Charging for hospital pharmaceutical services: combined product-service per diem fees

The development of a per diem hospital pharmacy charge is reviewed after five years of use. The itemized pharmacy charges for every tenth patient (total of 250 patients) admitted to the hospital during a three-month period were studied to determine the average daily charges for drugs and pharmaceutical services. Six categories of rates were designated, based on the type of hospital service. A comparison of the actual charges and the projected per diem rate indicated that the per diem rate would produce the same revenue as the itemized charging method. A procedure for periodically monitoring the per diem rate was also established. The per diem pharmacy charges range from $3.50 (for patients admitted to the psychiatric service) to $12 (surgical patients). Intravenous solutions, i.v. admixtures, normal human serum albumin, drugs administered in the intensive care and cardiac care units, and drug with an acquistion cost of more than $10 are not included in the per diem charging system. The per diem system enabled the hospital to reduce administrative and accounting costs while continuing to provide quality pharmaceutical services.