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NURSING HOME CARE IN THE U S - FAILURE IN PUBLIC POLICY DRUGS IN NURSING HOMES - MISUSE, HIGH COSTS, AND KICKBACKS - PREPARED BY THE SPECIAL COMMITTEE ON AGING, UNITED STATES, 94TH CONGRESS, 1ST SESSION, JANUARY 1975

NCJ Number
53330
Author(s)
ANON
Date Published
1975
Length
89 pages
Annotation
THIS PAPER DEALS WITH PROBLEMS IN THE ADMINISTRATION OF DRUGS TO PATIENTS IN NURSING HOMES AND KICKBACKS FROM PHARMACISTS TO NURSING HOME OPERATORS.
Abstract
IN ADDITION TO SUMMARIZING THE MAJOR POINTS OF THIS PAPER, THE MAJOR POINTS OF THE OTHER SUPPORT PAPERS DEALING WITH THE CHARACTER OF NURSING HOME CARE IN THE UNITED STATES ARE ALSO PRESENTED. MUCH OF THE INFORMATION IN THIS REPORT COMES FROM TRANSCRIPTS OF RELEVANT HEARINGS BEFORE THE U.S. SENATE SUBCOMMITTEE ON PROBLEMS OF THE AGED AND AGING, ALONG WITH SEVERAL SUPPLEMENTARY STUDIES BY THE SUBCOMMITTEE STAFF, THE U.S. GENERAL ACCOUNTING OFFICE, AND PRIVATE GROUPS. THE LIBRARY OF CONGRESS, OTHER CONGRESSIONAL COMMITTEES, PROFESSIONAL ORGANIZATIONS, THE U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE, AND OTHER ADMINISTRATIVE OR INDEPENDENT AGENCIES ALSO PROVIDED DATA USED IN CONSTRUCTING THE REPORT. IT IS NOTED THAT THE DRUG BILL OF THE AVERAGE NURSING HOME PATIENT, WHO TAKES FROM FOUR TO SEVEN DIFFERENT DRUGS A DAY, COMES TO $300 A YEAR AS COMPARED WITH $87 A YEAR FOR SENIOR CITIZENS WHO ARE NOT INSTITUTIONALIZED. THIS CONSTITUTES 10 PERCENT OF THE NATION'S TOTAL NURSING HOME BILL. DRUG DISTRIBUTION SYSTEMS USED BY MOST NURSING HOMES ARE INEFFICIENT AND INEFFECTIVE, WITH DOCTORS VISITING THE HOMES RARELY, NURSES OVERWORKED, AND AIDES AND ORDERLIES FREQUENTLY ENTRUSTED WITH THE ADMINISTRATION OF MEDICATION, THUS CONTRIBUTING TO A REPORTED 20 TO 40 PRCENT RATE OF ERROR IN ADMINISTRATION. THEFT AND MISUSE OF NURSING HOME DRUGS, A HIGH INCIDENCE OF ADVERSE REACTIONS, EVIDENCE OF DRUG ADDICTION, AND LACK OF ADEQUATE CONTROLS IN THE REGULATION OF DRUG EXPERIMENTATION ARE ALSO EVIDENT IN NURSING HOMES. THE MISUSE OF TRANQUILIZERS TO CONTROL PATIENTS IS ALSO DISCUSSED. THE WIDESPREAD PRACTICE OF KICKBACKS, WHEREBY A PHARMACIST IS FORCED TO PAY A CERTAIN PERCENTAGE OF THE PRICE OF NURSING HOME PRESCRIPTION DRUGS BACK TO THE NURSING HOME OPERATOR FOR THE PRIVILEGE OF PROVIDING THOSE SERVICES, IS DISCUSSED IN THE SECOND MAJOR PART OF THE REPORT. RECOMMENDATIONS ARE OFFERED FOR THE CORRECTION OF THESE ABUSES. THE APPENDIXES INCLUDE EXTENSIVE, DETAILED INFORMATION ON SOME OF THE MATERIAL DISCUSSED IN THE BODY OF THE REPORT. (RCB)