의료기관 마약류관리 업무의 제도적 개선을 위한 정책 연구
Policy Research for Enhancing Institutional Narcotic Management Systems
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Background : This study aimed to evaluate the relative value of pharmacists’ work in managing narcotics in healthcare institutions, assess the appropriateness of narcotics management fee introduced in 2019, and propose appropriate workforce sizes and reim bursement fees for safe narcotics management. Methods : A survey was conducted to examine narcotic management workload, the time spent on each task, and the relative value of each task. Tasks were categorized by opioid and psychotropic medication. They were also categorized by outpatient and inpatient set tings. Workforce sizes were calculated using the hours spent per day in full-time equiva lent (FTE) units. Relative importance and intensity of each task were examined to estimate relative value of narcotics management workload. Results : From 50 hospitals with a survey response rate of 49.5%. In June 2023, the number of inpatient narcotic prescriptions per 100 beds was 1,033.0, while the number was 624.2 for psychotropic drugs. On a per 100-bed basis, 0.45 FTE (10.1% of the total pharmacists) were involved in narcotics management out of the 4.46 FTE pharmacists. Average monthly fee for narcotics management was KRW 1,997,356, approximately 9% of the labor cost of pharmacists engaged in this field. The analysis indicated that 1 FTE pharmacist was required for every 156 opioid prescriptions and every 180 psychotropic prescriptions. Relative values of dispensing-counseling for opioid/psychotropic drugs in inpatient and outpatient settings were found to be 1.62 to 2.46 times higher, while rel ative values for medication management were 3.33 to 6.20 times higher for opioids and psychotropic drugs in these settings compared to standard dispensing-counseling. Conclusion : This study identified a discrepancy between measured relative values reflect ing actual workload and current reimbursement for narcotic management, which should be revised to reflect actual workload and improve manpower.
Abstract
Background : This study aimed to evaluate the relative value of pharmacists’ work in managing narcotics in healthcare institutions, assess the appropriateness of narcotics management fee introduced in 2019, and propose appropriate workforce sizes and reim bursement fees for safe narcotics management. Methods : A survey was conducted to examine narcotic management workload, the time spent on each task, and the relative value of each task. Tasks were categorized by opioid and psychotropic medication. They were also categorized by outpatient and inpatient set tings. Workforce sizes were calculated using the hours spent per day in full-time equiva lent (FTE) units. Relative importance and intensity of each task were examined to estimate relative value of narcotics management workload. Results : From 50 hospitals with a survey response rate of 49.5%. In June 2023, the number of inpatient narcotic prescriptions per 100 beds was 1,033.0, while the number was 624.2 for psychotropic drugs. On a per 100-bed basis, 0.45 FTE (10.1% of the total pharmacists) were involved in narcotics management out of the 4.46 FTE pharmacists. Average monthly fee for narcotics management was KRW 1,997,356, approximately 9% of the labor cost of pharmacists engaged in this field. The analysis indicated that 1 FTE pharmacist was required for every 156 opioid prescriptions and every 180 psychotropic prescriptions. Relative values of dispensing-counseling for opioid/psychotropic drugs in inpatient and outpatient settings were found to be 1.62 to 2.46 times higher, while rel ative values for medication management were 3.33 to 6.20 times higher for opioids and psychotropic drugs in these settings compared to standard dispensing-counseling. Conclusion : This study identified a discrepancy between measured relative values reflect ing actual workload and current reimbursement for narcotic management, which should be revised to reflect actual workload and improve manpower.
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