透過您的圖書館登入
IP:3.230.162.238
  • 期刊

藥師判斷性服務實行成效

Outcomes of Cognitive Services by Pharmacists in a Teaching Hospital

摘要


目的:判斷性服務是藥師接受處方箋後,發現藥物治療問題,針對問題進行介入,解決問題並記錄過程之行為。判斷性服務的編碼系統(AABBCC codes),就是將整個流程以六個位數代碼記錄之,藉由此編碼系統,不但能簡化記錄過程,還為未來申請健保給付藥師服務做準備。本研究目的在看判斷性服務是否能減少藥品的花費。方法:回溯收集95年度市立醫院藥師判斷性服務案例,分析實行成效。結果:共收集1918件案例。其中7大類藥品治療問題:(1)需增加藥物治療,佔0.6%,平均每案例可節省藥費39.0元;(2)不需增加藥物治療,佔36.0%,平均每案例可節省藥費251.4元;(3)藥物選擇不適當,佔12.3%,平均每案例可節省藥費158.8元;(4)藥物劑量不足,佔10.8%,平均每案例需補藥費53.2元;(5)藥物劑量過高,佔24.4%,平均每案例可節省藥費596.7元;(6)藥物不良反應,佔2.9%,平均每案例可節省藥費95.6元;(7)其他,佔12.7%,平均每案例可節省藥費2572.2元。其中67.8%案件介入後會使藥費降低,14.4%案件介入後會使藥費增加。平均每進行一次判斷性服務約可節省藥費581.72元,整年度可節省健保藥費約111萬元。結論:判斷性服務的編碼系統能呈現及分析藥事服務的內容及價值,以期讓更多人可以看見本項服務的重要性。藥師專業服務的價值在本研究中已證實,這服務不但保護病患的用藥安全,還能降低醫療資源使用,並減少健保給付之金額。此項服務有價值、值得推廣,並應獲得健保給付。

並列摘要


Objectives: Cognitive service is a behavior that pharmacists identify, resolve, and record the drugs therapy problems before or after dispensing a prescription. Cognitive coding system (AABBCC codes) records the entire process by a six-digit code. Using this coding system, not only simplify the service record process but also pave the way for future application of service reimbursement. The purpose of this study is to confirm that pharmacist providing cognitive service can save drug costs. Methods: Retrospective analyzes the cases of pharmacists' cognitive service collected in 10 campus of Taipei City Hospital in 2006 to evaluate the outcomes of the service. Results: A total of 1,918 cases reported. Among them, outcomes of seven major drug therapy problems are: (1) Need to add drug treatment, happened 0.6%, and saved drug cost of NT$ 39.0/ case. (2) Need to delete drug therapy, occupy 36.0% of the cases, and saved NT$251.4/case in average. (3) Inappropriate selection of drug, 12.3%, saved NT$158.8/case. (4) Dosage too low, 10.8% of the cases, and increased drug cost of NT$53.2/case. (5) Dosage too high, 24.4%, saved NT$596.7/case drug cost. (6) Prevent adverse drug reactions, 2.9% of the cases, saved NT$95.6/case. (7) Others, 12.7%, and saved drug cost NT$2572.2/case. Overall, drug cost decreased in 67.8% of the cases, but increased in 14.4% of the cases. The cognitive service can save NT$581.72/case in average, and the annual savings on the drug expenditure are about 1.11 million. Conclusions: The cognitive service coding systems is valuable in presenting the content and value of the services, and allows more people to see the importance of this service. The value of professional service conducted by pharmacists is confirmed by this study, it not only protect the safety of patient care, but also decrease the medical resources utilization and save the expenditure of the health insurance reimbursement.

延伸閱讀