Zingone Michelle M, Malcolm Karen E, McCormick Stephanie W, Bledsoe Kristir R
College of Pharmacy, University of Tennessee, Knoxville, TN 37920, USA.
Am J Health Syst Pharm. 2007 Sep 1;64(17):1827-31. doi: 10.2146/ajhp060438.
Pharmacist charges for medication therapy management (MTM) services in an outpatient setting were analyzed.
Patients' visits with pharmacists in three ambulatory care clinics in a large, urban teaching institution from December 2005 through February 2006 were analyzed. Data collected included the number and type of current diseases, insurance coverage, number of medications patients were taking, pharmacist time spent per patient visit, pharmacy services provided, and estimated charge for services based on level of care provided using physician and pharmacist billing codes. Data were analyzed using descriptive statistics.
A total of 500 pharmacist-patient visits were evaluated. The mean +/- S.D. patient age was 59.0 +/- 13.3 years. Patients had a mean +/- S.D. of 4.0 +/- 2.0 diseases and were taking 9.1 +/- 4.6 medications. The majority of visits (83%) lasted 30 minutes or less. The mean charge per visit using incident-to physician care billing was $37.09 and $63.24 for level 1 and level 2 visits, respectively. Pharmacist billing was found to result in an average charge of $26.58 ($1 per minute), $53.16 ($2 per minute), or $79.72 ($3 per minute) per visit. There was no difference in pharmacist time spent with complex patients versus noncomplex patients ( p = 0.1314). The use of pharmacist billing codes would not be beneficial unless each visit was billed as $3 per minute.
Converting from incident-to physician billing to pharmacist billing would not generate additional revenue for this medical center at this time.
分析门诊环境中药剂师提供药物治疗管理（MTM）服务的收费情况。
对2005年12月至2006年2月期间，一家大型城市教学机构的三家门诊护理诊所中患者与药剂师的就诊情况进行分析。收集的数据包括当前疾病的数量和类型、保险覆盖情况、患者正在服用的药物数量、每次患者就诊时药剂师花费的时间、提供的药房服务，以及根据使用医生和药剂师计费代码提供的护理级别估算的服务费用。使用描述性统计方法对数据进行分析。
共评估了500次药剂师与患者的就诊情况。患者的平均年龄为59.0±13.3岁（均值±标准差）。患者平均患有4.0±2.0种疾病，正在服用9.1±4.6种药物。大多数就诊（83%）持续30分钟或更短时间。使用医生附带服务计费时，1级和2级就诊每次的平均费用分别为37.09美元和63.24美元。发现药剂师计费导致每次就诊的平均费用为26.58美元（每分钟1美元）、53.16美元（每分钟2美元）或79.72美元（每分钟3美元）。药剂师与复杂患者和非复杂患者相处的时间没有差异（p = 0.1314）。除非每次就诊按每分钟3美元计费，否则使用药剂师计费代码不会带来益处。
目前，从医生附带服务计费转换为药剂师计费不会为该医疗中心带来额外收入。
