A survey of current operations and future plans for ambulatory pharmacy services.

Survey results indicate that the number of hospital-based ambulatory pharmacies in the survey area is increasing substantially. By the end of 1989, there would have been a 71 percent increase in the number of hospitals providing ambulatory pharmacy services in this region. This assumes that those hospitals in the planning stages of developing ambulatory pharmacy services completed their plans. While the number of hospital-based ambulatory pharmacies is on the rise, there has been a concurrent increase in the number of services provided by the pharmacies already in operation. There has been a 38 percent increase in the number of services provided by these pharmacies since the inception of DRGs. The services that have been added are primarily specialized services including home TPN compounding, intravenous antibiotic compounding, intravenous chemotherapy compounding, medical supplies, and durable medical equipment. It is likely that these services will continue to increase in the coming years as home therapies continue to become more advanced. The study also indicates that most hospital-based ambulatory pharmacies in this region are operated as nonprofit entities. A trend toward for-profit pharmacy operations was anticipated, and this is still anticipated as more ambulatory pharmacy operations become separate entities from inpatient services. Future studies of this type should monitor this possible trend. Most hospital-based ambulatory pharmacies are owned by the hospital or a hospital affiliate. More than half of respondents reported their ambulatory pharmacies are located within the inpatient pharmacy of the hospital. As the trend toward separate ambulatory pharmacy operations increases, it would not be unusual for the pharmacies to be operated by for-profit affiliates of the hospital or outside contractors. Barker predicts that hospital-based ambulatory pharmacies could become units of major drug store chains in the future. This is another area that is worthy of future studies of hospital-based ambulatory pharmacy operations. Overall, the results of this study indicate that hospitals in this region have not remained static since the inception of DRGs. There seems to be a dynamic period of change evolving in the delivery of health care services in this region. The demographic section of this study reveals that the majority (more than 70 percent) of the hospitals surveyed are operating fewer numbers of beds for inpatient services since ther inception of DRGs. The length of time that patients remain in the hospital for inpatient services is decreasing, resulting in decreased demand for inpatient beds.(ABSTRACT TRUNCATED AT 400 WORDS)