Pharmacist Avoidance or Reductions in Medical Costs in Critically and Emergently Ill Pediatrics: PHARM-PEDS Study.

Autor:	Kiskaddon AL; Department of Pharmacy, Johns Hopkins All Children's Hospital, St. Petersburg, FL.; Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD., Smith MM; Division of Critical Care Medicine, Johns Hopkins All Children's Hospital, St. Petersburg, FL., Gilliland F; Division of Critical Care Medicine, Johns Hopkins All Children's Hospital, St. Petersburg, FL., Rech MA; Department of Veterans Affairs, Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr. VA Hospital, Hines, IL.; Department of Emergency Medicine, Loyola University Medical Center, Maywood, IL.
Jazyk:	angličtina
Zdroj:	Critical care explorations [Crit Care Explor] 2023 Oct 05; Vol. 5 (10), pp. e0980. Date of Electronic Publication: 2023 Oct 05 (Print Publication: 2023).
DOI:	10.1097/CCE.0000000000000980
Abstrakt:	Objectives: To comprehensively classify interventions performed by pediatric critical care clinical pharmacists and quantify cost avoidance (CA) generated through their accepted interventions. Design: A multicenter, prospective, observational study performed between August 2018 and January 2019. Setting: Academic and community hospitals in the United States with pediatric critical care units. Subjects: Pediatric clinical pharmacists. Interventions: Pharmacist recommendations were classified into one of 38 total intervention categories associated with CA. Measurements and Main Results: Nineteen pediatric pharmacists at five centers documented 1,458 accepted interventions during 112 shifts on 861 critically ill pediatric patients. This calculated to an associated CA of $450,590. The accepted interventions and associated CA in the six established categories included as follows: adverse drug event prevention (155 interventions, $118,901 CA), resource utilization (267 interventions; $59,020), individualization of patient care (898 interventions, $217,949 CA), prophylaxis (8 interventions, $453 CA), hands-on care (30 interventions, $35,509 CA), and administrative/supportive tasks (108 interventions, $18,758 CA). The average associated CA was $309 per accepted intervention, $523 per patient day, and $4,023.13 per pediatric clinical pharmacist shift. The calculated potential annualized CA of accepted interventions from a pediatric pharmacist was $965,550, resulting in a potential monetary-associated CA-to-pharmacist salary ratio between $1.5:1 and $5.2:1. Conclusions: There is potential for significant avoidance of healthcare costs when pediatric pharmacists are involved in the care of critically and emergently ill pediatric patients, with a monetary potential CA-to-pediatric pharmacist salary ratio to be between $1.5:1 and $5.2:1. Competing Interests: Dr. Rech’s institution received funding from Spero Pharmaceutics (investigator-initiated research). The remaining authors have disclosed that they do not have any potential conflicts of interest. (Copyright © 2023 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine.)
Databáze:	MEDLINE
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