[Standards for the securing of Czechoslovak health care with pharmaceutical service. IX. Comprehensive data and suggested ratios for pharmaceutical service].
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Community Health Services↗
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Results for “Pharmaceutical Services”
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
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[Hospital pharmacy - a pharmaceutical service unit. 13 hospital pharmacists contribute cross-clinical pharmaceutical services].
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Denmark↗
Reimbursement for clinical pharmaceutical services.
Reimbursement for four clinical pharmaceutical services (growth hormone home instruction, patient consultation, patient visit and pharmacokinetic consultation), separate from other drug-related fees, is discussed. Included are descriptions of the clinical services, how they were provided, how charges were determined and documented, and how the proposal was submitted which initiated the charges. During a four-month observation period, from May to August 1977, 27 physicians requested a total of 71 clinical pharmaceutical services. Pharmacy charges generated by these requests totaled $4,492. Patients' and physicians' comments concerning the services have been positive, and pharmacy charges generated continue to average $1,100/month.
Fees, Pharmaceutical↗
Joint Commission on Accreditation of Hospitals' 1977 standards for pharmaceutical services.
New standards for pharmaceutical services in hospitals, recently approved by the Board of Commissioners of the Joint Commision of Accreditation of Hospitals (JCAH), are presented and compared with the previous standards. The efforts of the American Society of Hospital Pharmacists in working with JCAH to upgrade the pharmacy standards are reviewed. The new standards reflect progressive hospital pharmacy practice and focus of the hospital pharmacist's patient-care activities.
Accreditation↗
State on pharmaceutical service in home health care. Academy of Pharmacy Practice.
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Home Care Services↗
Comprehensive pharmaceutical services in an 85-bed hospital: a one-year evaluation.
The economics of a comprehensive pharmaceutical service in a small hospital was evaluated. The pharmacy program includes total unit dose drug distribution, centralized compounding of intravenous admixtures, and clinical involvement. Data were collected for two fiscal years prior to the development of formal pharmaceutical services (FY 72-73 and FY 73-74), the fiscal year during the implementation phase (FY 74-75) and the fiscal year following full development (FY 75-76). The total cost of the pharmaceutical services for FY 75-76 was $5.66 per patient day, a 106% increase over the previous year. The revenue per patient day in FY 75-76 was $7.77, a 72% increase over FY 74-75. Inventory costs decreased during and after implementation of comprehensive pharmaceutical services. The evaluation emphasizes the need for assessing pharmacy programs as an integrated system representative of the service of pharmacy. The need for an equitable method of third party payment for pharmaceutical services is discussed.
Costs and Cost Analysis↗
Comprehensive pharmaceutical services in the emergency room.
A decentralized pharmaceutical service functioning in a hospital emergency room from 4 p.m. to midnight daily is described. Start-up costs were determined to be less than $2,200 for the system which includes a mobile medication cart stocked with a limited inventory of prepackaged medications. Approximately 94% of the prescriptions originating from the emergency room from 4 p.m. to 8 a.m. can be filled from the cart. Results of a nine-month survey indicated that an average of 20.6 prescriptions were filled on the 4 p.m. to midnight shift each day, producing an average daily profit over drug expense of $60.51, which was more than the salary expense of the pharmacists providing the service. The time required to provide traditional prescription services has not interfered with the provision of clinical services or opportunities for educating undergraduate pharmacy students who rotate through the area. Implementation of clinical pharmaceutical services with a traditional component is suggested as a cost-effective method of providing such services.
Education, Pharmacy↗
Decentralization of pharmaceutical services without satellite pharmacies.
The decentralization of pharmaceutical services without the addition of pharmacy satellites is described. Mobile, master medication carts are used by pharmacy personnel in the patient-care areas to fill the unit dose carts used by nurses. A combination medication administration record and patient profile eliminates duplication of effort by pharmacy and nursing. Responsibilities of pharmacists and technicians, the process of hospital-wide implementation of the system, current levels of service, and a clerkship designed to improve staff pharmacists' clinical abilities are described. The ratio of the number of drug doses administered to the number of drug doses handled per patient-day increased after the implementation of the new system. This indicated that individual doses were handled fewer times by pharmacy personnel. This method of decentralization permitted integration of distributive and clinical pharmaceutical services with a minimal personnel cost increase, no additional space requirements nor expenditures for renovation, and only a small cost for master medication carts. Because the pharmacists work in the patient-care areas, they are in more frequent contact with nurses, physicians and patients.
Costs and Cost Analysis↗
Cost-benefit and cost-effectiveness: methodologies for evaluating innovative pharmaceutical services.
Cost-benefit and cost-effectiveness analysis techniques which can be of assistance in the evaluation of innovative pharmaceutical services are reviewed. Process and outcome measures are considered, and suggested steps in a cost-benefit study are presented. Samples of pharmacy studies using these techniques are appraised. Possible measures for benefits and costs along with literature references for evaluations of innovative pharmaceutical services are presented. Areas of pharmaceutical service discussed are ambulatory patient consultation, unit dose drug distribution, drug information services, monitoring drug therapy in acute care and long-term care, parenteral admixture services, patient and therapy responsibilities, patient discharge interviews, patient drug histories and profiles, and personnel substitutions. Although there have been several encouraging reports on the cost-benefit of pharmaceutical services, more evaluative research is needed to develop programs which maximize the benefit-to-cost ratio to society.
Cost-Benefit Analysis↗
Pharmaceutical services in a medical screening clinic.
Pharmaceutical services in a medical screening clinic are described. Services provided include medication refills, patient education and medication histories. During the first year 1,067 patients were interviewed, evaluated and received these services from the pharmacist. The majority of these patients were seen for medication refills. A clinical assessment was made by the pharmacist of the current drug therapy, evidence of new or drug-related problems, and compliance with medication regimens. One hundred seventy-six patients were found to be receiving inappropriate drug therapy, 69 patients were found to have drug-related problems and 248 patients were found to be noncompliant with their drug regimens. Patients received 1,633 refills and 24 new prescriptions. One hundred fifty patients were refused refills because the medications were being abused or were not indicated. Many patients (564) received extensive education about their medications and diseases. One hundred eleven laboratory tests were ordered and 323 clinic appointments were made. The pharmacist is providing services which are an asset to both patients and other members of the health care team.
Ambulatory Care↗
Pharmaceutical services for the cancer patient.
Pharmaceutical services for cancer patients in a hospital-tumor institute are described. The duties of the pharmacists discussed are: (1) providing necessary medication including the preparation of chemotherapeutic agents for administration and (2) providing drug information for the oncology specialist, the private physician, the nurse and the patient. As part of the information service, discharged patients and clinic patients are given brief monographs on the chemotherapeutic drugs included in their treatment. Pharmacists attend ward rounds regularly with four different medical services.
Drug Compounding↗
Charging for hospital pharmaceutical services: product cost, per diem fees and fees for special clinical services.
A method of charging for pharmaceutical services is described which includes the cost of drug products, dispensing fees for intravenous drug admixtures, per diem fees for basic dispensing and clinical services (according to patient type), and fees for special clinical services. The basic per diem charge covers drug purchasing and inventory control, department management, drug information services, dose preparation, drug order interpretation, drug therapy monitoring, and the availability of pharmacists to answer the questions of nurses and physicians. The clinical services for which special fees are charged are: hemogram drug report, drug liver function report, aminoglycoside dosing guidelines, heparin i.v. infusion, oral anticoagulation, patient drug history, operant conditioning, parenteral nutrition guidelines, and pharmacokinetic drug level interpretations and consultations. The reasons for changing to the system, the services provided and experiences with the system are discussed. Implementation of the system is discussed in relation to the calculation of fees; comparisons with alternate charging methods; approval of special clinical service charges; computer billing; information about pharmacy charges for patients; and third-party payers.
California↗
Computer support of pharmaceutical services for ambulatory patients.
A prototype computerized pharmaceutical services support system (CPSSS) is described. CPSSS maintains records on approximately 40,000 patients; 1,300 outpatient prescriptions are dispensed per day. Using Univac hardware and software developed inhouse, CPSSS provides an online drug therapy profile. The prescription label, including auxiliary information, storage and stability guidelines as well as the traditional information, is automatically generated. Prior to medication dispensing, all information is verified by a pharmacist after the computer searches the patient medication profile for 5,400 potential drug-drug, 1,500 drug-disease state, over 100 drug-allergy and 200 drug-laboratory test interactions as well as identifying duplicate pharmacological therapy. Retrospectively, the patient population is described as to sex, age and number of diagnoses. The number of prescriptions per physician also is reported. Twenty drugs represent one-half of the total prescriptions, with 32% of patients taking diuretics and 30% taking tranquilizers. All new prescriptions were prospectively reviewed. Approximately 2% had potential interactions or pharmacological duplication of therapy problems. Approximately 30% of all new prescriptions duplicated exactly an active prescription on file. When a pharmacist initiated physician contact as a result of CPSSS and profile review, physicians changed therapy approximately 73% of the time when informed of duplicate therapy, 27% of the time when informed of potential drug-disease state interactions and 32% of the time when informed of potential drug-drug interactions.
Ambulatory Care↗
Survey of clinical pharmaceutical services in Florida hospitals.
A survey of clinical pharmaceutical services in Florida hospitals is described. Questionnaires were mailed to the pharmacy departments of 210 hospitals containing 50 or more beds; 172 (82%) responded. Data were collected concerning the extent and types of clinical services provided; the reasons for not implementing the services were also obtained. Twenty (12%) hospitals employed a full-time clinical pharmacist. Inservice drug education, formalized drug information, cardiopulmonary resuscitation and patient medication histories were provided by 78%, 47%, 19% and 6% of the hospitals, respectively. Hospitals with a total or partial unit dose drug distribution system seemed more likely to provide clinical services than those with other types of distribution systems. Hospitals employing a clinical pharmacist were engaged in a wider range of clinical services and provided these services to a larger portion of their patient population. The reason most frequently cited for not implementing clinical services was inadequate staff.
Florida↗
Charging for hospital pharmaceutical services: combined product-service per diem fees.
The development of a per diem hospital pharmacy charge is reviewed after five years of use. The itemized pharmacy charges for every tenth patient (total of 250 patients) admitted to the hospital during a three-month period were studied to determine the average daily charges for drugs and pharmaceutical services. Six categories of rates were designated, based on the type of hospital service. A comparison of the actual charges and the projected per diem rate indicated that the per diem rate would produce the same revenue as the itemized charging method. A procedure for periodically monitoring the per diem rate was also established. The per diem pharmacy charges range from $3.50 (for patients admitted to the psychiatric service) to $12 (surgical patients). Intravenous solutions, i.v. admixtures, normal human serum albumin, drugs administered in the intensive care and cardiac care units, and drug with an acquistion cost of more than $10 are not included in the per diem charging system. The per diem system enabled the hospital to reduce administrative and accounting costs while continuing to provide quality pharmaceutical services.
Colorado↗
Cost of comprehensive pharmaceutical services in a 45-bed rural hospital.
The financial impact of a comprehensive pharmacy program on patient charges and hospital operating costs in a 45-bed community hospital was studied. Data were collected retrospectively for the fiscal year prior to initiating pharmacy services (FY73), the fiscal year during program development (FY74) and the fiscal year following full operations (FY75). The total cost of pharmacy services increased 75% from FY73 to FY75, with the largest dollar increase being in pharmacy salaries. Large increases among other cost items also were noted. The average total cost for pharmacy services increased from $3.28 per patient day in FY73 to $6.04 in FY75 (84%). Total hospital cost per patient day increased by approximately $35 from FY73 to FY75 (5%). The pharmaceutical services fee per dose of medication administered did not change from FY73 to FY75. Patient charges per day for medications and pharmaceutical services increased $0.55 (9.8%) from FY73 to FY75. There was a 55% reduction in the number of items carried in pharmacy inventory from FY73 to FY74 following the initiation of a formulary and a unit dose drug distribution system.
Costs and Cost Analysis↗
Model for the development of rural pharmaceutical services.
The Central Pharmacy of Presbyterian Medical Services (PMS) a nonprofit corporation operating a rural comprehensive health care system in New Mexico, is discussed. PMS Central Pharmacy provides pharmaceutical services to a 34-bed acute care hospital and 24 widely scattered clinics for ambulatory patients. The financial base, administration, development of a formulatory, purchasing, prepackaging of medications, and consulting services of the PMS Central Pharmacy are described. Central Pharmacy acts as a drug wholesaler for PMS; the gross margin between acquisition cost and average wholesale price covers 90% of the cost of the pharmacy operation. In addition, the clinics pay a fee and travel expenses for pharmacist consultation. Seven clinics employ drug technicians who are trained and supervised by Central Pharmacy. It is concluded that this system may serve as a model for the development of pharmaceutical services in other rural areas or in poverty-stricken urban areas.
Costs and Cost Analysis↗
[New methods for planning financial and economic indices of pharmaceutic services].
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Financial Management↗