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Z T Grapes

Publications and source records attributed to Z T Grapes.

7 recordsLinked to original sources
PubMed1994

Factors associated with preventable adverse drug reactions.

Factors associated with preventable adverse drug reactions (ADRs) in a community hospital patient population were studied. The following data were collected by concurrent review of all ADRs reported from July 1992 through January 1993: patient demographics, ADR variables, length of stay, and preventability of ADR. These data were analyzed to determine factors associated with preventable ADRs. Of the 203 ADRs reported, 38 (19%) were identified as preventable. The only significant difference found between preventable and nonpreventable ADRs was in severity (preventable ADRs were more severe). Length of stay (LOS) for patients who experienced ADRs was longer than the national average for patients in the same diagnosis-related group. Most of the preventable ADRs involved (1) a documented allergy to medication ordered or to similar medications, (2) anticoagulants or thrombolytics, (3) that required serum drug concentration monitoring (in the absence of pharmacokinetics service involvement), and (4) renally eliminated drugs for which dosage adjustments were not made in patients with impaired renal function. Strategies for minimizing ADRs were developed based on these factors. An ADR reporting program helped in identifying preventable ADRs, determining factors associated with preventable ADRs, and developing strategies for preventing ADRs in a community hospital patient population.

Adolescent↗
PubMed1976

A review of prescription pricing and a call for equitable payment.

All of these systems are designed in order than a fair and equitable profit may be included for pharmaceutical services but this profit need not be excessive. For many years, the pharmacy has been considered a profit generator to offset the losses in other services departments. However, because of increased consumer awareness of prices and the close scrutiny of third party payers, including the federal government, this practice appears to be diminishing. With enactment of a comprehensive national health insurance, it is unlikely that the government will allow the type of cost accounting whereby one department generates profit to offset a deficit in other departments. Therefore, hospitals must develop a fair, equitable, and efficient pricing system. It is believed that the per diem charge system may be the most suitable for several reasons. First, it provides a mechanism for the charging of services not associated with the dispensing of pharmaceuticals. Second, this system appears to be more efficient because it eliminates the need to price individual prescriptions, which may result in an annual savings of $20 per bed as reported in one study. Third, the per diem mechanism promotes cost efficiency by focusing attention on the actual daily operating cost of providing pharmaceutical services. It is obvious that the general public is aware of the expense of health care, including pharmaceuticals. Hospital pharmacy has enjoyed a relative period of immunity from such public scrutiny for many years. We must, therefore, make every effort to encourage a pricing system that is equitable to both the hospital and the patient. In viewing these four mechanisms of payment, it is believed that the per diem rate for pharmaceutical services can and will be utilized to a much greater extent. When one considers its advantages along with the imminence of some form of a national health insurance program, this system appears to be the reimbursement mechanism of the future.

Consumer Behavior↗