A severity of illness-adjusted multiple regression analysis was employed to determine relationships and associations. Study populations ranged from 934-1029 hospitals (all hospitals for which variables could be matched). The only pharmacy variable associated with positive outcomes with all four health care outcome measures was the number of clinical pharmacists/occupied bed. That figure tended to have the greatest association (slope) with reductions in mortality rate, drug costs, and length of stay. As clinical pharmacist staffing levels increased from the tenth percentile (0.34/100 occupied beds) to the ninetieth percentile (3.23/100 occupied beds), hospital deaths declined from 113/1000 to 64/1000 admissions (43% decline). This resulted in a reduction of 395 deaths/hospital/year when clinical pharmacist staffing went from the tenth to the ninetieth percentile. This translated into a reduction of 1.09 deaths/day/hospital having clinical pharmacy staffing between these staffing levels, or 320 dollars of pharmacist salary cost/death averted. Three hospital pharmacy variables were associated with reduced length of stay in 1024 hospitals: drug protocol management (slope -1.30, p=0.008), pharmacist participation on medical rounds (slope -1.71, p<0.001), and number of clinical pharmacists/occupied bed (slope -26.59, p<0.001). As drug costs/occupied bed/year increased, severity of illness-adjusted mortality rates decreased (slope -38609852, R(2) 8.2%, p<0.0001). As the total cost of care/occupied bed/year increased, those same mortality rates decreased (slope -5846720642, R(2) 14.9%, p<0.0001). Seventeen clinical pharmacy services were associated with improvements in the four variables.

Cost Savings↗
PubMed2001

Pharmacists' assessment of dispensing errors: risk factors, practice sites, professional functions, and satisfaction.

Certain demographic, practice, staffing, and pharmacist satisfaction variables may contribute to dispensing errors. A survey was randomly mailed to 7298 (50%) Texas pharmacists, of which 2862 were returned (39% response rate). Responders were 2437 pharmacists who indicated that they were in practice. Of these, 535 (23%) reported no risk to patients for dispensing errors and 793 (34%) reported at least one patient/week was at risk for such an error. There was a positive relationship between number of prescription orders filled/hour and the estimated risk of dispensing errors (r(s)=0.285, p<0.001). Pharmacists practicing in mail service pharmacies (risk score = 1.85 +/- 1.32), traditional chain store pharmacies (1.66 +/- 1.18), and hospital pharmacies (1.61 +/- 1.09) reported a higher risk than other groups. Pharmacists practicing in independent community pharmacies (0.75 +/- 0.84), home health care (0.83 +/- 0.99), grocery chain store pharmacies (1.30 +/- 0.96), and mass merchandise chain store pharmacies (1.30 +/- 1.08) reported a lower risk (H=260, df=8, p<0.001). Nine job satisfaction variables were strongly associated with the risk of dispensing errors (r(s) = between -0.3 and -0.422, p<0.001), as were prescription volume, practice site, staffing, training, pharmacist functions, and professional organization membership. The results of this survey should help pharmacists and management develop specific plans for reducing the risks of dispensing errors. These data should be useful for more in-depth study of such errors.

Chi-Square Distribution↗
PubMed2000

Changes in pharmacy, nursing, and total personnel staffing in U.S. hospitals, 1989-1998.

Pharmacy, nursing, and total hospital personnel inpatient staffing in U.S. medical-surgical hospitals for 1989, 1992, 1995, and 1998 was studied. Nursing and total personnel staffing data were obtained from the American Hospital Association, and pharmacy personnel data were obtained from the National Clinical Pharmacy Services database. Between 1989 and 1998, mean +/- S.D. registered-nurse staffing per 100 occupied beds increased from 124.46 +/- 92.24 to 196.57 +/- 131.92, or 57.94%. Pharmacist staffing per 100 occupied beds increased from 6.47 +/- 3.01 to 7.95 +/- 4.88, or 22.87%. The total number of registered nurses increased by 126,960 (15.78%), and the total number of pharmacists declined by 320 (0.72%). The increase in pharmacist staffing per 100 occupied beds was due almost entirely to decreases in hospital census between 1989 and 1998. Total hospital personnel staffing per 100 occupied beds and the absolute number of hospital employees increased at much higher rates (55.2% and 12.95%, respectively) than pharmacist staffing. Pharmacy technician staffing per 100 occupied beds increased by 42.96%, and pharmacy clerk staffing increased by 25.37%. Between 1989 and 1998, pharmacist staffing in U.S. medical-surgical hospitals increased at less than half the rates for registered nurses and total hospital personnel.

Humans↗
PubMed2000

1998 national clinical pharmacy services study.

This study determined the extent of hospital-based clinical pharmacy services in 950 United States acute care, general, medical-surgical, and pediatric hospitals with 50 or more licensed beds in 1998 and compared results with data from similar national surveys in 1989, 1992, and 1995. Fifteen clinical pharmacy services were assessed to determine pharmacists' specific patient care responsibilities. Two services increased substantially over both the 9-year period and between 1995 and 1998: drug therapy protocol management and clinical pharmacokinetics consultations, which were offered in 70% and 80% of hospitals in 1998, respectively. Pharmacists' provision of in-service programs decreased 6% between 1995 and 1998, whereas other services remained constant. Pharmacists conducted clinical research in 14% of hospitals in 1998, averaging 7.2 +/- 19.7 protocols/department annually; total budget was $224,572 +/- 753,321; and mean clinical research funding increased 2.3-fold between 1995 and 1998. Clinical pharmacy services continue to expand, with pharmacists providing higher-level direct patient care related to drug therapy management and pharmacokinetics consultations.

Adverse Drug Reaction Reporting Systems↗
PubMed2000

Clinical pharmacy services, pharmacy staffing, and the total cost of care in United States hospitals.

This study evaluated direct relationships and associations among clinical pharmacy services, pharmacist staffing, and total cost of care in United States hospitals. A database was constructed from the 1992 American Hospital Association's Abridged Guide to the Health Care Field and the 1992 National Clinical Pharmacy Services Database. A multiple regression analysis, controlling for severity of illness, was employed to determine the relationships and associations. The study population consisted of 1016 hospitals. Six clinical pharmacy services were associated with lower total cost of care: drug use evaluation (p=0.001), drug information (p=0.003), adverse drug reaction monitoring (p=0.008), drug protocol management (p=0.001), medical rounds participation (p=0.0001), and admission drug histories (p=0.017). Two services were associated with higher total cost of care: total parenteral nutrition (TPN) team participation (p=0.001) and clinical research (p=0.0001). Total costs of care/hospital/year were lower when any of six clinical pharmacy services were present: drug use evaluation $1,119,810.18 (total $1,005,589,541.64 for the 898 hospitals offering the service), drug information $5,226,128.22 (total $1,212,461,747.04 for the 232 hospitals offering the service), adverse drug reporting monitoring $1,610,841.02 (total $1,101,815, 257.68 for the 684 hospitals offering the service), drug protocol management $1,729,608.41 (total $614,010,985.55 for the 355 hospitals offering the service), medical rounds participation $7,979,720.45 (total $1,212,917,508.41 for the 152 hospitals offering the service), and admission drug histories $6,964,145.17 (total $208,924,355.10 for the 30 hospitals offering the service). Clinical research $9,558,788.01 (total $1,013,231,529.06 for the 106 hospitals offering the service) and TPN team participation $3,211,355.12 (total $1,027,633,638.43 for the 320 hospitals offering the service) were associated with higher total costs of care. As staffing increased for hospital pharmacy administrators (p=0.0001) and clinical pharmacists (p=0.007), total cost of care decreased. As staffing increased for dispensing pharmacists, total cost of care increased (p=0.006). Based on this total cost of care model, optimal hospital pharmacy administrator staffing was 2.01/100 occupied beds. Staffing for dispensing pharmacists should be as low as possible, and definitely fewer than 5.11/100 occupied beds. Staffing for clinical pharmacists should be as high as possible, but definitely more than 1.11/100 occupied beds. The results of this study suggest that increased staffing levels of clinical pharmacists and pharmacy administrators, as well as some clinical pharmacy services, were associated with reduced total cost of care in United States hospitals.

Adverse Drug Reaction Reporting Systems↗
PubMed1999

Clinical pharmacy services, pharmacist staffing, and drug costs in United States hospitals.

We evaluated direct relationships and associations among clinical pharmacy services, pharmacist staffing, and drug costs in United States hospitals. A database was constructed from the 1992 American Hospital Association's Abridged Guide to the Health Care Field and the 1992 National Clinical Pharmacy Services database. Multiple regression analysis, controlling for severity of illness, was employed to determine the associations. The study population consisted of 934 hospitals. Four clinical pharmacy services were associated with lower drug costs: in-service education, $77,879.19+/-$56,203.42 (a total of $48,518,735.37 for the 623 hospitals offering this service, p=0.016); drug information, $430,579.84+/-$299,232.76 ($90,852,346.24 for the 211 hospitals offering this service, p=0.015); drug protocol management, $137,333.67+/-$98,617.83 ($45,045,443.76 for the 328 hospitals offering this service, p=0.049); and admission drug histories, $213,388.21+/-$201,537.85 ($5,548,093.46 for the 26 hospitals offering this service, p=0.011). As staffing increased for hospital pharmacy administrators (p<0.0001), dispensing pharmacists (p<0.0001), and pharmacy technicians (p<0.0001), drug costs increased. As staffing increased for clinical pharmacists, drug costs decreased (p=0.018). The results of this study show that increased staff levels of clinical pharmacists and some clinical pharmacy services are associated with reduced hospital drug costs.

Data Collection↗
PubMed1999

Health care professional staffing, hospital characteristics, and hospital mortality rates.

To evaluate associations among hospital characteristics, staffing levels of health care professionals, and mortality rates in 3763 United States hospitals, a data base was constructed from the American Hospital Association's Abridged Guide to the Health Care Field and hospital Medicare mortality rates from the Health Care Financing Administration. A multivariate regression analysis controlling for severity of illness was employed to determine the associations. Hospital characteristics associated with lower mortality were occupancy rate and private nonprofit and private for-profit ownership. Mortality rates decreased as staffing level per occupied bed increased for medical residents, registered nurses, registered pharmacists, medical technologists, and total hospital personnel. Mortality rates increased as staffing level per occupied bed increased for hospital administrators and licensed practical-vocational nurses. To our knowledge, this is the first study to show that pharmacists were associated with lower mortality rates.

Hospital Mortality↗
PubMed1999

Clinical pharmacy services and hospital mortality rates.

We evaluated the associations between clinical pharmacy services and mortality rates in 1029 United States hospitals. A data base was constructed from Medicare mortality rates from the Health Care Financing Administration and the National Clinical Pharmacy Services data base. A multivariate regression analysis, controlling for severity of illness, was employed to determine the associations. Four clinical pharmacy services were associated with lower mortality rates: clinical research (p<0.0001), drug information (p=0.043), drug admission histories (p=0.005), and participation on a cardiopulmonary resuscitation (CPR) team (p=0.039). The actual number of deaths (lower) associated with the presence of these four services were clinical research 21,125 deaths in 108 hospitals, drug information 10,463 deaths in 237 hospitals, drug admission histories 3843 deaths in 30 hospitals, and CPR team participation 5047 deaths in 282 hospitals. This is the first study to indicate that both centrally based and patient-specific clinical pharmacy services are associated with reduced hospital mortality rates. This suggests that these services save a significant number of lives in our nation's hospitals.

Data Collection↗
PubMed1999

Staffing and the cost of clinical and hospital pharmacy services in United States hospitals.

A survey was mailed to pharmacy directors at all United States acute care medical-surgical hospitals that related to staffing and cost components of hospital pharmacies and clinical services. Cost information was evaluated as both unadjusted and adjusted for severity of illness using the Health Care Financing Administration's Medicare case mix index (CMI). Unadjusted drug costs/occupied bed/year were $13,350+/-6927, a 36% increase over 1992 and a 112% increase over 1989, with statistically significant differences observed by geographic region, hospital size, hospital ownership, and drug delivery system. Annual median pharmacist salary costs/patient associated with centrally based clinical pharmacy services were drug use evaluation $111, in-service education $20, drug information $117, poison information $24, and clinical research $35. Annual median pharmacist salary costs/patient associated with patient-specific clinical services were drug therapy monitoring $5, pharmacokinetic consultation $8, patient counseling $6, medical rounds $4, admission drug histories $7, and drug therapy protocol management (prescribing) $9. Drug costs continue to increase at double-digit rates. Substantial differences exist among various regions of the country with salary and specific cost components. Registered nursing staffing is increasing at twice the rate of pharmacists staffing increases.

Hospital Costs↗
PubMed1995

Cost of pharmaceutical services in U.S. hospitals in 1992.

The results of a 1992 national survey of hospital-based pharmaceutical services are reported and compared with data collected during a similar survey in 1989. A questionnaire was mailed to pharmacy directors at all 3756 medical-surgical hospitals in the United States that had 50 or more licensed beds. Cost results were evaluated both as unadjusted data and as data adjusted for severity of illness with the case mix index. The response rate was 43% (1597 usable responses). Mean +/- S.D. unadjusted medication costs per occupied bed were $9850 +/- 4744 (a 46% increase over 1989 costs); significant differences were observed for geographic region, hospital ownership, drug delivery system, and pharmacy director's education. Mean +/- S.D. unadjusted total pharmacy costs per occupied bed were $16,550 +/- 6,249 (a 40% increase over 1989 costs); significant differences were observed for geographic region, hospital ownership, drug delivery system, and pharmacy director's education. Other mean +/- S.D. unadjusted pharmacy cost components were as follows: injectable solution costs, $2627 +/- 2191 (a 38% increase over 1989 costs); inventory costs, $2029 +/- 2593 (70% increase); pharmacist salary costs per occupied bed, $2997 +/- 1267 (33% increase); pharmacy technician costs per occupied bed, $995 +/- 876 (24% increase); pharmacist salary costs per full-time equivalent (FTE), $43,791 +/- 12,206 (14% increase); pharmacy technician salary costs per FTE, $18,953 +/- 6,154 (15% increase); and pharmacy staff development costs per occupied bed, $45 +/- 41 (29% increase). Pharmacist salary costs associated with centrally based clinical pharmacy services ranged from a high of $361 per occupied bed per year for drug-use evaluation to a low of $15 per occupied bed per year for inservice education. Pharmacist salary costs for patient-specific pharmaceutical services ranged from $3 per patient for medical rounds to $8 per patient for cardiopulmonary resuscitation team participation and drug protocol management. A 1992 survey provided comprehensive data on the cost structure of hospital-based pharmaceutical services and a basis for comparison with 1989 cost data.

Geography↗
PubMed1994

Evaluation of recent pharmacy graduates' practice patterns, professional lifelong learning, pharmacy organization memberships, and salary.

OBJECTIVES: To document information on recent bachelor of science (B.S.) pharmacy graduates' practice patterns, professional lifelong learning (PLL) methods, pharmacy organization memberships, and salary. The association between advanced training and education on PLL methods, pharmacy organization membership, and salary are explored. DATA SOURCES: Pertinent literature was identified by MEDLINE searches (1966-1992). STUDY DESIGN: The results of a Fall 1991 survey of recent B.S. pharmacy graduates (n = 371) of the University of Wisconsin School of Pharmacy are reported (55 percent response rate). RESULTS: Hospital pharmacists devoted more time to PLL outside of work (18.00 +/- 17.89 h/mo) than community pharmacists (9.93 +/- 8.76 h/mo), t = 5.02, degrees of freedom (df) = 289, p < 0.001. Graduates who had completed an advanced degree program, residency, or fellowship (advanced degree/training [ADT]) spent more time in PLL (17.76 +/- 10.63 h/mo) compared with graduates who had only obtained a B.S. degree (10.63 +/- 8.56 h/mo), t = 3.80, df = 311, p < 0.001. Graduates who had ADT were more likely to belong to multiple pharmacy organizations (2.14 +/- 1.38 organizations) than hospital pharmacists (1.61 +/- 1.27 organizations) and community pharmacists (1.11 +/- 1.06 organizations). Of the pharmacists who graduated in 1989 and 1990 (one to two years postgraduation), 55 percent belonged to the American Pharmaceutical Association. This declined to 19 percent of the graduates from 1984 and 1985 (six to seven years postgraduation), a 62 percent decline in membership. Membership in the American Society of Hospital Pharmacists (ASHP) was held by 19 percent of graduates one to two years after graduation; and 34 percent of graduates belonged to ASHP six to seven years after graduation, an 81 percent increase. Graduates with ADT (compared with graduates with the B.S. degree only) showed the strongest correlation of membership affiliation, which was about equal with ASHP (phi = 0.32) and ACCP (phi = 0.33). Although pharmacists changed their individual pharmacy organization memberships during the first seven years after graduation, there was no evidence of a decline in overall interest in pharmacy organization membership. Pharmacists who had completed ADT had an annual mean salary of $51,112 +/- $10,012; those pharmacists who did not complete an ADT program had an annual mean salary of $46,440 +/- $7802, a difference of $4672 per year. Hospital pharmacists who had obtained ADT had an annual mean salary of $51,840 +/- $9765; B.S. pharmacists without ADT in hospital practice had an annual mean salary of $43,603 +/- $8192, a difference of $8237 per year. CONCLUSIONS: Pharmacists' PLL methods, organization memberships, and salaries varied significantly by their practice site and the completion of an ADT program.

Education, Pharmacy, Continuing↗
PubMed1993

Optimizing resuscitation outcomes with pharmacologic therapy.

Pharmacologic therapy plays a key role in the emergency resuscitation of patients with cardiac arrest. The Advanced Cardiac Life Support guidelines sanctioned by the American Heart Association provide flexible treatment protocols (algorithms) that serve as a valuable tool for clinicians. Vasoactive (vasopressive) therapy with epinephrine is of primary importance in all patients with nonperfusing rhythms (for example, ventricular fibrillation [VF], pulseless ventricular tachycardia [VT], electromechanical dissociation [EMD], and asystole) because it raises myocardial and cerebral perfusion pressures, thereby increasing the likelihood of successful resuscitation. Antiarrhythmic drugs play a secondary role to electrocardioversion in the treatment of VF and pulseless VT. Despite continued investigation and recent advances in our understanding of the role of drugs and other therapeutic interventions, the short-term and long-term prognoses of patients with cardiac arrest, especially out-of-hospital arrest, remain dismal. Clearly, much study into the prevention and treatment of sudden cardiac death is desperately needed.

Adult↗
PubMed1992

Legal status and functions of hospital-based pharmacy technicians and their relationship to clinical pharmacy services.

The relationships among (1) laws and regulations governing hospital-based pharmacy technicians, (2) functions pharmacy technicians perform, and (3) pharmacists' provision of clinical pharmacy services were studied. A state-level technician-restriction score was developed, based on state rules and regulations in effect in 1989. Scoring included (1) type of supervision required for hospital-based pharmacy technicians, (2) ratio of technicians to pharmacists, (3) pharmacist-only reconstitution of injectable products, and (4) pharmacist-only counting and pouring. Actual use of hospital pharmacy technicians was measured with the technician-use index, and overall provision of clinical pharmacy services was measured with the pharmaceutical-care index. Based on the technician-restriction scores, 25 states and the District of Columbia were categorized as having less restrictive laws and 25 states as having more restrictive laws. Technician use varied with hospital size, teaching affiliation, owner-ship, type of drug delivery system, and education level of the director of pharmacy. Use of pharmacy technicians increased with the severity of hospital-patient illness treated. A fair correlation was found between the pharmaceutical-care index and the technician-use index. A positive association was found between pharmacy technician use and pharmacists' provision of clinical pharmacy services.

Certification↗
PubMed1992

Pharmaceutical services in U.S. hospitals in 1989.

The results of a spring 1989 national survey of hospital-based pharmacy services are reported. The study group (n = 2112) comprised half of U.S. acute-care general surgical or medical hospitals with 50 or more licensed beds. Pharmacy directors were asked about their hospital's provision of 14 clinical pharmacy services. The survey had a response rate of 56% (1174 usable responses). Provision levels varied significantly with the pharmacy drug delivery system for 14 services, pharmacy director's education for 12 services, hospital teaching affiliation for 12 services, hospital ownership for 9 services, hospital size for 9 services, and geographic region for 5 services. The following percentages of respondents offered specific services: drug-use evaluation, 90%; inservice education, 66%; adverse drug reaction (ADR) management, 46%; drug therapy monitoring, 41%; pharmacokinetic consultations, 40%; parenteral-enteral nutrition team participation, 28%; patient medication counseling, 26%; drug therapy protocol management, 25%; cardiopulmonary resuscitation (CPR) team participation, 25%; clinical research, 22%; drug information, 16%; participation in medical rounds, 13%; poison information, 9%; and medication histories, 2%. Pharmacist staffing requirements for clinical services usually centralized within the department were highest for drug information and poison information. Within hospitals offering the services, four of nine patient-specific services were potentially available to more than half the patients: ADR management, CPR team participation, drug therapy monitoring, and nutrition team participation. Drug therapy protocol management required the most pharmacist staff time. Only one service, pharmacokinetic consultations, was justified by more than half of the providers of that service. Respondents expected all the services to undergo net growth during 1989-90. The 1989 National Clinical Pharmacy Services Survey showed that provision of clinical pharmacy services varied with the pharmacy drug delivery system, pharmacy director's education, hospital teaching affiliation, hospital ownership, hospital size, and geographic region.

Adverse Drug Reaction Reporting Systems↗
PubMed1992

Cost of inpatient pharmaceutical services in U.S. hospitals in 1989.

The results of a spring 1989 national survey of hospital-based pharmacy services are reported; this article focuses on the cost structure of services. A questionnaire was sent to 2112 hospitals, comprising half of U.S. acute-care general medical or surgical hospitals with 50 or more licensed beds. Cost results were evaluated both as unadjusted data and as data adjusted with the case mix index (CMI). The survey had a response rate of 56% (1174 usable responses). Both pharmacy cost information and the CMI were obtained for 1000 hospitals. Mean +/- S.D. unadjusted medication costs per occupied bed were $6744 +/- $3048 and varied significantly with geographic region. Mean +/- S.D. pharmacist salary costs per full-time equivalent (FTE) were $38,432 +/- $8,550 and differed with geographic region, hospital ownership, the pharmacy drug delivery system, and the pharmacy director's education. Pharmacist salary costs associated with centrally based clinical pharmacy services ranged from a high of $60 per occupied bed per year for drug information services to a low of $15 for inservice education. The state with the highest mean +/- S.D. pharmacist annual salary per FTE was California ($45,900 +/- $11,037); the state with the lowest annual salary was Indiana ($29,637 +/- $7,110). A 1989 survey of clinical pharmacy services provided comprehensive data on complex cost structures.

Allied Health Personnel↗