Catania H F, Yee W P, Catania P N
Pharmacy Services, St. Joseph Medical Center, Stockton, CA 95204.
Am J Hosp Pharm. 1990 Dec;47(12):2701-5.
Four years of data are reported on the drug cost avoidance and the net cost savings associated with a clinical pharmacy intervention program. In 1986 the pharmacy department at a 324-bed nonprofit community medical center began a clinical intervention program by adding one full-time equivalent for providing clinical services. A new clinical pharmacist position was created in 1988. A reorganization in 1989 resulted in further increases in staffing, including the creation of a clinical coordinator position to oversee the intervention program, and in administrative time. Staff pharmacists self-report a broad range of interventions on a clinical documentation form. During the period 1986-1989, monthly data on the number of types of interventions recommended, the percentage of recommendations accepted by the medical staff, and drug cost avoidance were tabulated. Cost avoidance was calculated by subtracting the cost of therapy ordered by the physician from the cost of therapy initiated as a result of the intervention. Net drug cost savings were calculated by subtracting from cost avoidance the cost of pharmacist time required for performing the interventions. The average number of interventions per month ranged from 170 in 1986 to 292 in 1990. During an 18-month period before the clinical coordinator was added, average monthly cost avoidance and net savings were $4932 and $3739, respectively. Average monthly cost avoidance increased to $6244 and savings to $4644 in a 12-month period after the clinical coordinator was added. A four-year study of a clinical intervention program showed that the dollar value and impact outlasted the initial success expected for such programs.
报告了关于一项临床药学干预项目所带来的药品成本节约及净成本节省的四年数据。1986年，一家拥有324张床位的非营利性社区医疗中心的药房部门通过增加相当于一名全职人员来提供临床服务，启动了一项临床干预项目。1988年设立了一个新的临床药师职位。1989年的一次重组导致人员配置进一步增加，包括设立了一个临床协调员职位来监督干预项目，以及增加了行政时间。药剂师在临床文件表格上自行报告广泛的干预措施。在1986 - 1989年期间，每月记录所推荐的干预措施类型数量、医务人员接受建议的百分比以及药品成本节约情况。成本节约通过用因干预而启动的治疗成本减去医生所开治疗的成本来计算。净药品成本节省通过从成本节约中减去执行干预措施所需药剂师时间的成本来计算。每月干预措施的平均数量从1986年的170次到1990年的292次不等。在增加临床协调员之前的18个月期间，平均每月成本节约和净节省分别为4932美元和3739美元。增加临床协调员后的12个月期间，平均每月成本节约增至6244美元，节省增至4644美元。一项针对临床干预项目的四年研究表明，该项目的货币价值和影响超过了此类项目最初预期的成功。
