Measuring Equity Of Clinical Pharmacy Service Provision At The Regional And Rural Hospitals In Australia

• By: MIRKOV, Sanja (Cairns And Hinterland Hospital And Health Service, Australia)
• Co-author(s): Mrs Sanja Mirkov (Cairns And Hinterland Hospital And Health Service, Cairns, Australia)
  Dr Rhondda Jones (James Cook University, Townsville, Australia)
  Mr Alexander Ison (Children’s Health Queensland Hospital and Health Service, Brisbane, Australia)
  Mr Allan Wilesmith (Cairns And Hinterland Hospital And Health Service, Cairns, Australia)
  Mr Jason Black (Cairns And Hinterland Hospital And Health Service, Cairns, Australia)
  
• Abstract:

  Background information Provision of medication action plan (MAP) on admission and discharge medication record (DMR) are associated with reduced medication-related harm.
  Purpose To develop clinical pharmacy key performance indicators dashboard and evaluate coverage and equity of service provision at the regional and rural hospitals.
  Method 12-month retrospective period-prevalence study. The proportion of patients who received MAP and DMR were stratified by age, gender, Indigeneity and hospital type. Statistical analysis was performed using Chi-Squared tests and logistic regression in R. Ethics exemption EX/2023/QCH/94383-1684QA.
  Results 13,818 patients (37.9% of admissions) received MAP and 11,631 patients (32.7% of discharges) received DMR. The proportion of MAP and DMR was significantly higher at the rural hospitals compared to the regional hospital (MAP 50.6% vs 34.6%; DMR 33.1% vs 31.3%) and for male patients compared to female (MAP 42.2% vs 33.7%; DMR 36.4% vs 29.2%). When stratified by age groups, First Nations patients received higher proportion of MAP and DMR in each age group except for age 85 and over. The proportion of First Nations patients 50 and over who received MAP was significantly lower compared to non-Indigenous patients 65 and over (56.3% vs 59.8%), whilst the proportion of DMR was similar. The proportion of female patients 50 and over of the First Nations origin who received a MAP was significantly lower compared to the proportion of female patients 65 and over of non-Indigenous origin (56.1% vs 61.2%) and the proportion of DMR was similar.
  Conclusion The study defined clinical pharmacy key performance indicators for measuring equity of clinical pharmacy service provision in Australia. When adjusted for a difference in life expectancy, the proportion of First Nations patients who received MAP on admission was lower compared to non-Indigenous patients. Further improvements are required to establish prioritisation criteria to achieve equity of service provision for First Nations and female patients.