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一项关于药剂师在政府资助的急症医院发起的药物治疗和患者管理变更的前瞻性多中心研究。

A prospective multicentre study of pharmacist initiated changes to drug therapy and patient management in acute care government funded hospitals.

作者信息

Dooley Michael J, Allen Karen M, Doecke Christopher J, Galbraith Kirsten J, Taylor George R, Bright Jennifer, Carey Dianne L

机构信息

Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australian.

出版信息

Br J Clin Pharmacol. 2004 Apr;57(4):513-21. doi: 10.1046/j.1365-2125.2003.02029.x.

Abstract

AIMS

To determine the cost savings of pharmacist initiated changes to hospitalized patients' drug therapy or management in eight major acute care government funded teaching hospitals in Australia.

METHODS

This was a prospective study performed in eight hospitals examining resource implications of pharmacists' interventions assessed by an independent clinical panel. Pharmacists providing clinical services to inpatients recorded details of interventions, defined as any action that directly resulted in a change to patient management or therapy. An independent clinical review panel, convened at each participating centre, confirmed or rejected the clinical pharmacist's assessment of the impact on length of stay (LOS), readmission probability, medical procedures and laboratory monitoring and quantified the resultant changes, which were then costed.

RESULTS

A total of 1399 interventions were documented. Eight hundred and thirty-five interventions impacted on drug costs alone. Five hundred and eleven interventions were evaluated by the independent panels with three quarters of these confirmed as having an impact on one or more of: length of stay, readmission probability, medical procedures or laboratory monitoring. There were 96 interventions deemed by the independent panels to have reduced LOS and 156 reduced the potential for readmission. The calculated savings was $263 221 for the eight hospitals during the period of the study. This included $150 307 for length of stay reduction, $111 848 for readmission reduction.

CONCLUSIONS

The annualized cost savings relating to length of stay, readmission, drugs, medical procedures and laboratory monitoring as a result of clinical pharmacist initiated changes to hospitalized patient management or therapy was $4 444 794 for eight major acute care government funded teaching hospitals in Australia.

摘要

目的

确定在澳大利亚八家主要的由政府资助的急性护理教学医院中,药剂师发起的对住院患者药物治疗或管理的改变所节省的成本。

方法

这是一项在八家医院进行的前瞻性研究,通过一个独立的临床小组评估药剂师干预措施对资源的影响。为住院患者提供临床服务的药剂师记录干预措施的详细信息,干预措施定义为直接导致患者管理或治疗发生改变的任何行动。在每个参与中心召集一个独立的临床审查小组,确认或否决临床药剂师对住院时间(LOS)、再入院概率、医疗程序和实验室监测影响的评估,并量化由此产生的变化,然后计算成本。

结果

共记录了1399项干预措施。835项干预措施仅影响药物成本。独立小组评估了511项干预措施,其中四分之三被确认为对住院时间、再入院概率、医疗程序或实验室监测中的一项或多项有影响。独立小组认为有96项干预措施缩短了住院时间,156项降低了再入院可能性。在研究期间,八家医院计算得出的节省金额为263221美元。这包括因缩短住院时间节省150307美元,因减少再入院节省111848美元。

结论

由于临床药剂师发起的对住院患者管理或治疗的改变,澳大利亚八家主要的由政府资助的急性护理教学医院在住院时间、再入院、药物、医疗程序和实验室监测方面每年节省的成本为4444794美元。

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