Rech Megan A, Gurnani Payal K, Peppard William J, Smetana Keaton S, Van Berkel Megan A, Hammond Drayton A, Flannery Alexander H
Department of Pharmacy, Loyola University Medical Center, Maywood, IL.
Department of Emergency Medicine, Loyola University Medical Center, Maywood, IL.
Crit Care Explor. 2021 Dec 10;3(12):e0594. doi: 10.1097/CCE.0000000000000594. eCollection 2021 Dec.
To comprehensively classify interventions performed by ICU clinical pharmacists and quantify cost avoidance generated through their accepted interventions.
A multicenter, prospective, observational study was performed between August 2018 and January 2019.
Community hospitals and academic medical centers in the United States.
ICU clinical pharmacists.
Recommendations classified into one of 38 intervention categories (divided into six unique sections) associated with cost avoidance.
Two-hundred fifteen ICU pharmacists at 85 centers performed 55,926 interventions during 3,148 shifts that were accepted on 27,681 adult patient days and generated $23,404,089 of cost avoidance. The quantity of accepted interventions and cost avoidance generated in six established sections was adverse drug event prevention (5,777 interventions; $5,822,539 CA), resource utilization (12,630 interventions; $4,491,318), individualization of patient care (29,284 interventions; $9,680,036 cost avoidance), prophylaxis (1,639 interventions; $1,414,465 cost avoidance), hands-on care (1,828 interventions; $1,339,621 cost avoidance), and administrative/supportive tasks (4,768 interventions; $656,110 cost avoidance). Mean cost avoidance was $418 per intervention, $845 per patient day, and $7,435 per ICU pharmacist shift. The annualized cost avoidance from an ICU pharmacist is $1,784,302. The potential monetary cost avoidance to pharmacist salary ratio was between $3.3:1 and $9.6:1.
Pharmacist involvement in the care of critically ill patients results in significant avoidance of healthcare costs, particularly in the areas of individualization of patient care, adverse drug event prevention, and resource utilization. The potential monetary cost avoidance to pharmacist salary ratio employing an ICU clinical pharmacist is between $3.3:1 and $9.6:1.
全面分类重症监护病房（ICU）临床药师所实施的干预措施，并量化通过其被采纳的干预措施所避免的成本。
2018年8月至2019年1月期间进行了一项多中心、前瞻性观察性研究。
美国的社区医院和学术医疗中心。
ICU临床药师。
建议分为38个与成本避免相关的干预类别（分为六个独特部分）之一。
85个中心的215名ICU药师在3148个班次中实施了55926项干预措施，这些措施在27681个成人患者日被采纳，共避免了23404089美元的成本。六个既定部分中被采纳的干预措施数量及避免的成本分别为：预防药物不良事件（5777项干预措施；5822539美元成本避免）、资源利用（12630项干预措施；4491318美元）、患者护理个体化（29284项干预措施；9680036美元成本避免）、预防（1639项干预措施；1414465美元成本避免）、实际操作护理（1828项干预措施；1339621美元成本避免）以及行政/支持性任务（4768项干预措施；656110美元成本避免）。每项干预措施的平均成本避免为418美元，每个患者日为845美元，每个ICU药师班次为7435美元。一名ICU药师每年避免的成本为1784302美元。药师薪资与潜在货币成本避免的比率在3.3:1至9.6:1之间。
药师参与重症患者护理可显著避免医疗成本，尤其是在患者护理个体化、预防药物不良事件和资源利用方面。雇佣一名ICU临床药师，其潜在货币成本避免与药师薪资的比率在3.3:1至9.6:1之间。
