Transferring Pharmacy Service from Hospital to Community Pharmacy: Data from Bangkok and Vicinity

Abstract

The problem of overcrowded large hospitals remains severe and ongoing, exacerbated by the COVID-19 pandemic. To alleviate hospital congestion and reduce hospital infections, one approach is to provide extended pharmaceutical services at quality community pharmacies outside the hospital. The main objectives of this research were: (1) to study the public’s demand for pharmaceutical services that extended to participating community pharmacies, and (2) to assess the potential costs incurred. In this study, chi-square statistic was used to test statistical hypotheses regarding the public’s demand for services at the pharmacies. The cost analysis was based on an activity-based costing concept to estimate the marginal cost of providing or improving additional pharmaceutical services at the community pharmacies. The results revealed that (1) the most highly demanded services included preliminary disease screening, chronic disease management, various urgent medication-related consultations, and vaccination services. (2) There were a total of 8 services that community pharmacies could offer as supplementary transferred services from hospitals, namely: 1) blood pressure measurement, 2) blood sugar monitoring, 3) home medication delivery, 4) medication counselling and appropriate medication delivery to patients, 5) medication side effects explanation and adverse drug reactions monitoring, 6) consultation through email/phone/other channels, 7) preliminary disease screening, and 8) chronic disease management. The marginal cost incurred by the pharmacies ranged from 822 to 1,378 baht per day, or 187.50 to 312.50 baht per patient visit. The government should consider compensating this marginal cost to community pharmacies offering these services.