Quality of pharmaceutical care in hospitals

The objective of this study was to measure the quality of pharmaceutical services provided to hospital inpatients. Using Donabedian's model, normative standards from the Joint Commission on Accreditation of Hospitals and the American Society of Hospital Pharmacists were used to develop a personal interview schedule to access the structure and process components of pharmaceutical services. To determine the effect of bed size, rural vs. urban, and presence of a full- or part-time pharmacist on the quality of pharmaceutical services, three samples of short-term hospitals were drawn: a random sample of Mississippi hospitals with less than 100 beds; all Mississippi hospitals of 100 or more beds; and a sample of hospitals in Philadelphia, Pennsylvania. In each of the 112 hospitals a personal interview was conducted with either the chief pharmacist or the administrator responsible for the pharmaceutical service. The responses to the items were then tabulated and a structure and a process score were obtained for each hospital. The following conclusions can be made: (1) The quality of the "structural" components is positively related to the bed size and not to whether the hospital is located in a rural or urban setting; (2) the quality of the "process" components is related to both the bed size and the location of the hospital--hospitals having 100 or more beds or located in an urban area have a higher process quality than those having less than 100 beds or located in a rural area; and (3) hospitals employing a full-time pharmacist have a higher quality of care than those who do not.