A separate analysis
of data from pediatric hospitals was conducted for the 2001/2002
report, since this group is generally known to have differences
in drug costs, staffing and drug distribution. Table I-1 provides
a selection of key indicators comparing data provided by respondents
from pediatric facilities (n=7) to data submitted by all respondents
(n=123). The pediatric facilities identified for this analysis had
all responded to the main survey as distinct stand-alone operations.
The average of reported number of beds in 2001/2002 is only slightly
lower in pediatric hospitals than in the overall group, but a difference
is more evident for acute care length of stay (an average of 5.6
days in pediatric vs. 7.1 days overall). The shorter acute care
length of stay is reflected in a higher drug cost/patient day in
pediatric facilities ($48 vs. $31) whereas the drug costs/acute
care admission are similar for both clienteles (~$220/admission).
The situation is different for non acute drug costs, where interestingly,
although the average of non acute drug costs per non acute inpatient
day was lower for pediatric facilities than for the all respondent
group, the non acute drug costs per non acute admission were higher
in the pediatric group. The proportion of drug expenses by patient
care area are larger in ambulatory (take home) patients in pediatric
(23.8%) than in the all-respondent group (8.4%). This may be related
to expensive orphan drug programs available for a small cohort of
patients in pediatrics.
Respondents from pediatric hospitals reported a larger staffing
on average. This is probably due to factors such as longer pharmacy
opening hours (105 hours/week on average in pediatric vs 82 in the
all respondent group), larger IV admixture production (1.84 admixture/acute
patient days in pediatric vs 1.19 overall) and a larger proportion
of unit dose systems (55% in pediatric vs 45% overall). These services
create a more intensive pharmacy workload to the benefit of nursing.
The difference in staffing for pediatrics versus adults may also
be partially explained by the need to individualize doses based
on weight/body surface area, which requires both more preparation
time for drug distribution and more time spent verifying the physician’s
order by clinical pharmacists.
Finally, the potential for clinical pharmacy interventions is greater
or equal in pediatric populations than in adult hospitals. Although
the average of reported number of interventions per pharmacist was
lower in the pediatric group than in the overall group (446 vs.
568), the average of reported number of interventions per admission
was higher (0.7 vs. 0.6).
A selection of respondents was approached to complete a distinct
section on benchmarking, and four pediatric hospitals also completed
that questionnaire. Three of these four sites are represented in
the group of seven pediatric facilities discussed above; the fourth
was a pediatric facility operating within a larger pharmacy department
in a multi-site complex. For additional information and discussion
of the benchmarking results for pediatric facilities, please refer
to the section entitled “A Program Breakdown of Benchmark
Indicators for Pharmacy Staffing and Drug Costs.”