台湾药事居家照护之执行与成效

目的:探讨药师依法执行药事照护的成效。方法:选定台北地区及高屏地区的1100位高就诊民众,由培训及格的药师执行药事居家照护。1年之后对成功访视的808例就诊资料作统计。结果:2009年2-12月与2010年2-12月的数据比较显示,在门诊就医总次数上平均每例下降27次,降低29%;在门诊医疗总花费上平均每例下降新台币15669元(共节约新台币1266万,n=808),降低20%;而在门诊药品费用上平均每例下降新台币5777元(共节约新台币468万元,n=808),降低19%。药事照护费用为385万元(成本),在门诊医疗费用上节省1266万元(效益),门诊的成本利益比为1∶3.3。结论:药师执行药事照护可改善高就诊民众的就医行为,且符合成本-效益。

Implementation and Outcomes of Home Pharmaceutical Care Practice in Taiwan

Objectlve：To explore the outcomes of the pharmacist practice of pharmaceutical care by law. Methods： 1 100 individuals from Taipei and Kaopeen districts were selected for home care by the qualified pharmacists, of which 808 individuals were visited one year later and their medical information was analyzed. Results： The study presented that com- pared that of 2009, Feb.-Dec., the number of outpatient visit reduced in average 27 visits/case （around 29%） and the out- patient medical care expenditure reduced NT$15 669 case in average （around 20%） in 2010, Feb.-Dec.. The total saving on OPD medical care expenditure was around NT$12.66 million （n = 808）. For the cost of drug usage in outpatient ser- vices, it reduced NT$5 777 case in average （around 19%） and the total saving was NT$ 4.68 million. In addition, phar- macists got NT$3.85 million reimbursement from BNHI （cost）, reduced the total OPD medical care expenditure of NT $12.66 million （benefit）, making the cost-benefit ratio of the study reached 1：3.3. Conclusion： Pharmacist providing the home pharmaceutical care practice can improve the medical care seeking behavior and obtain the cost effectiveness.