PHP54 - A Time-Driven Activity-Based Cost Study of Primary Care Pharmacy Service of Chronic Diseases Among The Elderly at Community Health Center, Krabi Hospital and Sai Thai Contract Units Of Primary Care, Krabi Province, Thailand

Abstract

This study aimed to describe a cost of primary care pharmacy service, including home health visit, provided by Thai pharmacist from Community Health Center of Krabi hospital, Sai Thai Contract Units of Primary Care, and community pharmacy. A Time-driven activity-based costing method was applied in calculating cost of service. Bootstrapping technique was adopted to demonstrate the variation of time spending on each activity. Patients with chronic diseases diagnosed with either hypertension, or diabetes, or dyslipidemia were sampled. The lengths of time of each activity per patient's visit were observed. Time-to-pharmacy activities were compared between a primary care unit and a community pharmacy. At the community pharmacy, pharmacist spent about 3.11 minutes per patient (95%CI=3.08-3.15) on pharmaceutical diagnosis and 8.64 minutes per patient (95%CI=8.49-8.79) on counseling and dispensing. At the community health centre, pharmacists spent about 3.75 minutes per patient (95%CI=3.63-3.86) on counseling and dispensing, while, family pharmacist spent about 4.37 minutes per home visit (95%CI=4.14-4.59) on pharmaceutical diagnosis and 21.38 minutes per home visit (95%CI=20.33-22.41) on counseling and dispensing.Total cost of primary care pharmacy activities at the primary care unit and community pharmacy were 11.6501 USD and 1.4729 USD, respectively. At the Primary Care Unit, however, none of total cost of service was calculated because there were not activities provided by pharmacist. Integrating primary care pharmacy services between the community health center and community pharmacy is a suggested model, which is to attract more patients with uncomplicated chronic diseases to use primary care service, as well as, to decrease total cost of pharmacy service regarding public health service provider's perspective. Ultimately, primary care pharmacy service should be more financially supported by Thai public health purchasers in order to improve the effective provisions of service. Key words: Time-driven activity-based costing, Primary care pharmacy service, Chronic diseases