Levy Jason N, Wollen Joshua, Nguyen Phuoc Anne, Brimmer Catina, Dwivedi Rohan, Tolleson Shane
Harris Health, 4800 Fournace Place, Bellaire, TX 77401, United States.
University of Houston College of Pharmacy, Health 2, 4349 Martin Luther King Blvd, Houston, TX 77204, United States.
Explor Res Clin Soc Pharm. 2025 Jan 4;17:100560. doi: 10.1016/j.rcsop.2025.100560. eCollection 2025 Mar.
The hospital at home (HaH) model has become more prevalent in the American healthcare system due to its ability to decrease acute care costs and readmission risk. Recent publications have provided guidance on optimizing medication management and patient safety by leveraging clinical pharmacy services. There is limited data on pharmacoeconomic impact of HaH implementation, specifically in underinsured patients.
To describe the development of HaH-related pharmacy workflows and evaluate the operational success of the program in an underinsured patient population.
This report describes HaH program implementation between August 1st, 2022, and March 19th, 2024. Patients were eligible for home treatment if they met geographic, clinical, financial, and social criteria.
The primary outcome measured was the quantity and cost of medication waste for patients treated at home. Secondary outcomes included HaH medication turnaround time, healthcare resource utilization, and patient safety. All study outcomes were reported using descriptive statistics.
Out of 450 patients screened, 3 met criteria and provided consent for HaH enrollment. The total cost of medication waste for all 3 patients was $41.15, and 21 out of 53 dispensed doses (40 %) were wasted. The mean medication verification time was 8.1 min, and the mean medication preparation time was 50.2 min.
Study data provides insight into enhancing dispensing practices while establishing the benefits pharmacists bring to the HaH care team. Future research should elaborate on other measures of operational success to identify optimal performance metrics to support expanding pharmaceutical services within the HaH care model.
由于能够降低急性护理成本和再入院风险，居家医院（HaH）模式在美国医疗保健系统中变得越来越普遍。最近的出版物通过利用临床药学服务，为优化药物管理和患者安全提供了指导。关于实施HaH的药物经济学影响的数据有限，特别是在未充分投保的患者中。
描述与HaH相关的药房工作流程的发展，并评估该项目在未充分投保患者群体中的运营成功情况。
本报告描述了2022年8月1日至2024年3月19日期间HaH项目的实施情况。如果患者符合地理、临床、财务和社会标准，则有资格接受家庭治疗。
测量的主要结果是在家接受治疗的患者的药物浪费数量和成本。次要结果包括HaH药物周转时间、医疗资源利用和患者安全。所有研究结果均使用描述性统计报告。
在450名筛查的患者中，有3名符合标准并同意加入HaH。所有3名患者的药物浪费总成本为41.15美元（约合人民币207元），53剂配药中有21剂（40%）被浪费。平均药物核查时间为8.1分钟，平均药物准备时间为50.2分钟。
研究数据为改进配药实践提供了见解，同时确立了药剂师给HaH护理团队带来的益处。未来的研究应详细阐述运营成功的其他衡量标准，以确定最佳绩效指标，以支持在HaH护理模式内扩大药学服务。
