Lipowski E E, Wiederholt J B, Kreling D H, Collins T M
Am J Hosp Pharm. 1986 Jun;43(6):1467-72.
A profile of Wisconsin pharmacies that provide services to Medicaid recipients in long-term-care facilities (LTCFs) was developed, and the relationships among pharmacy characteristics and drug use and reimbursement for pharmaceutical services in these pharmacies were studied. Computer-generated reports of Medicaid claims of all pharmacies that had received $1000 or more for services provided to LTCFs from July through September 1984 were included in the study; these claims were submitted by 255 pharmacies on behalf of 32,410 recipients. The reports contained the following individual pharmacy data: geographic location, total dollar payments, total number of Medicaid recipients served, percentage of recipients residing in LTCFs, total number of payments from Medicaid for prescriptions, amount paid to the pharmacy for LTCF recipients as a percentage of total payments, percentage of prescriptions paid at the unit dose rate, and average number of prescriptions and cost per LTCF recipient. An average of $137.30 per recipient was reimbursed, representing an average of 12.3 prescriptions per recipient. The average number of prescriptions per recipient did not vary among pharmacies on the basis of unit dose or traditional distribution system, vendor-consultant status of the pharmacist, location of the pharmacy, or the proportion of LTCF claims to total Medicaid prescription claims. The average amount paid per recipient was related to the average number of prescriptions per recipient, the use of a unit dose system, and the proportion of nursing home claims to total claims submitted. A Medicaid database can be useful for characterizing pharmaceutical services and drug use in LTCFs.
我们制定了一份为长期护理机构（LTCF）中的医疗补助受助人提供服务的威斯康星州药房概况，并研究了这些药房的药房特征、药物使用与药品服务报销之间的关系。该研究纳入了计算机生成的所有药房医疗补助索赔报告，这些药房在1984年7月至9月期间因向长期护理机构提供服务而获得了1000美元或更多收入；这些索赔由255家药房代表32410名受助人提交。报告包含以下各药房的数据：地理位置、支付的总金额、服务的医疗补助受助人总数、居住在长期护理机构中的受助人百分比、医疗补助为处方支付的总次数、支付给药房的长期护理机构受助人费用占总支付金额的百分比、按单位剂量率支付的处方百分比，以及每位长期护理机构受助人的平均处方数和费用。每位受助人平均报销137.30美元，平均每位受助人有12.3张处方。每位受助人的平均处方数在不同药房之间没有因单位剂量或传统分发系统、药剂师的供应商顾问身份、药房位置或长期护理机构索赔占医疗补助处方索赔总数的比例而有所不同。每位受助人支付的平均金额与每位受助人的平均处方数、单位剂量系统的使用以及疗养院索赔占提交的总索赔的比例有关。医疗补助数据库可用于描述长期护理机构中的药品服务和药物使用情况。
