Bond C A, Raehl C L, Pitterle M E
School of Pharmacy, University of Wisconsin (UW), Madison, USA.
Am J Health Syst Pharm. 1995 Mar 15;52(6):603-13. doi: 10.1093/ajhp/52.6.603.
The results of a 1992 national survey of hospital-based pharmaceutical services are reported and compared with data collected during a similar survey in 1989. A questionnaire was mailed to pharmacy directors at all 3756 medical-surgical hospitals in the United States that had 50 or more licensed beds. Cost results were evaluated both as unadjusted data and as data adjusted for severity of illness with the case mix index. The response rate was 43% (1597 usable responses). Mean +/- S.D. unadjusted medication costs per occupied bed were $9850 +/- 4744 (a 46% increase over 1989 costs); significant differences were observed for geographic region, hospital ownership, drug delivery system, and pharmacy director's education. Mean +/- S.D. unadjusted total pharmacy costs per occupied bed were $16,550 +/- 6,249 (a 40% increase over 1989 costs); significant differences were observed for geographic region, hospital ownership, drug delivery system, and pharmacy director's education. Other mean +/- S.D. unadjusted pharmacy cost components were as follows: injectable solution costs, $2627 +/- 2191 (a 38% increase over 1989 costs); inventory costs, $2029 +/- 2593 (70% increase); pharmacist salary costs per occupied bed, $2997 +/- 1267 (33% increase); pharmacy technician costs per occupied bed, $995 +/- 876 (24% increase); pharmacist salary costs per full-time equivalent (FTE), $43,791 +/- 12,206 (14% increase); pharmacy technician salary costs per FTE, $18,953 +/- 6,154 (15% increase); and pharmacy staff development costs per occupied bed, $45 +/- 41 (29% increase). Pharmacist salary costs associated with centrally based clinical pharmacy services ranged from a high of $361 per occupied bed per year for drug-use evaluation to a low of $15 per occupied bed per year for inservice education. Pharmacist salary costs for patient-specific pharmaceutical services ranged from $3 per patient for medical rounds to $8 per patient for cardiopulmonary resuscitation team participation and drug protocol management. A 1992 survey provided comprehensive data on the cost structure of hospital-based pharmaceutical services and a basis for comparison with 1989 cost data.
本文报告了1992年全国医院药学服务调查的结果,并与1989年类似调查收集的数据进行了比较。向美国所有3756家拥有50张或更多许可床位的内科-外科医院的药房主任邮寄了一份调查问卷。成本结果既作为未调整数据进行评估,也作为根据病例组合指数对疾病严重程度进行调整的数据进行评估。回复率为43%(1597份有效回复)。每张占用床位的平均未调整药物成本为9850美元±4744美元(比1989年成本增加46%);在地理区域、医院所有权、药品配送系统和药房主任的教育程度方面观察到显著差异。每张占用床位的平均未调整药房总成本为16550美元±6249美元(比1989年成本增加40%);在地理区域、医院所有权、药品配送系统和药房主任的教育程度方面观察到显著差异。其他平均±标准差的未调整药房成本组成部分如下:注射剂溶液成本,2627美元±2191美元(比1989年成本增加38%);库存成本,2029美元±2593美元(增加70%);每张占用床位的药剂师工资成本,2997美元±1267美元(增加33%);每张占用床位的药房技术员成本,995美元±876美元(增加24%);每个全时当量(FTE)的药剂师工资成本,43791美元±12206美元(增加14%);每个FTE的药房技术员工资成本,18953美元±6154美元(增加15%);以及每张占用床位的药房人员发展成本,45美元±41美元(增加29%)。与集中式临床药学服务相关的药剂师工资成本范围从药物使用评估的每张占用床位每年361美元的高位到在职教育的每张占用床位每年15美元的低位。针对特定患者的药学服务的药剂师工资成本范围从医疗查房的每位患者3美元到参与心肺复苏团队和药物方案管理的每位患者8美元。1992年的调查提供了关于医院药学服务成本结构的全面数据,并为与1989年成本数据进行比较提供了基础。