Murphy Andrea L, MacKinnon Neil J, Flanagan Priti S, Bowles Susan K, Sketris Ingrid S
Drug Use Management and Policy, College of Pharmacy, Dalhousie University, Halifax, Nova Scotia, Canada.
Ann Pharmacother. 2005 Apr;39(4):655-61. doi: 10.1345/aph.1E286. Epub 2005 Feb 22.
An intervention (termed Initiative) was initiated to facilitate converting beneficiaries of a public drug insurance program in the province of Nova Scotia from respiratory nebulization medications to inhalers. Community pharmacists provided patient education and billed professional fees for conversions or optimizing inhaled respiratory medication technique.
To determine community pharmacists' self-reported participation rate and identify facilitators and barriers to billing for professional fees.
A survey was developed and mailed to Nova Scotia pharmacists. Information on demographics, work environment, professional experience, financial aspects, billing experiences, and the billing process was collected. Quantitative and qualitative data were evaluated using bivariate and multivariate analyses, and a thematic process, respectively.
Two hundred ninety-seven pharmacists responded. Self-reported billing rates for fees were 34% (switching delivery devices), 58% (optimizing AeroChamber use), and 37% (follow-up when replacing Aerochambers). Awareness of fees and the perception of consistent claim reimbursement were associated with billing for each fee (p < 0.05). Predisposing billing factors included awareness of fees, identifying situations requiring education, owner/manager position, male gender, perception that billing for education for optimizing technique is a minimum standard of practice, and prescription volume. Themes identified as barriers included inefficient billing process, inadequate fees, and lack of Initiative awareness.
Predisposing factors were the most important facilitators of community pharmacists' participation in this program, while a cumbersome and time-consuming billing process was the primary barrier. Further research should determine the impact of the professional fee on patient health outcomes.
发起了一项干预措施（称为“倡议”），以促进新斯科舍省公共药物保险计划的受益人从呼吸雾化药物转换为吸入器。社区药剂师提供患者教育，并为转换或优化吸入式呼吸药物技术收取专业费用。
确定社区药剂师自我报告的参与率，并确定收取专业费用的促进因素和障碍。
制定了一项调查并邮寄给新斯科舍省的药剂师。收集了有关人口统计学、工作环境、专业经验、财务方面、计费经验和计费流程的信息。分别使用双变量和多变量分析以及主题分析方法对定量和定性数据进行评估。
297名药剂师做出了回应。自我报告的费用计费率分别为：34%（更换给药装置）、58%（优化储物罐使用）和37%（更换储物罐时进行随访）。对费用的知晓以及对索赔报销一致性的认知与每项费用的计费相关（p < 0.05）。促成计费的因素包括对费用的知晓、识别需要教育的情况、业主/经理职位、男性、认为优化技术教育计费是最低执业标准以及处方量。被确定为障碍的主题包括计费流程效率低下、费用不足以及对“倡议”缺乏认知。
促成因素是社区药剂师参与该计划的最重要因素，而繁琐且耗时的计费流程是主要障碍。进一步的研究应确定专业费用对患者健康结果的影响。
