Pharmaceutical services in U.S. hospitals in 1989

Raehl, Cynthia L.; Bond, C.A.; Pitterle, Michael E.

doi:10.1093/ajhp/49.2.323

Cited by 19 publications

(70 citation statements)

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“…All clinical pharmacy services increased (% of hospitals offering service) between 1989 and 1992. 42,46 Services with the lowest and greatest increases were DUE (5.6% increase) and drug admission histories (50%), respectively. Table 2 shows simple regression analysis for severity of illness, clinical pharmacy services, and mortality rates described as slope, standard error (SE), probability, and CI.…”

Section: Resultsmentioning

confidence: 95%

“…44 Data for 14 clinical pharmacy services were obtained from the 1992 National Clinical Pharmacy Services (NCPS) data base, which is the largest hospital-based pharmacy data base in the United States. 42 The NCPS survey was updated from previous surveys 45,46 and pretested by 25 directors of pharmacy. It was then mailed to the director of pharmacy in each acute care, generalmedical surgical hospital listed in the American Hospital Association's (AHA) Abridged Guide to Health Care.…”

Section: Sources Of Datamentioning

confidence: 99%

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Clinical Pharmacy Services and Hospital Mortality Rates

1999

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We evaluated the associations between clinical pharmacy services and mortality rates in 1029 United States hospitals. A data base was constructed from Medicare mortality rates from the Health Care Financing Administration and the National Clinical Pharmacy Services data base. A multivariate regression analysis, controlling for severity of illness, was employed to determine the associations. Four clinical pharmacy services were associated with lower mortality rates: clinical research (p<0.0001), drug information (p=0.043), drug admission histories (p=0.005), and participation on a cardiopulmonary resuscitation (CPR) team (p=0.039). The actual number of deaths (lower) associated with the presence of these four services were clinical research 21,125 deaths in 108 hospitals, drug information 10,463 deaths in 237 hospitals, drug admission histories 3843 deaths in 30 hospitals, and CPR team participation 5047 deaths in 282 hospitals. This is the first study to indicate that both centrally based and patient-specific clinical pharmacy services are associated with reduced hospital mortality rates. This suggests that these services save a significant number of lives in our nation's hospitals.

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confidence: 95%

Section: Sources Of Datamentioning

confidence: 99%

Clinical Pharmacy Services and Hospital Mortality Rates

1999

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“…64 Pharmacist-managed aminoglycoside or vancomycin therapy has grown from 31.6% of hospitals in 1992 55 to 63.1% in 1998 (a 99.4% increase) 64 and is the most common drug management service provided in U.S. hospitals. 1,55,56,64 These findings are not surprising, since many colleges of pharmacy have incorporated the management of antibiotics, using pharmacokinetic and pharmacodynamic principles, into their core curricula and training programs. This emphasis has been a major focus of pharmaceutical science faculty and pharmacy practice faculty over the past 25 years and appears to have produced major health care dividends.…”

Section: Discussionmentioning

confidence: 99%

“…63 The current study demonstrated the association between major health care outcomes and pharmacistmanaged aminoglycoside or vancomycin therapy in Medicare patients with diagnoses indicating the probable use of these drugs. Pharmacistmanaged drug therapy is the fastest growing clinical pharmacy service in U.S. hospitals, present in 25% of the hospitals studied in 1989 55 and 70% of hospitals in 1998 (a 180% increase). 64 Pharmacist-managed aminoglycoside or vancomycin therapy has grown from 31.6% of hospitals in 1992 55 to 63.1% in 1998 (a 99.4% increase) 64 and is the most common drug management service provided in U.S. hospitals.…”

Section: Discussionmentioning

confidence: 99%

“…53 The National Clinical Pharmacy Services Study survey instrument was updated from previous surveys and pretested by 25 directors of pharmacy. [54][55][56] The questionnaire was mailed to directors of pharmacy at 3701 acute care, general medical-surgical, and acute care pediatric hospitals listed in the American Hospital Association Abridged Guide to the Healthcare Field. 57 Surveys were mailed in the spring of 1995, with one follow-up mailing.…”

Section: Methodsmentioning

confidence: 99%

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Clinical and economic outcomes of pharmacist-managed aminoglycoside or vancomycin therapy

Bond¹,

Raehl

2005

American Journal of Health-System Pharmacy

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Clinical Pharmacy Services, Pharmacist Staffing, and Drug Costs in United States Hospitals

1999

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We evaluated direct relationships and associations among clinical pharmacy services, pharmacist staffing, and drug costs in United States hospitals. A database was constructed from the 1992 American Hospital Association's Abridged Guide to the Health Care Field and the 1992 National Clinical Pharmacy Services database. Multiple regression analysis, controlling for severity of illness, was employed to determine the associations. The study population consisted of 934 hospitals. Four clinical pharmacy services were associated with lower drug costs: in-service education, $77,879.19+/-$56,203.42 (a total of $48,518,735.37 for the 623 hospitals offering this service, p=0.016); drug information, $430,579.84+/-$299,232.76 ($90,852,346.24 for the 211 hospitals offering this service, p=0.015); drug protocol management, $137,333.67+/-$98,617.83 ($45,045,443.76 for the 328 hospitals offering this service, p=0.049); and admission drug histories, $213,388.21+/-$201,537.85 ($5,548,093.46 for the 26 hospitals offering this service, p=0.011). As staffing increased for hospital pharmacy administrators (p<0.0001), dispensing pharmacists (p<0.0001), and pharmacy technicians (p<0.0001), drug costs increased. As staffing increased for clinical pharmacists, drug costs decreased (p=0.018). The results of this study show that increased staff levels of clinical pharmacists and some clinical pharmacy services are associated with reduced hospital drug costs.

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Pharmaceutical services in U.S. hospitals in 1989

Cited by 19 publications

References 0 publications

Clinical Pharmacy Services and Hospital Mortality Rates

Clinical Pharmacy Services and Hospital Mortality Rates

Clinical and economic outcomes of pharmacist-managed aminoglycoside or vancomycin therapy

Clinical Pharmacy Services, Pharmacist Staffing, and Drug Costs in United States Hospitals

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