Ethical, economic, and professional issues in home health care.

Important ethical, economic, and professional issues in home health care (HHC) are identified and discussed. Patient services issues in HHC involve the ethics of providing high-technology feeding therapies to terminally ill patients and the controversies surrounding drug products, such as the appropriate amount of drug to be dispensed, the appropriate individual to compound home-care drug products, acceptable types of product packaging, and the impact of a switch in venders on the drug products supplied to patients. Economic issues include reasonable profit for HHC services, methods used to charge for products and services, payments to physicians for patient referrals, and pharmacies owned and operated by the HHC industry. Pharmacy relations issues center on the influence of nonpharmacists on pharmacy-based HHC services and the effect of HHC services on intraprofessional relations. How pharmacists resolve the many ethical, economic, and professional issues in HHC will determine the quality of services provided to patients, the nature of the working relationships between pharmacists and other health professionals, and the direction that pharmacy HHC services will take in the future.