Background Electronic prescription was traditionally used in our country by primary health centres but it has also been progressively introduced into hospitals. This has had an economic impact on some products, such as those used in artificial home nutrition.
Purpose To assess the economic impact arising from electronic prescription of diet products at a specialty hospital.
To establish effective measures to compensate for the economic impact resulting from the transfer of responsibilities from primary health care to hospital care.
Material and methods Retrospective observational study of the increase in spending and number of prescriptions for diet products in outpatient clinics and on hospital discharge. The period from November 2014 to October 2015 was compared with an equivalent period from the previous year. These data were then correlated with percentage of implementations of the electronic prescription module. Prescription details, number of prescriptions and costs were retrieved from the Microstrategy assistance application. The data were broken down by medical service, prescriber and product.
Results After analysing the data, an increase in home prescriptions for diet products was found: the number of prescriptions rose by 45.24%, which caused a total increase in costs of 55.14%. These data are explained by a higher degree of implementation of the electronic prescription module (88% in 2014 vs 98.28% in 2015), as well as greater flexibility in computer based procedures for visa issuance. The endocrinology department was responsible for 66.9% of diet product spending. We observed a greater increase in prescription of complete formulae for diabetics (99.08%); polymeric, normoproteic, normocaloric, fibre-free formulae (538.46%), and hypercaloric, fibre-rich formulae (149.36%). A project was developed to incorporate the pharmacist into the visa circuit, in order to ensure efficient management of diet products in compliance with national legislation. To accomplish this goal, the unit of clinical management of pharmacy undertakes the management of visa approval for diet products.
Conclusion Prescribing via electronic prescription has involved an increase in spending on artificial home diet at our centre. Incorporating a hospital pharmacist into the visa circuit might optimise usage of dietary therapeutic products, thereby ensuring compliance with safety and efficacy criteria, as well as appropriateness of treatment and patient follow-up.
No conflict of interest
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