The next challenge will be the creation of a tool to determine the economic effects of pharmacists’ interventions. Up to now, there is the possibility to enter direct cost savings that can be generated through the rational use of medicines. The calculation of indirect cost savings (for example reduction of the length of stay, reduction of costs arising from inappropriate dosage, adverse effects or interactions, decrease of morbidity and/or mortality) is much more difficult, and therefore has not yet been included into DokuPIK.
During a ten-year period scaphoid fracture was suggested in 541 wrists, but in 283 cases could not be confirmed at the initial radiographic examination. These cases were immobilized in plaster of Paris and examined clinically and radiologically 10 to 14 days later. A total of 274 additional radiographic examinations revealed 32 scaphoid fractures not initially recognized. Two fractures were at the retrospective analysis found to have been neglected. In the 249 cases where a fracture was never demonstrated, the immobilization and resulting sick leave were in retrospect considered not to have been indicated. In a retrospective analysis of case records and radiographic material including the configuration of the scaphoid fat stripe (SFS) at the initial radiographic examination the SFS was found to be useful in diagnosing scaphoid fractures. The use of the SFS in differential diagnosis would result in reduction of costs and inconvenience for patients without scaphoid fracture.
Potential reduction of costs and hospital emergency department visits resulting from prehospital transtelephonic triage-the shahal experience in israel