Crane V S
College of Pharmacy, University of Texas, Austin.
DICP. 1990 Nov;24(11 Suppl):S24-7.
The critically ill patient is at high risk for developing complications and, consequently, higher costs of treatment. Because of the high costs associated with these patients, healthcare payers are demanding the development of criteria to ensure cost-effective care. Pharmacists can play an important role in ensuring cost-effective and appropriate care of critically ill patients. The length of hospital stay, the single most important variable influencing the overall cost of patient care, is increased by lack of a structured patient management plan and by the development of complications. Many of these complications are preventable by appropriate drug therapy and monitoring, thus representing the cost factor most controllable by pharmacists. Pharmacists can use newer tools such as cost-effective analysis and clinical decision analysis to identify and utilize drug therapies that result in decreased complications and decreased length of hospital stay, as measured by decreased costs. Equally important is the development of criteria for the appropriate use of drug therapies. Pharmacists must take an active role in working with physicians, nurses, payers, and risk managers.
重症患者发生并发症的风险很高，因此治疗成本也更高。由于这些患者的治疗成本高昂，医疗保健支付方要求制定标准以确保具有成本效益的护理。药剂师在确保对重症患者进行具有成本效益且恰当的护理方面可以发挥重要作用。住院时间是影响患者总体护理成本的唯一最重要变量，缺乏结构化的患者管理计划以及出现并发症会延长住院时间。这些并发症中有许多可通过适当的药物治疗和监测来预防，因此是药剂师最可控的成本因素。药剂师可以使用成本效益分析和临床决策分析等更新的工具，来识别和采用能减少并发症并缩短住院时间（以降低成本来衡量）的药物治疗方法。同样重要的是制定药物治疗合理使用的标准。药剂师必须积极与医生、护士、支付方和风险管理人员合作。
