South University School of Pharmacy, Savannah, GA, USA.
Novonordisk (previously South University School of Pharmacy at time of research), Plainsboro, NJ, USA.
J Prim Care Community Health. 2023 Jan-Dec;14:21501319231174768. doi: 10.1177/21501319231174768.
The financial and clinical impact of transitional care management (TCM) outcomes through pharmacist integration within primary care is not well described.
The primary objective of this study was to determine the financial impact of pharmacist conducted post-discharge phone calls. The secondary objectives included readmission rates and number of interventions.
A computer-generated list identified patients discharged from St. Joseph's/Candler Health System (SJ/C) with a listed primary care provider within the SJ/C Primary Care Medical Group at Eisenhower from November 1, 2019 to April 30, 2020. Eligible patients who received a post-discharge phone call from a pharmacist were compared to those who received a call by another staff member. Data was collected regarding the financial impact of pharmacist conducted post-discharge phone calls. Readmission rates and medication related interventions were also assessed.
There were 104 patients discharged meeting criteria. Twenty-four patients were contacted by a pharmacist resulting in 20 subsequent hospital follow up appointments scheduled with the provider. Total amount billed for those appointments was $4220 (average of $211 per visit). Twenty-five calls were made by non-pharmacist staff with 23 appointments scheduled. Total amount billed for those appointments was $2445 (average of $106 per visit). Increased reimbursement was generated by a qualifying 2-way communication by the pharmacist as outlined by Center for Medicaid and Medicare Services enabling providers to bill for a TCM visit versus standard office visit. Pharmacists made 33 clinical interventions including medication reconciliation, medication procurement, referrals, lab orders, and education. One intervention was made by non-pharmacist staff. The 30-day readmission rate for pharmacist contacted patients was 8% versus 12% for non-pharmacist contacted patients.
Pharmacist involvement in TCM while integrated into a primary care office is previously not well described. This data highlights an opportunity for pharmacists to demonstrate sustainability and improved outcomes related to TCM.
通过药师整合到初级保健中实现过渡性护理管理（TCM）的结果，在财务和临床方面的影响尚未得到充分描述。
本研究的主要目的是确定药师进行出院后电话随访的财务影响。次要目标包括再入院率和干预次数。
计算机生成的清单确定了 2019 年 11 月 1 日至 2020 年 4 月 30 日期间从圣约瑟夫/坎德勒卫生系统（SJ/C）出院且 SJ/C 初级保健医疗集团内有初级保健提供者名单的患者。将接受药师进行的出院后电话随访的合格患者与接受其他工作人员电话随访的患者进行比较。收集有关药师进行的出院后电话随访的财务影响的数据。还评估了再入院率和与药物相关的干预措施。
符合标准的出院患者共 104 例。有 24 名患者与药师联系，随后安排了 20 次后续与提供者的医院随访预约。这些预约的总计费金额为 4220 美元（平均每次就诊 211 美元）。有 25 个电话由非药师工作人员打出，安排了 23 次预约。这些预约的总计费金额为 2445 美元（平均每次就诊 106 美元）。药师通过符合医疗保险和医疗补助服务中心规定的双向沟通产生了额外的报销，从而使提供者能够对 TCM 就诊而不是标准的门诊就诊进行计费。药师进行了 33 项临床干预，包括药物重整、药物采购、转介、实验室订单和教育。非药师工作人员进行了一次干预。药师联系的患者 30 天再入院率为 8%，而非药师联系的患者为 12%。
药师参与整合到初级保健办公室的 TCM 此前尚未得到充分描述。这些数据突出了药师在 TCM 方面展示可持续性和改善结果的机会。
