Health systems

G. K. McEvoy, ed.,MHFS Drug Information, American Society of Health-System Pharmacists, Bethesda, Md., 1995, pp. 2439. 

Several national organizations serve the professional needs of U.S. pharmacists. These reflect the practice milieu of members, eg, independent community pharmacies, chain dmg stores, and hospitals. The American Pharmaceutical Association (APhA), founded in 1852, is composed of the Academy of Pharmaceutical Research and Science, Academy of Pharmaceutical Practice and Management, and the Academy of Students of Pharmacy. Other organizations include the American Society of Health-Systems Pharmacists (ASHP), National Association of Chain Dmg Stores (NACDS), and National Association of Retail Dmggists (NARD). 

Division of Thoracic and Cardiovascular Surgery, University of Florida College of Medicine, P.O. Box 100286, Gainesville, FL 32610-0286, USA Surgical Therapeutic Advancement Center, University of Virginia Health System,... 

Hughes Spalding Children s Hospital Grady Health System 80 Butler St., S.E. 

St. Luke s/Iowa Health System 2720 Stone Park Blvd. 

WFIO (2000). World Health Report 2000—Health Systems Improving Perfortnance. Geneva WHO. 

Tisdale JE. Arrhythmias. In Tisdale JE, Miller DA, eds. Drug-Induced Diseases. Prevention, Detection and Management. Bethesda, MD American Society of Health-Systems Pharmacists 2005 289-327. 

American Society of Health-System Pharmacists. ASHP therapeutic guidelines on the pharmacologic management of nausea and vomiting in adult and pediatric patients receiving chemotherapy or radiation therapy or undergoing surgery. Am J Health-Syst Pharm 1999 56 729-764. 

Cefazolin or cefuroxime are appropriate for prophylaxis in cardiothoracic and vascular surgeries. In the case of 3-lactam allergy, vancomycin or clindamycin are advised. Debate exists on the duration of antimicrobial prophylaxis. The National Surgical Infection Prevention Project cites data that extending prophylaxis beyond 24 hours does not decrease SSI rates and may increase bacterial resistance.1 American Society of Health-System Pharmacists guidelines from 1999 allow for the continuation of prophylaxis for up to 72 hours.22 Duration of therapy should be based on patient factors and risk of development of an SSI. SSIs are rare after cardiothoracic operations, but the potentially devastating consequences lead some clinicians to support longer periods of prophylaxis. 

Medical College of Georgia Health System Augusta, Georgia... 

Drug Information Specialist University of Virginia Health System Charlottesville, Virginia Chapter 59 Allergic Rhinitis... 

Kelly, D. L. el al. (2006). Clozapine utilization and outcomes by race in a public mental health system 1994-2000./. Clin. Psychiatry, 67, 1404-11. 

Coveil, N.H., Jackson, C.T., Evans, A.C. Essock, S. M. (2002). Antipsychotic prescribing practices in Connecticut s public mental health system rates of changing medications and prescribing styles. Schizophr. Bull., 28( 1), 17-29. 

Several issues have to be kept in mind when reading this chapter. First, there are vast differences between the economically disadvantaged countries (Sartorius, 2001). In most of them, however, the gap between the richest and poorest parts of the population has grown over the past few decades and continues to grow. The health care for the poorest groups in the population has also become weaker and of poorer quality. In relation to pharmacotherapy this means that even when low-cost medications are made available the poor do not benefit from this, because the weakness of the health system makes it impossible for them to get to health care staff who could advise them and guide them in taking these medications. 

International Pharmaceutical Abstracts. International Pharmaceutical Abstracts [104], published semimonthly, is an abstracting/indexing publication which covers all pharmaceutical literature. IPA covers approximately 700 worldwide pharmaceutical, medical, herbal, cosmetics, and health-related publications. IPA features all abstracts from American Society of Health-System Pharmacist s Annual, Midyear Clinical, and Home, Hospice, and Long-Term Care Meetings, coverage of state pharmacy journals, and American Pharmaceutical Association and American College of Clinical Pharmacy meeting abstracts. IPA indicates articles that offer CE credit. IPA is commercially available in several formats. 

LD Jaggers. Differentiation of critical pathways from other health care management tools. Am J Health-System Pharm 53(Feb 1) 311 313, 1996. 

Veterans Administration, Greater Los Angeles Health System and the Department of Psychology, UCLA School of Medicine, Los Angeles, CA 91343, USA... 

Veterans Administration, Greater Los Angeles Health System, Sepulveda,... 

Table 1.2 Cost sharing in the health systems of western European countries... 

This book consists of a series of works that evaluate various aspects related to the public financing of pharmaceuticals. In all health systems with majority public funding, the financing of pharmaceuticals constitutes one of the key factors in reform policies and health cost containment measures. This importance of pharmaceutical spending can be explained by both its relative size (its share within health expenditure as a whole), and its rapid growth, which is closely related to the constant incorporation of therapeutic innovations. 

In Chapter 7, professor B. Gonzalez Lopez-Valcarcel of the University of Las Palmas de Gran Canaria analyses the participation of the insuree in the payment of the price of the pharmaceutical. In spite of the widespread application of pharmaceutical co-payment in European health systems, the author observes that this mechanism does not appear to have been very effective in cost containment. Co-payments represent a way of making the user share the burden of the cost rather than an essential source of income for the public system. Theory and comparative experience of the system alike indicate that the indiscriminate application of co-payments is a source of inequalities, and that in any event its effects on consumption depend largely on prescriber incentives. For this reason the author recommends that co-payments should not be uniform for different population groups, and that they should not be applied in isolation, as their effectiveness is enhanced in combination with other instruments. 

The third group of contributions consists of the two final chapters that focus specifically on the present situation and the outlook for the future of pharmaceutical expenditure within the Spanish health system. 

Generally it can be observed that price elasticity is low, a trend that is aggravated by the fact that in most health systems the consumer does not pay the totality of the price. Some authors state that the elasticity of substitution between medicines in different therapeutic groups can be almost nil. The existence of insurance is an incentive for greater consumption and facilitates the application of higher prices (moral hazard). 

---