Culbertson V L, Rhodes R S, Hill E P, Rhodes P J
Division of Clinical Programs, University Hospital, University of Colorado School of Pharmacy, Denver.
Am J Hosp Pharm. 1988 Jun;45(6):1346-9.
The impact of home infusion therapies on the pharmaceutical services drug budget of the Colorado Medicaid program was evaluated retrospectively. Pharmacy billing claims and prior authorization forms for home infusion therapies submitted to the Colorado Department of Social Services during a 26-month period were reviewed to determine the costs of the drug or hydration solutions and ancillary products necessary for the preparation and administration of the solutions. A dispensing fee of +3.40 per dose was figured into calculations of total costs of home infusion therapies, and an estimated cost of +100-+150 per day for follow-up care was added. Equivalent costs of hospitalization were calculated using an average per diem charge of +315. A total of 61 patients received 1361 days of home infusion therapy during the study period. The majority of patients received home antimicrobial therapy; 752 days of hospitalization theoretically were avoided because of home administration of antimicrobial agents, which translates into a cost savings of +76,716-+114,316. Patients also received home parenteral nutrition therapy, analgesic therapy, and rehydration therapy that yielded cost savings of +48,374-+78,824 but in some cases resulted in higher costs than hospitalization would have. Home infusion therapies increased pharmaceutical services costs by +99,475, representing an important shift of costs from the hospital services budget to the pharmaceutical services budget. Home infusion therapies generally incur lower costs than would be incurred during an equivalent hospital stay. The Colorado Medicaid budget should be adjusted to compensate for the shift of costs from hospital to pharmaceutical services.
对家庭输液疗法对科罗拉多医疗补助计划药品服务药物预算的影响进行了回顾性评估。审查了在26个月期间提交给科罗拉多社会服务部的家庭输液疗法的药房计费索赔和事先授权表格，以确定制备和施用溶液所需的药物或补液溶液以及辅助产品的成本。每剂3.40美元的配药费计入家庭输液疗法总成本的计算中，并增加了随访护理每天估计100至150美元的成本。使用每天315美元的平均费用计算住院的等效成本。在研究期间，共有61名患者接受了1361天的家庭输液治疗。大多数患者接受家庭抗菌治疗；由于在家中使用抗菌药物，理论上避免了752天的住院治疗，这意味着节省了76,716至114,316美元的成本。患者还接受了家庭胃肠外营养治疗、镇痛治疗和补液治疗，节省了48,374至78,824美元的成本，但在某些情况下，成本高于住院治疗。家庭输液疗法使药品服务成本增加了99,475美元，这代表了成本从医院服务预算向药品服务预算的重要转移。家庭输液疗法的成本通常低于同等住院期间的成本。科罗拉多医疗补助预算应进行调整，以补偿成本从医院向药品服务的转移。
