The impact of hospitalisation on prescribing costs for medical patients returning to the community.

As prescribed drugs represent an increasing expense in the health service, and prescribers assume more responsibility for costs, practitioners both in hospitals and the community are trying to define and limit this cost. We calculated drug costs in 107 consecutive medical admissions through the Accident and Emergency Department of admission and on discharge from hospital. The estimated (mean +/- SD) patient daily cost of drugs rose on admission from Pounds 0.90 +/- Pounds 1.32 to Pounds 2.06 +/- Pounds 2.57 on discharge (p < 0.01) which was partly due to an increased number of drugs on discharge [4.6 +/- 3.0 compared with 2.8 +/- 2.4 on admission (P < 0.01)]. However, the mean daily cost per item per patient also increased significantly from Pounds 0.23 +/- 0.30 to Pounds 0.38 +/- 0.39 during hospitalisation (P < 0.002). This mean daily cost on discharge from hospital was not influenced by patient age or duration of hospital stay. These results confirm that patients on discharge from hospital are prescribed more drugs than on admission but each item on the prescription tends to be more expensive on discharge from hospital.