Student-run low-income family medicine clinic

Controlling costs while providing comprehensive medication management

Jaclyn J. Dvoracek, Kristen M Cook, Donald G Klepser

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Objectives: To evaluate the impact of implementing cost-control measures on drug use and financial performance of a student-run safety net clinic and to assess the effect of the measures on patient care. Methods: Medication histories and patient information were obtained from the University of Nebraska Medical Center's student-run safety net clinics' (SHARING and GOODLIFE) computer databases and internal medication cost documents for all patients treated with medications at the clinics from April 1, 2006, through March 31, 2008. Main outcome measures were cost, use, and source of all medications and the resultant financial savings between the pre- and postperiods. Results: 200 patients were treated with medications during the 2-year period (164 patients before April 1, 2007, and 137 after). A majority of clinic patients were treated for chronic conditions, including 62% for hypertension, 54% for diabetes, 46% for dyslipidemia, and 26% for depression. The average monthly cost to the clinics for medications decreased from $5,444.87 before April 1, 2007, to $3,714.05 (P = 0.002) after. With these changes, the cost per prescription from any delivery method decreased from $15.28 to $13.02 (P < 0.001) and the average cost per prescription decreased from $27.32 to $20.27 (P < 0.001) after formulary implementation. The number of prescriptions per patient per month was unchanged. Conclusion: Medication management with a closed formulary in a diverse uninsured population reduced expenditures, with the largest savings coming from using prescriptions more efficiently while also providing a similar level of medical care.

Original languageEnglish (US)
Pages (from-to)384-387
Number of pages4
JournalJournal of the American Pharmacists Association
Volume50
Issue number3
DOIs
StatePublished - Jan 1 2010

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Medicine
Students
Costs and Cost Analysis
Prescriptions
Safety-net Providers
Formularies
Costs
Cost Control
Medical problems
Dyslipidemias
Health Expenditures
Medical Students
Health care
Patient Care
Outcome Assessment (Health Care)
Databases
Depression
Hypertension
Pharmaceutical Preparations
Population

Keywords

  • Drug costs
  • Health insurance
  • Medication management
  • Student pharmacists
  • Underserved patients

ASJC Scopus subject areas

  • Pharmacology (nursing)
  • Pharmacy
  • Pharmacology

Cite this

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title = "Student-run low-income family medicine clinic: Controlling costs while providing comprehensive medication management",
abstract = "Objectives: To evaluate the impact of implementing cost-control measures on drug use and financial performance of a student-run safety net clinic and to assess the effect of the measures on patient care. Methods: Medication histories and patient information were obtained from the University of Nebraska Medical Center's student-run safety net clinics' (SHARING and GOODLIFE) computer databases and internal medication cost documents for all patients treated with medications at the clinics from April 1, 2006, through March 31, 2008. Main outcome measures were cost, use, and source of all medications and the resultant financial savings between the pre- and postperiods. Results: 200 patients were treated with medications during the 2-year period (164 patients before April 1, 2007, and 137 after). A majority of clinic patients were treated for chronic conditions, including 62{\%} for hypertension, 54{\%} for diabetes, 46{\%} for dyslipidemia, and 26{\%} for depression. The average monthly cost to the clinics for medications decreased from $5,444.87 before April 1, 2007, to $3,714.05 (P = 0.002) after. With these changes, the cost per prescription from any delivery method decreased from $15.28 to $13.02 (P < 0.001) and the average cost per prescription decreased from $27.32 to $20.27 (P < 0.001) after formulary implementation. The number of prescriptions per patient per month was unchanged. Conclusion: Medication management with a closed formulary in a diverse uninsured population reduced expenditures, with the largest savings coming from using prescriptions more efficiently while also providing a similar level of medical care.",
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