药剂师与初级保健医生同地办公:了解跨专业初级保健的提供。

IF 3.3 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Medical Care Pub Date : 2024-02-01 Epub Date: 2023-12-05 DOI:10.1097/MLR.0000000000001960
Emily M Hawes, Cristen Page, Evan Galloway, Mary Roth McClurg, Brianna Lombardi
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引用次数: 0

摘要

背景:虽然有证据支持包括药剂师在内的跨专业初级保健模式,但药剂师在初级保健中的工作范围以及与同地工作相关的因素尚不清楚:本研究旨在分析药剂师与初级保健提供者(PCP)的实际同地工作情况,并研究与同地工作相关的预测因素:这是一项回顾性横断面研究,研究对象是国家计划和提供商枚举系统数据库中拥有个人国家提供商标识符的药剂师和初级保健提供商。药剂师和初级保健医生的医疗保健专业人员的执业地址被进行了地理编码,距离小于 0.1 英里被视为物理上的同地办公:共纳入 502,373 名医生和 221,534 名药剂师:如果不包括医院药剂师,每 10 个药剂师中就有 1 个(11%)与初级保健医生同处一地。与农村地区的药剂师相比,城市地区的药剂师更有可能与初级保健医生合用药房(OR=1.32,CI:1.26-1.38)。每 100,000 人中执业药剂师比例最高的县的同房率更高(OR=1.38,CI:1.32-1.45)。在执业范围扩大的州(OR 1.37,CI:1.32-1.42)和医疗补助范围扩大的州(OR 1.07,CI:1.03-1.11),同地执业的比例明显更高。同地执业的药剂师通常在规模较大的医生诊所工作:尽管将药剂师纳入初级医疗团队可改善临床疗效、降低医疗成本并提高患者和医疗服务提供者的体验,但在美国,药剂师同地工作的分布似乎并不均衡,农村地区的药剂师同地工作比例较低。随着药剂师融入初级保健的范围不断扩大,了解其普及率和增长的促进因素将对政策制定者、研究人员和临床管理者有所帮助。
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Pharmacists Colocated With Primary Care Physicians: Understanding Delivery of Interprofessional Primary Care.

Background: While evidence supports interprofessional primary care models that include pharmacists, the extent to which pharmacists are working in primary care and the factors associated with colocation is unknown.

Objectives: This study aimed to analyze the physical colocation of pharmacists with primary care providers (PCPs) and examine predictors associated with colocation.

Research design: This is a retrospective cross-sectional study of pharmacists and PCPs with individual National Provider Identifiers in the National Plan and Provider Enumeration System's database. Pharmacist and PCP practice addresses of the health care professionals were geocoded, and distances less than 0.1 miles were considered physically colocated.

Subjects: In all, 502,373 physicians and 221,534 pharmacists were included.

Results: When excluding hospital-based pharmacists, 1 in 10 (11%) pharmacists were colocated with a PCP. Pharmacists in urban settings were more likely to be colocated than those in rural areas (OR=1.32, CI: 1.26-1.38). Counties with the highest proportion of licensed pharmacists per 100,000 people in the county had higher colocation (OR=1.38, CI: 1.32-1.45). Colocation was significantly higher in states with an expanded scope of practice (OR 1.37, CI: 1.32-1.42) and those that have expanded Medicaid (OR 1.07, CI: 1.03-1.11). Colocated pharmacists more commonly worked in larger physician practices.

Conclusion: Although including pharmacists on primary care teams improves clinical outcomes, reduces health care costs, and enhances patient and provider experience, colocation appears to be unevenly dispersed across the United States, with lower rates in rural areas. As the integration of pharmacists in primary care continues to expand, knowing the prevalence and facilitators of growth will be helpful to policymakers, researchers, and clinical administrators.

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来源期刊
Medical Care
Medical Care 医学-公共卫生、环境卫生与职业卫生
CiteScore
5.20
自引率
3.30%
发文量
228
审稿时长
3-8 weeks
期刊介绍: Rated as one of the top ten journals in healthcare administration, Medical Care is devoted to all aspects of the administration and delivery of healthcare. This scholarly journal publishes original, peer-reviewed papers documenting the most current developments in the rapidly changing field of healthcare. This timely journal reports on the findings of original investigations into issues related to the research, planning, organization, financing, provision, and evaluation of health services.
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