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45th ESCP-NSF international symposium on clinical pharmacy: clinical pharmacy tackling inequalities and access to health care. Oslo, Norway, 5-7 October 2016.

https://arctichealth.org/en/permalink/ahliterature283198
Source
Int J Clin Pharm. 2017 Feb;39(1):208-341
Publication Type
Conference/Meeting Material
Date
Feb-2017

The 1982 Hoechst Lecture: "Cost effectiveness--the emerging 'bottom line' for pharmacy?!".

https://arctichealth.org/en/permalink/ahliterature243460
Source
Can J Hosp Pharm. 1982 Mar-Apr;35(2):39-41
Publication Type
Article
Author
J A Marshman
Source
Can J Hosp Pharm. 1982 Mar-Apr;35(2):39-41
Language
English
Publication Type
Article
Keywords
Aged
Canada
Cost-Benefit Analysis
Efficiency
Humans
Ontario
Patient Education as Topic - economics
Pharmacy Service, Hospital - economics
Abstract
In the current climate of budgetary restraint in the health care system, cost effectiveness is a concept which surfaces with increasing frequency, especially in reference to health care services funded by government. Since significant elements of pharmacy services in Canada are thus funded (including in most provinces, hospital pharmacy services, and prescription drug plans for senior citizens), it is important that pharmacy "tune into" the concept, and recognize it as an essential criterion to be met in the maintenance of existing services and in the development of new services. Prerequisite to a consideration of cost effectiveness is, of course, consideration of effectiveness; and a statement about the effectiveness; and a statement about the effectiveness of a service implies a potential for measurement of effect or outcome. In the 1980s, as pharmacy focuses its efforts on patients rather than products, that effect must surely be defined in "people" terms. One of the important dimensions of today's patient-focussed pharmacy services is patient counselling, more broadly, patient education.
PubMed ID
10309676 View in PubMed
Less detail

An analysis of pharmacist interventions.

https://arctichealth.org/en/permalink/ahliterature225576
Source
Can J Hosp Pharm. 1991 Oct;44(5):245-8, 270
Publication Type
Article
Date
Oct-1991
Author
A. Torchinsky
D. Landry
Author Affiliation
Sir Mortimer B. Davis Jewish General Hospital, Montréal, Québec.
Source
Can J Hosp Pharm. 1991 Oct;44(5):245-8, 270
Date
Oct-1991
Language
English
Publication Type
Article
Keywords
Communication
Cost Savings - methods
Drug Therapy - standards
Hospital Bed Capacity, 500 and over
Hospitals, Teaching - organization & administration
Humans
Patient care team
Pharmacists
Pharmacy Service, Hospital - economics
Quebec
Abstract
In a 620-bed acute care teaching hospital, the hospital pharmacists are therapeutic specialists and have become integrated members of the health care team working on the nursing units. To determine the extent of cost avoidance and savings achieved by pharmacist monitoring of drug prescribing and administration, a six month study was undertaken in one of five pharmacy satellites. The pharmacists documented each clinical intervention on form designed for this investigation. Cost reductions or cost avoidance accrued due to the pharmacists' clinical interventions, such as monitoring overuse of drugs, unnecessarily prolonged hospitalization, correction of medication errors, and reassessment of prescriptions. This study suggests that pharmacists clinical expertise in drug use can benefit patients, physicians, nurses, and the hospital administrators who are confronted with ever increasing costs.
PubMed ID
10115578 View in PubMed
Less detail
Source
Can J Hosp Pharm. 1990 Oct;43(5):221-5, xxxii
Publication Type
Article
Date
Oct-1990
Author
J M Lazor-Bajcar
Author Affiliation
St. Michael's Hospital, Toronto, Ontario M5B 1W8.
Source
Can J Hosp Pharm. 1990 Oct;43(5):221-5, xxxii
Date
Oct-1990
Language
English
Publication Type
Article
Keywords
Cefoxitin - administration & dosage
Cost Control - methods
Data Collection
Drug Utilization - statistics & numerical data
Evaluation Studies as Topic
Female
Hospital Bed Capacity, 500 and over
Hospital Departments - statistics & numerical data
Humans
Male
Ontario
Pharmacy Service, Hospital - economics
Retrospective Studies
Abstract
Due to an increase in cefoxitin use at The Mississauga Hospital, a Drug Utilization Review (DUR) was conducted as part of the DUR program. The study was designed to determine the cefoxitin prescribing pattern, assess the appropriateness of use, calculate the cost associated with inappropriate use, and estimate future potential cost savings. Two evaluators (pharmacist and infectious disease specialist), reviewed cefoxitin use retrospectively during a four-month period for 82 patients who received a total of 100 courses of therapy. The appropriateness of cefoxitin use was assessed according to the predefined criteria that were developed and accepted by the hospital pharmacy, infectious disease and medical staff. Cefoxitin was prescribed more frequently by the department of surgery (45%) of the courses studied, while the medical and obstetric and gynecology services were responsible for the remainder of courses (24% and 31% respectively). Overall, 42% of the courses were deemed inappropriate and 11% were questionable, based on the choice of agent (62%) and the duration of treatment and prophylaxis (33%). The observed inappropriate use represented 22% of the amount spent on the total cefoxitin treatment of the 82 study patients. If cefoxitin had been prescribed appropriately, an estimated $11,873 could potentially have been saved annually by the hospital. Based on these results, recommendations for improving the quality and quantity of cefoxitin use were developed. Follow-up concurrent DUR's with pharmacist interventions were initiated and found to be cost-effective.
PubMed ID
10107924 View in PubMed
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Children in need of Pharmacare: medication funding requests at the Toronto Hospital for Sick Children.

https://arctichealth.org/en/permalink/ahliterature186005
Source
Can J Public Health. 2003 Mar-Apr;94(2):121-6
Publication Type
Article
Author
Wendy J Ungar
Carolyn Daniels
Ted McNeill
Mahdie Seyed
Author Affiliation
Division of Population Health Sciences, Hospital for Sick Children, Toronto, ON. wendy.ungar@sickkids.ca
Source
Can J Public Health. 2003 Mar-Apr;94(2):121-6
Language
English
Publication Type
Article
Keywords
Child
Financing, Organized
Health Services Accessibility - economics
Health services needs and demand
Health Services Research
Hospitals, Pediatric - economics
Humans
Insurance, Pharmaceutical Services - economics
Medical Assistance
Medically Uninsured
National Health Programs
Ontario
Pharmacy Service, Hospital - economics - utilization
Program Evaluation
Public Sector
Retrospective Studies
Social Class
Abstract
Although a national Pharmacare program ensuring access to and affordability of needed medications has repeatedly been cited as a priority to policymakers, 20% of families remain either uninsured or under-insured. The Hospital for Sick Children's Patient Amenities Fund (PAF) covers out-of-pocket medication expenses for inpatient and outpatient children. The research objectives were to 1) examine family demographics and socio-economic status (SES), the types of medications requested and government program process issues of PAF applicants in 1998 and 1999, and 2) describe trends in PAF requests from 1998 to 2000.
Data were extracted retrospectively from fund requests, charts and social work and discharge planning reports. Descriptive statistics were used to summarize the data and to examine time trends.
Eighty-six applicants submitted 112 requests from 1998-1999. Most were for children with cancer, neurological disorders and transplant patients. Medication expenditures were 22,408 dollars in 1999, a 39% increase over 1998. Most requests came from two-parent nuclear families where one or both parents were employed. High deductibles, waiting time, application form complexity and request denials were cited as problems encountered with government drug plans.
The findings suggest that for provinces that do not provide universal drug insurance programs, relying on a patchwork of government plans and community agencies may not be effective in ensuring easy and timely access to necessary medications for children.
PubMed ID
12675168 View in PubMed
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Ciprofloxacin use under a reserved drug and stepdown promotion program.

https://arctichealth.org/en/permalink/ahliterature215833
Source
Can J Hosp Pharm. 1995 Feb;48(1):35-42
Publication Type
Article
Date
Feb-1995
Author
L. Frighetto
S M Martinusen
F. Mamdani
P J Jewesson
Author Affiliation
Vancouver Hospital and Health Sciences Centre, BC.
Source
Can J Hosp Pharm. 1995 Feb;48(1):35-42
Date
Feb-1995
Language
English
Publication Type
Article
Keywords
Adult
British Columbia
Ciprofloxacin - economics - therapeutic use
Data Collection
Drug Costs
Drug Utilization Review - statistics & numerical data
Hospital Bed Capacity, 500 and over
Hospitals, Teaching
Humans
Male
Parenteral Nutrition
Pharmacy Service, Hospital - economics
Research Design
Retrospective Studies
Treatment Outcome
Abstract
This study retrospectively evaluated the use of parenteral ciprofloxacin (PC) under the influence of a reserved antimicrobial drug program and an intravenous-oral stepdown program. During the first three months following its formulary introduction, 92 PC treatment courses were initiated. Fifty of these treatment courses in 49 adults were randomly selected for study. The hematology service accounted for 50% of the courses reviewed. The balance were initiated in the intensive care unit (16%), and six other services (34%). PC was used for the treatment of febrile neutropenia (50%), respiratory tract infections (20%), gram-negative sepsis (10%), and five other indications. Initial use of the intravenous formulation was considered appropriate in 92% of courses. Stepdown therapy occurred in 17 (34%) of treatment courses. Of the 26 patients considered candidates for oral therapy, seven patients (27%) were eligible for earlier stepdown and nine patients (35%) did not receive oral drug. According to our criteria, unnecessary use of the intravenous route occurred in 20% of PC treatment days. Mean total cost (acquisition plus delivery) of therapy per course was $668. This cost was higher in the hematology service (mean $990) than any other service (p = 0.0015). When stepdown therapy was employed the mean daily cost of therapy was $43.63 vs. $55.61 when the oral dosage form was not used (p = 0.04). Parenteral drug costs totalling $6245 were avoided by subsequent use of the oral dosage form. If full compliance with stepdown criteria had occurred, an estimated total savings of $10,769 could have been realized.
PubMed ID
10141061 View in PubMed
Less detail
Source
Am J Health Syst Pharm. 1995 Apr 1;52(7):757-8
Publication Type
Article
Date
Apr-1-1995
Author
K. Maclean
Source
Am J Health Syst Pharm. 1995 Apr 1;52(7):757-8
Date
Apr-1-1995
Language
English
Publication Type
Article
Keywords
Canada
Cost Allocation - methods
Drug Costs
Drug Prescriptions - economics
Humans
Pharmacy Service, Hospital - economics
Notes
Comment On: Am J Hosp Pharm. 1994 May 15;51(10):1331-48085571
PubMed ID
7627745 View in PubMed
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The clinical pharmacology departments should develop their services according to the local health care needs.

https://arctichealth.org/en/permalink/ahliterature179462
Source
Eur J Clin Pharmacol. 2004 Jul;60(5):381-2
Publication Type
Article
Date
Jul-2004
Source
J Can Diet Assoc. 1988;49(2):121-3
Publication Type
Article
Date
1988
Author
S. Stansfield
Source
J Can Diet Assoc. 1988;49(2):121-3
Date
1988
Language
English
Publication Type
Article
Keywords
Canada
Cost Control
Efficiency
Humans
Parenteral Nutrition, Total - economics
Pharmacy Service, Hospital - economics
Planning Techniques
Abstract
There are many costs associated with parenteral nutrition: physician time, nursing time, biochemical monitoring, patient education, ancillary equipment and the nutrition solutions themselves. The solutions are easily identified as responsible for a large proportion of these costs. There are several strategies that can be used to help control pharmacy costs, such as selection of ingredients, purchasing contracts, standardized formulae and prescribing procedures, preprinted doctor's order forms, automated manufacturing and labelling processes, patient monitoring, all-in-one preparation, and contracted manufacturing services. Individual pharmacies need to know what options are available in order to select those that, in the context of their own institutions, can lead to cost savings and improved efficiency.
PubMed ID
10312527 View in PubMed
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Cost analysis of the Kozak protocol as used in an Ontario hospital in the treatment of children with epidermolysis bullosa.

https://arctichealth.org/en/permalink/ahliterature240709
Source
Can Med Assoc J. 1984 Mar 15;130(6):715-7
Publication Type
Article
Date
Mar-15-1984
Author
H B Wodinsky
Source
Can Med Assoc J. 1984 Mar 15;130(6):715-7
Date
Mar-15-1984
Language
English
Publication Type
Article
Keywords
Adolescent
Child
Child, Preschool
Costs and Cost Analysis
Direct Service Costs
Epidermolysis Bullosa - economics - therapy
Female
Food Service, Hospital - economics
Germany, West
Humans
Infant
Male
Nursing Staff, Hospital - economics
Ontario
Pharmacy Service, Hospital - economics
Abstract
Conventional treatment of epidermolysis bullosa is often unsuccessful. The Kozak protocol is an alternative that has been given considerable public support in Ontario. The incremental cost of this treatment program at the Hospital for Sick Children, Toronto, was examined. The departments of nursing, pharmacy and food services each kept records of salaries and supply costs applicable to the care of nine patients with epidermolysis bullosa who were treated in the fiscal year 1982-83. The selected direct costs to the hospital were compared with the projected costs if these patients had been treated in Dr. Kozak's clinic in West Germany or under the financial arrangements offered to Dr. Kozak by the Ontario minister of health. At a total incremental cost of +255.92 per patient-day, care at the Hospital for Sick Children may not currently be the least expensive means of offering the Kozak protocol to Ontario children. However, the major expense of the program, the nurses' salaries, could be reduced if the patients' parents were to assume many of the nursing tasks; this would make the hospital's program the most cost-effective method of treating children with epidermolysis bullosa.
Notes
Cites: Mod Probl Paediatr. 1975;17:77-841186692
PubMed ID
6697279 View in PubMed
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44 records – page 1 of 5.