Cost Saving and Health Workers Perceptions of Pharmacist Integration in Operating Rooms: A Mixed-Methods Cross-Section Study.

Abstract

Developed nations maximize pharmacists, while developing nations underutilize them, especially in operating rooms (ORs), necessitating cost-effectiveness and feedback evaluations. We investigated the impact of pharmacist involvement in operating rooms (OR) at Muhimbili National Hospital. We contrasted a "before era" (BE) without pharmacists to an "after era" (AE) with their presence. We conducted a comparative observational analysis. We examined data from April 1, 2016, to June 30, 2018 (BE), and July 1, 2018, to September 2020 (AE). We interviewed 127 OR Health workers to appreciate pharmacist presence during AE. We performed statistical analysis using Stata 12/IC. We used chi-square and Student's t-tests for categorical and continuous data, respectively. We set statistical significance at P < .05. In the BE, 32 568 patients underwent surgery, with 31.7% being male, while in the AE, 40 195 patients were operated on, with 40.2% being male. Patient payment method distribution did not significantly differ between eras (P = .68351). The total medication and medical supply costs decreased from TZS 8 631 547 372 in the BE to TZS 6 695 832 350 in the AE. Despite an additional cost of TZS 1 409 400 000 for pharmacist integration, a net cost saving of TZS 526 315 022 was achieved, resulting in an incremental cost-effectiveness ratio (ICER) of TZS 69 007 cost savings per patient served during AE. Health workers satisfaction regarding the inclusion of 40 pharmacists was high, with 98.4% reporting satisfaction. During the AE, 92.9% of OR Health workers were content with pharmacist performance. However, some Health workers did not understand about pharmacist roles in OR due to their limited numbers and suggested prioritizing supply management over direct OR presence. Pharmacists are indispensable members of healthcare teams, particularly in ORs, where their contributions significantly improve patient outcomes and reduce costs. The findings strongly support increased pharmacist deployment in healthcare facilities and further research to explore their impact on healthcare resource utilization.