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Biomedical subjects

N V Carroll

Publications and source records attributed to N V Carroll.

At least 37 records · Page 2Linked to original sources
PubMed1987

The effects of differences in state drug product selection laws on pharmacists' substitution behavior.

The objective of this project was to examine and quantify the effects of specific requirements of state drug product selection (DPS) laws on pharmacists' generic drug substitution practices. The specific requirements on which state laws differ included, for example, whether the law mandated or simply allowed DPS, whether some type of formulary was required, and whether pharmacists were required to pass on cost savings to consumers. Data on state DPS laws were found in the National Association of Boards of Pharmacy's annual Surveys of Pharmacy Law and by contacting state boards of pharmacy. Estimates of state substitution rates were provided by IMS, America. Multiple regression analysis was employed to estimate the effects of legal requirements on substitution rates. Results indicated that substitution was more prevalent in states that did not require additional record keeping and in those that did require patient consent prior to substitution. The relationship between formulary restrictions, requirements regarding the passing on of savings, and liability limiting laws and substitution rates differed significantly between those states that required a two-line prescription form and those allowing use of one-line forms. Three nonlegal variables--time the DPS law had been in effect, percent of generic prescribing in the state, and mean pharmacist age--were also associated with substitution rates.

Community Participation↗
PubMed1987

Patient shifting as a response to Medicare Prospective Payment.

The Medicare Prospective Payment System (PPS) regulations provide hospitals with strong incentives to discharge patients sooner. It seems reasonable to assume that a large number of these discharged patients may require posthospital care in long-term care facilities (LTCFs). Such shifting of patients from hospitals to LTCFs would be evidenced by a sicker population of patients requiring more extensive and intensive treatments in the post-PPS period. The purpose of this study was to determine the extent to which patient shifting occurred after implementation of the PPS regulations. Data were collected from the medical records of 353 patients admitted to 10 LTCFs in Georgia both before and after the PPS was implemented. Comparisons of the two groups indicated no significant differences in LTCF admitting diagnoses, numbers of patients dying or being readmitted to the hospital within 30 days of LTCF admission, prognosis, or rehabilitative potential. The groups differed to a statistically significant extent on three treatment and health status variables: patients in the post-PPS group were more likely to be incontinent of bladder, to have nasogastric tubes, and to be on dietary supplements. These differences may suggest the beginning of a trend to shift heavier care patients into LTCFs. As a whole, however, the results of this study indicated limited shifting of patients from hospitals to LTCFs in Georgia during the first year after implementation of the PPS regulations.

Aged↗
PubMed1987

Estimating demand for health information: pharmacy counseling services.

Consumers want more information about their health care. Before giving more information, health care providers need valid, reliable estimates of the amounts consumers will pay for health information. Using the example of pharmacist counseling services, the authors demonstrate a method for developing, estimates of consumer demand for health information.

Community Participation↗
PubMed1987

Faculty evaluations of texts used to teach pharmacy financial management.

The objectives of this survey were to determine which texts were used to teach financial management to pharmacy students, to gather instructors' evaluations of the texts, and to determine which financial management topics were most often covered in pharmacy courses. Data for the study were collected via a mail questionnaire survey sent to a selected pharmacy administration faculty member at each school of pharmacy in the United States and Puerto Rico. A 90 percent response rate was achieved. The results indicated that the most frequently used texts were Effective Pharmacy Management and Principles and Methods of Pharmacy Management. Evaluations of these texts indicated that instructors who used them were, for the most part, satisfied with them. Major points of dissatisfaction were the number and types of problems included. Pharmacy courses covered a wide range of financial management and managerial accounting topics. Bookkeeping topics were much less likely to be covered. None of the available pharmacy texts covered all topics which are usually taught in courses of pharmacy financial management.

Books↗
PubMed1985

Continuing education in management: a survey of practitioners' perceived needs, knowledge and interest.

A survey of 519 Georgia pharmacists' was conducted to determine pharmacists perceived need for knowledge, their perceived knowledge, and their interest in continuing education programs in a wide range of managerial areas. The 269 usable responses indicated that pharmacists felt they needed to know at least a moderate amount about all topics listed. They perceived a greater need to know about basic management than about marketing or finance. Respondents felt they knew less than they needed to about most topics. However, they were not overly interested in attending continuing education programs. As a group, they reported moderate interest in programs in management and less interest in programs in marketing and finance. Managers, directors and owners were more interested in continuing education programs in all areas than pharmacists in other positions.

Data Collection↗
PubMed1984

Consumer demand for patient-oriented pharmacy services.

The purpose of this study was to investigate the extent of consumer demand for patient-oriented pharmacy services. Data, collected via a self-administered questionnaire distributed to 300 households, were analyzed using Kruskal's program for additive conjoint analysis. The results indicate substantial consumer demand for making advisory services available on request, moderate demand for provision of patient medication records, and little demand for voluntary provision of advisory services.

Counseling↗
PubMed1984

Practice patterns of Doctor of Pharmacy graduates: educational implications.

The purpose of this study was to evaluate the appropriateness of the predominantly clinical PharmD curriculum in light of actual employment patterns of PharmD graduates. Data were gathered via a survey of PharmD graduates from the seven post-baccalaureate programs active since 1972. Respondents were asked about their employment patterns and characteristics; about their formal education in the areas of management, statistics, and research methods; and to indicate whether they had completed residencies or fellowships. The results indicate that many PharmD graduates are employed in positions requiring considerable nonclinical skills, especially management skills. The results further indicate that few respondents have completed formal education, residencies, or fellowships which would prepare them for management or other nonclinical positions. Consequently, it appears that PharmD programs should require considerably more management training and education in order to adequately prepare their graduates for the positions open to them.

Analysis of Variance↗
PubMed1983

The relationship between patient variables and frequency of pharmacist counseling.

Over the past 20 years, much research has focused on evaluating pharmacists' performance as drug consultants to patients and on identifying factors that affect pharmacists' performance in this role. Little has been done, however, to assess the impact of patient characteristics, such as age, income, education, and drug expenditures, on pharmacists' performance as drug consultants. The purpose of this study was to examine this impact. Data were gathered via a mail survey of 300 households in Raleigh, NC. Multiple regression analysis was used to analyze the data. Results indicated that pharmacists generally are available to answer patients' drug-related questions, that pharmacists usually do not provide counseling to patients voluntarily, and that pharmacists are significantly more likely to counsel patients who have lower educational attainment and higher drug expenditures. These results appear to suggest that pharmacists have adopted the role of drug consultant to patients, but only to a limited extent.

Adolescent↗
PubMedDate not supplied

Profitability, third-party reimbursement, and access to community pharmacies.

The purpose of this study was to analyze the extent to which third-party reimbursement programs have affected the profitability and availability of community pharmacies. Data were taken from records maintained by the Virginia Board of Pharmacy and a survey of 177 community pharmacies. Between 1989 and 1994, 258 outpatient pharmacies opened and 342 closed. Chain and independent pharmacies suffered net losses, and supermarket and mass merchandiser pharmacies experienced net increases. Few significant changes occurred in the distribution of pharmacies over the study period. Fifty-nine chain and independent pharmacies and 1 supermarket pharmacy chain provided usable profit and reimbursement data. These pharmacies experienced declines in profits and increases in the percentage of prescriptions reimbursed by private third-party prescription programs over the last several years. Regression analyses indicated that higher ratios of sales of private third-party prescriptions to private-pay prescriptions were associated with lower profits. All respondents indicated that changes in private third-party reimbursement had substantially reduced profits over the past 5 years. The results indicate that the growth of private third-party payment has led to lower pharmacy profits but has not yet resulted in problems of consumer access.

Costs and Cost Analysis↗
PubMedDate not supplied

Costs incurred by outpatient surgical centers in managing postoperative nausea and vomiting.

STUDY OBJECTIVE: To estimate the financial costs incurred by outpatient surgical centers in managing postoperative nausea and vomiting (PONV). DESIGN: Prospective, observational study. SETTING: 6 hospital-based outpatient surgery centers. PATIENTS: 211 adult patients undergoing outpatient surgery for laparoscopy, dilatation and curettage, knee arthroscopy, or hernia repair. MEASUREMENTS AND MAIN RESULTS: Of the 211 patients studied, 34 experienced PONV in the recovery room. For those patients experiencing PONV, personnel, supply, and drug costs for management of this condition averaged $14.94 per patient. In addition, PONV increased the centers' operating costs by delaying patient discharge by an average of 24 minutes. A minimum estimate of this cost, based on nurses' wage rates, was $7.12. This estimate is appropriate only for short-run considerations in outpatient surgery centers that operate at low capacity. An appropriate valuation for long-run considerations and for centers operating near capacity is based on the revenue that centers lose as a result of extended stays. Lost revenue was estimated to be $415 per patient experiencing PONV. CONCLUSIONS: PONV substantially increases the costs incurred by outpatient surgical centers.

Adult↗
PubMedDate not supplied

Changes in number and distribution of community and ambulatory pharmacies in Virginia from 1994 to 1999.

OBJECTIVE: To determine whether market changes have resulted in a decrease in the number or geographic distribution of pharmacies available to ambulatory patients in Virginia. DESIGN: Retrospective review of Virginia Board of Pharmacy records of pharmacy registrations in 1994 and 1999. SETTING: The Commonwealth of Virginia. PARTICIPANTS: All pharmacies classified as outpatient pharmacies (including community and other types of ambulatory pharmacies) and operating in Virginia in 1994 and 1999. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Changes in the total number, geographic distribution, and metropolitan/nonmetropolitan distribution of outpatient pharmacies between 1994 and 1999. RESULTS: The total number of outpatient pharmacies increased from 1,290 to 1,337 between 1994 and 1999. Chain pharmacies, mass merchandiser, and grocery pharmacies increased in number while independent pharmacies declined. There was little change in the geographic or metropolitan/nonmetropolitan distribution of pharmacies. CONCLUSION: Changes in the number and distribution of community and other ambulatory pharmacies in Virginia have not diminished their availability to consumers.

Pharmacies↗