The Ohio State University Wexner Medical Center, Ross Ambulatory Care Center, 452 West 10th Avenue, Columbus, OH 43210, USA.
Am J Health Syst Pharm. 2012 Sep 15;69(18):1569-73. doi: 10.2146/ajhp110270.
The economic impact of pharmacist-managed antiarrhythmic drug therapy monitoring on an academic medical center's electrophysiology (EP) program was investigated.
Data were collected for the initial two years of patient visits (n = 816) to a pharmacist-run clinic for antiarrhythmic drug therapy monitoring. A retrospective cost analysis was conducted to assess the direct costs associated with three appointment models: (1) a clinic office visit only, (2) a clinic visit involving electrocardiography and basic laboratory tests, and (3) a clinic visit including pulmonary function testing and chest x-rays in addition to electrocardiography and laboratory testing. A subset of patient cases (n = 18) were included in a crossover analysis comparing pharmacist clinic care and usual care in an EP physician clinic. The primary endpoints were the cost benefits and cost savings associated with pharmacy-clinic care versus usual care. A secondary endpoint was improvement of overall EP program efficiency.
The payer mix was 61.6% (n = 498) Medicare, 33.2% (n = 268) managed care, and 5.2% (n = 42) other. Positive contribution margins were demonstrated for all appointment models. The pharmacist-managed clinic also yielded cost savings by reducing overall patient care charges by 21% relative to usual care. By the second year, the pharmacy clinic improved EP program efficiency by scheduling an average of 24 patients per week, in effect freeing up one day per week of EP physician time to spend on other clinical activities.
Pharmacist monitoring of antiarrhythmic drug therapy in an out-patient clinic provided cost benefits, cost savings, and improved overall EP program efficiency.
调查药剂师管理抗心律失常药物治疗监测对学术医疗中心电生理 (EP) 项目的经济影响。
收集了 816 名患者在药剂师管理的抗心律失常药物治疗监测诊所就诊的前两年的数据。进行了回顾性成本分析，以评估三种预约模式（1. 仅诊所就诊；2. 诊所就诊包括心电图和基本实验室检查；3. 诊所就诊包括肺功能测试和胸部 X 光检查，以及心电图和实验室检查）相关的直接成本。对 18 例患者病例进行了交叉分析，比较了药剂师诊所护理和 EP 医生诊所的常规护理。主要终点是与常规护理相比，药房诊所护理的成本效益和成本节约。次要终点是提高 EP 项目整体效率。
支付方构成比例为 61.6%（n=498）医疗保险、33.2%（n=268）管理式医疗和 5.2%（n=42）其他。所有预约模式均显示出正的边际贡献。与常规护理相比，药剂师管理的诊所还通过降低总患者护理费用 21% 实现了成本节约。到第二年，药房诊所通过平均每周安排 24 名患者，实际上每周为 EP 医生腾出一天时间用于其他临床活动，提高了 EP 项目的效率。
在门诊诊所中，药剂师对抗心律失常药物治疗的监测带来了成本效益、成本节约，并提高了 EP 项目的整体效率。
