Method of quality improvement and economic efficiency of pharmacotherapy for community-acquired pneumonia and its utility in Ukraine health-care facilities

Abstract

Aim. Development of a method quality improvement and economic efficiency of pharmacotherapy for community-acquired pneumonia with the possibility of its further use in Ukraine health care facilities. Material and Methods. The object of the study was medical documentation of patients (n=370) diagnosed with community-acquired pneumonia (1st group - patients treated in 2017 on a regular prescription (n=270); 2nd group - patients treated in 2018 according to the "Standardized prescription form" developed by the authors (n=100)). According to the presence of complications or concomitant pathology, patients of both groups were divided into 4 subgroups: subgroup 1 - patients with the main diagnosis - community-acquired pneumonia without complications and concomitant pathology; 2 - patients with community-acquired pneumonia and its complications; 3 - patients with community-acquired pneumonia and concomitant pathology; 4 - patients with community-acquired pneumonia, its complications and concomitant pathology. The following methods were applied: system analysis, analytical and comparative, systematic literature searching, clinical, pharmacological, pharmaceutical, statistical, structural and logical, economic. Results and Discussion. The "Standardized prescription form" was developed and implemented in the therapeutic department of one of inpatient health care establishments of Lviv, which treated 100 patients at the time of the study. Quality assessment of pharmacotherapy revealed a decrease in the number of medication-related problems in patients of group 2 (17 medication-related problems per 100 patients) compared to patients of group 1 (4364 medication-related problems in 270 patients). The results of the study of differences in the average cost of one prescription form of patients of the 1st and 2nd groups revealed a possiblility ofa significant reduction of the average cost of pharmacotherapy per patient (p <0.0001) with the application of our invention: in subgroup 1 - by 1426. 23 UAH [47.81 $] (from 2418.325 UAH [84. 47 $] in 2017 to 992. 10 UAH [36.66 $] in 2018); in subgroup 2 - by 1527.72 UAH [50.94 $] (from 2724.40 UAH [95.16 $] to 1196.68 UAH [44.22 $]); in subgroup 3 - by 1267.87 UAH [42.11 $] (from 2338.31 UAH [81.67 $] to 1070.44 UAH [39.56]) and in subgroup 4 - by 908.39 UAH [28.96 $] (from 2272.755 UAH [79.38 $] in 2017 to 1364.37 UAH [50.42 $] in 2018). Thus, the new form of regular prescription form used by us allowed rationalizing pharmacotherapy of community-acquired pneumonia, saving 128 255. 25 UAH [4245.5 $] on averagefor 100 treated patients. Conclusions. By applying the "Standardized prescription form", we not only managed to reduce the number of medication-related problems resulting from irrational use of medications, but also significantly reduced economic costs of treating patients with community-acquired pneumonia. The total cost savings as a result of the patients' pharmacotherapy rationalization was 128,255.25 UAH ($ 4,245.50) per 100 treated patients.

Keywords

• community-acquired pneumonia, medication-related problems, cost of pharmacotherapy, rational pharmacotherapy