Costs of pharmaceutical interventions in the intensive care unit of a public urgency and emergency hospital

Abstract

Objective: Describe the costs of pharmaceutical interventions in the ICU of a public urgent and emergency hospital and evaluate the impact on the length of hospital stay of diseases that required additional medication after pharmaceutical intervention. Method: Pharmacotherapeutic follow-up data were collected from May to July 2022 and the prices of medications, diluents and materials were used to calculate three types of costs: maximum intervention, accepted intervention and rejected intervention costs. For the evaluation of the impact on the length of hospital stay of diseases that required additional medication, a panel of specialists was carried out. Results: A total of 163 patients were monitored, and 5,770 medications were evaluated. The most frequent pharmaceutical intervention was the suggestion of changing pharmacotherapy (93.37%). The estimated saving of resources was US$ 2,092.91, a mean of US$ 1.83/patient-day. The maximum intervention and rejected intervention costs were US$ 2,462.56 and US$ 3.85, respectively. Infectious conditions required more interventions, resulting in more than 85% of total savings. Items A on the ABC curve corresponded to 77.00% of interventions, with savings of US$ 2,408.47. The expert panel agreed that the absence of medication for stress ulcer prophylaxis, combination therapy for ventilator-associated pneumonia, and septic shock could increase the patient’s ICU stay at five, seven, and seven days, respectively. Conclusion: The clinical pharmacist, in the care of critical patients, provided savings in the use of medications. Infectious conditions and medications A of ABC curve are strategic points for professional action. Improving communication and building clinical protocols are important for greater clinical and financial return.