Tarification a l'activite mise a jour des outils financiers en pharmacie hospitaliere
Resume Objectif L'objectif de cet article est de presenter le financement axe sur les patients et de brosser un portrait des differentes actions realisees par le personnel du departement de pharmacie du Centre hospitalier universitaire Sainte Justine au cours des derniers mois afin de preparer le financement a l'activite. Description de la problematique Dans le contexte de la pharmacie en etablissement de sante, le financement axe sur le patient suppose pouvoir tracer adequatement les depenses en medicaments et de repartir les couts associes aux ressources humaines en fonction des differents types d'activites. Au Centre hospitalier universitaire Sainte Justine, le departement de pharmacie utilise plus d'une vingtaine de systemes d'information pour les activites de services, de soins, d'enseignement, de recherche et de gestion. Tous ces systemes sont concus pour faciliter des operations de services et de soins, mais aucun d'entre eux n'est specifiquement concu pour calculer un cout par patient. Resolution de la problematique Afin d'evaluer la possibilite de calculer un cout par patient, une demarche structuree en 10 etapes a ete entreprise. En tout, 183 heures de ressources professionnelles ont ete necessaires pour mener une dizaine de simulations. Cette demarche de mise a jour des systemes informatiques a permis d'expliquer 78,8 des depenses reelles en medicaments. Conclusion Nos travaux ont permis d'expliquer 78,8 des depenses en medicaments afin d'etablir un profil des depenses par patient. Cette reflexion nous a permis de mettre en evidence huit actions concretes qui pourraient etre mises en place dans chaque etablissement. Abstract Objective: The objective of this article is to present patient based funding and to describe the different measures taken by the Department of Pharmacy at the Centre hospitalier universitaire Sainte Justine during the past few months to prepare for activity based funding. Problem description: In the context of institutional pharmacy, patient based funding involves being able to properly track drug expenses and allocate human resource costs according to the different types of activity. The Centre hospitalier universitaire Sainte Justine's Department of Pharmacy uses more than 20 information systems to support its management, research, teaching, care and service activities. All of these systems have been designed to support care and service operations, but none has been specifically designed to determine a per patient cost. Problem resolution: A 10 step, structured approach was undertaken to assess the possibility of determining a per case cost. About 10 simulations were conducted, requiring 183 hours of professional resource time. This process of updating the computer systems enabled us, after numerous alterations and simulations, to determine an expense of 78.8% of the actual cost. Conclusion: Our approach required 10 steps and close to 200 hours of professional resource time. It accounted for 78.8% of the drug expenses for the purpose of establishing a profile of per patient expenses. This exercise enabled us to identify eight concrete measures that could be put in place at every facility.