Yang Ruixia, Wang Xin, Wu Huizhen, Sun Qian, Zhang Sijie, Dong Qian, Li Mengjiao, Xu Xiaoli, Bai Jing, Liang Ping, Hou Juan
Department of Pharmacy, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China.
Department of Pharmacy, Hebei General Hospital, Shijiazhuang, China.
Front Pharmacol. 2025 Jan 7;15:1520058. doi: 10.3389/fphar.2024.1520058. eCollection 2024.
Pharmacists are increasingly adopting patient-centered roles, improving healthcare outcomes by reducing medication errors and costs. In China, recent healthcare reforms recognize and compensate for pharmacy services. However, patient awareness of these services and their willingness to pay (WTP) remain underexplored. Therefore, this study aims to examine inpatient understanding of pharmacy services, their WTP in Hebei Province, and the factors affecting it.
Between July and August 2024, a questionnaire was used to survey inpatients from 22 medical institutions across 11 prefecture-level cities in Hebei Province regarding their awareness of WTP for pharmacy services. Further investigation targeted inpatients unwilling to pay. The survey results were analyzed descriptively, with frequencies and percentages (%) used for categorical data and continuous data were presented as mean ± standard deviation (X ± SD). The chi-square test was used to determine statistically significant influences, and logistic regression analysis was performed to identify significant factors affecting inpatient WTP for pharmacy services. A column-line graph was validated using receiver operating characteristic curves and calibration graph analysis.
In total, 464 questionnaires were distributed, with 432 valid responses, yielding a 93.10% effective response rate. Most inpatients (89.58%) viewed hospital pharmacists as primarily responsible for dispensing medication, while only 5.79% were aware of broader pharmacy services. Despite this, 72.69% of the inpatients were willing to receive pharmacy services, and 95.38% of those who had received such services found them beneficial. Half of the inpatients (216, or 50.00%) indicated WTP for pharmacy services. Among those initially unwilling to pay (216 inpatients), 102 indicated they would consider payment if a doctor recommended clinical pharmacist guidance. Of the 318 inpatients who were WTP, 315 (99.06%) chose health insurance reimbursement as a payment method. Key factors influencing inpatient WTP included literacy level, preferred source of medication counseling, prior pharmacy service experience, understanding of pharmacy service policies, and readiness to recommend these services ( < 0.05).
Most inpatients lacked knowledge and trust in clinical pharmacists, with limited awareness of the value of pharmacy services. However, they demonstrated high acceptance and WTP for these services, with nearly all inpatients preferring health insurance reimbursement. Integrating pharmacy service fees into health insurance is crucial for promoting these services.
药剂师越来越多地承担以患者为中心的角色，通过减少用药错误和成本来改善医疗保健结果。在中国，近期的医疗改革认可并补偿药学服务。然而，患者对这些服务的认知及其支付意愿（WTP）仍未得到充分探索。因此，本研究旨在调查河北省住院患者对药学服务的理解、他们的支付意愿以及影响支付意愿的因素。
在2024年7月至8月期间，采用问卷调查了河北省11个地级市22家医疗机构的住院患者对药学服务支付意愿的认知情况。对不愿意支付的住院患者进行了进一步调查。对调查结果进行描述性分析，分类数据采用频数和百分比（%）表示，连续数据以均数±标准差（X±SD）呈现。采用卡方检验确定具有统计学意义的影响因素，并进行逻辑回归分析以识别影响住院患者对药学服务支付意愿的显著因素。使用受试者工作特征曲线和校准图分析对柱状图进行验证。
共发放问卷464份，有效问卷432份，有效回收率为93.10%。大多数住院患者（89.58%）认为医院药剂师主要负责配药，而只有5.79%的患者了解更广泛的药学服务。尽管如此，72.69%的住院患者愿意接受药学服务，95.38%接受过此类服务的患者认为这些服务有益。一半的住院患者（216名，即50.00%）表示愿意为药学服务付费。在最初不愿意支付的患者（216名住院患者）中，102名表示如果医生推荐临床药师指导，他们会考虑支付费用。在愿意支付的318名住院患者中，315名（99.06%）选择医疗保险报销作为支付方式。影响住院患者支付意愿的关键因素包括文化程度、首选的用药咨询来源、既往药学服务经历、对药学服务政策的理解以及推荐这些服务的意愿（<0.05）。
大多数住院患者对临床药师缺乏了解和信任，对药学服务价值的认知有限。然而，他们对这些服务表现出高度的接受度和支付意愿，几乎所有住院患者都倾向于医疗保险报销。将药学服务费用纳入医疗保险对于推广这些服务至关重要。
