DISPENSING

TO
OUT-PATIENTS /
AMBULATORY PATIENTS

Dr Furqan K Hashmi
 OUT PATIENTS ARE THOSE WHO DO
NOT OCCUPY BEDS IN HOSPITAL
• They are also referred to as ambulatory
patients
• Out patients mostly need primary care.
• Out patient dispensing is one of the basic
function of the pharmacy department in any
hospital
 AMBULATORY PATIENTS
• Ambulatory refers to patients not occupying beds in hospitals or
other settings, and to care given in physician’s offices, clinics, other
health centers and other places where ambulatory patients usually
go for healthcare
CONTENTS:
LOCATION
LAYOUT
RECEIPT AND ISSUE SYSTEM
RECOVERY AND SERVICE CHARGES
THE PROFESSIONAL FEE
PRESCRIPTION PRICES
PRE-PACKING
 1.LOCATION
• It is always preferable to have a separate out
patient pharmacy.
• When this is not possible units are combined and
the services provided from the same or separate
window.
• There is no general rule regarding location of out-
patient pharmacy ,it should be so located that
minimum disturbance is caused to the in-
patients and routine working of the hospital and
its pharmacy.
 2.LAYOUT
• It is important because the out patient can carry
good or a bad impression about the hospital
depending on the services they get.
• Unit must have prescription receiving window &
delivery window.
• Waiting area should be provided.
• This area should be elegant , clean ,ventilated
and provided with comfortable seats.
• Some publications related to medicine and
pharmacy as well as news papers, magazines can
be provided.
 3.Reciept &Issue system
• If a visit for first time –registration is must.
• Depending on the symptoms ,the patients are
directed to particular department.
• Physician prescribes prescription-name , age ,
registration number and diagnosis of patient.
• Prescription is to be produced before the
pharmacist at the prescription receiving
counter.
• Any clarification about prescription-contact
physician.
• The compounded prescriptions should be
filled in the container and labeled to include
details(name ,age reg.no,and directions for
use and storage)
• Call check system can employed-for delivering
compounded drug.
 4.Recovery and service charges
• In charitable hospitals the patients have to pay
the charge for the medication , services.
• 3 important methods of pricing are based on
(a) fee depending on dosage form and number
of doses supplied
(b)a simple mark up procedure ,depend on the
cost of the drug.
(c) a professional fee system.
 Professional fee
• It is most widely used .
• The concept is not new.
• It represents an amount that covers the cost
of providing services and a reasonable profit
the for pharmacist.
• The professional fee is same for all types of
prescriptions irrespective of the cost of the
ingredients.
 5.Prescription prices
• It can be calculated by
prescription price =drug cost + professional fee
• Professional fee may vary depending on the
practitioner’s environment.
• Thus, PFi=CODi + PROFIT
CODi =professional services + over head
• professional fee based on operating expenses
can be calculated as-
• Professional fee = A+(B*C)/D+E
• A=Manager’s salary
• B=prescription sales to total sales
• C=expenses minus manager’s salary
• D=total no.of prescriptions and
• E=net profit per prescription
 6.prepacking
• It is a very convenient method of improving
the standard of dispensing in hospital
pharmacies.
• It can be employed for fast moving items (or)
too much time for packaging.
• It requires accurate procedures ,controls and
records in order to trace the identity of the
drug.
• Pre-packing policy is based on –
1. Demand for the product
2. Size of unit to be packaged and numbers in each
unit.
3. Type of containers and closure to be used.
4. Special labeling required ,if any
5. Packaging facilities available i.e., manual or
mechanical.
6. Stability of the product and expiry date ,and
7. Unit cost of pre-packaging.
 Advantages
• Improves standard of dispensing.
• Cuts down patient’s waiting time .
• No special equipment is necessary.
• It can be employed for both in-patient and
out-patient dispensing.
Package size : In most hospitals-20 or 25
tablets considered to be pre-package size for
in-patients.
• Outpatient-depends on no.of appoinments in
a month.