Clinical pharmacist staffing in United States hospitals.


We evaluated hospital demographics (census regions, size, teaching affiliation, hospital ownership, hospital pharmacy director's degree, pharmacist location within the hospital) and clinical pharmacist staffing/occupied bed in United States hospitals. A database was constructed from the 1992 American Hospital Association's Abridged Guide to the Health Care Field and the 1992 National Clinical Pharmacy Services database. Simple statistical tests and multiple regression analysis were employed. The study population consisted of 1391 hospitals that reported information on clinical pharmacist staffing. The mean number of clinical pharmacists/100 occupied beds was 0.51 +/- 0.18. Factors associated with increased clinical pharmacist staffing were west north central region (slope = 0.0029439, p = 0.002), Pacific region (slope = 0.0032089, p = 0.004), affiliation with pharmacy teaching hospitals (slope = 0.0025330, p = 0.0001), teaching hospitals (slope = 0.0028122, p = 0.001), federal government ownership (slope = 0.0029697, p = 0.012), directors with Pharm.D. degrees (slope = 0.0335020, p = 0.002), directors with M.S. Pharmacy degrees (slope = 0.0028622, p = 0.003), pharmacists in a decentralized location (slope = 0.0035393, p = 0.0001), and pharmacy technician staffing (slope = 0.0517713, p = 0.0001). Statistically significant associations between demographic variables and decreased clinical pharmacist staffing/occupied bed were mid-Atlantic region (slope = -0.0028237, p = 0.002), small size (slope = -0.0028894, p = 0.001), pharmacy directors with B.S. degrees (slope = -0.0019271, p = 0.023), and pharmacy administrator staffing (slope = -0.0184513, p = 0.042). The R2 for this multiple regression analysis was 28.31% and adjusted R2 was 24.83%. Increased pharmacy technician staffing had the greatest association (slope = 0.0517713) with increased clinical pharmacist staffing. Significant differences were observed between clinical pharmacist staffing and hospital demographic factors. It appears that one of the most effective ways to increase clinical pharmacist staffing is to increase pharmacy technician staffing (slope). These findings will help future researchers determine specific reasons why some types of hospitals have higher and some lower levels of clinical pharmacist staffing.


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