The Northwest Territories Legislative Assembly in March of 1979, recommended that the Government of the Northwest Territories introduce a Pharmacare program for Senior Citizens on July 1, 1979. The Northwest Territories has a population of 46,400 people, spread through 59 settlements and over 3,379,500 square kilometers. Senior Citizens account for 2.8% of the population. The problem faced in the introduction of the program was that it also required consolidation of three existing programs. Rather than offer a universal program, the Territorial Government chose a program for those residents age 65 and over to complement the existing programs, specifically the one in the Department of Health which covers prescription drugs for twelve defined illnesses. The Government did so without introducing Pharmacare legislation but rather through a financial appropriation of the Finance Legislation. This left the final definition of policy planning and program introduction in the hands of bureaucrats. The planning of the program took place in a bureaucratic setting. The approach used was an incremental approach based on a comparison of the major features of the existing plans of British Columbia, Saskatchewan, Manitoba and Ontario. The detailed design involved the construction of a formulary, the quantification and numerical identification of all information in order that it could be placed in an electronic data processing format to be operated on a data base inter-active system of a Hewlett-Packard 3000 computer. The consolidated program was successfully implemented on July 1, 1979 and has worked successfully from that point. The report concludes with an evaluation of the system and how introduction of this program may be of use in the design of Pharmacare programs or other programs in other similar jurisdictions. / Medicine, Faculty of / Population and Public Health (SPPH), School of / Graduate

No description available.

Decision-making by hospital pharmacy directors when deciding which clinical pharmacy services to implement and/or continue to provide was assessed. Also examined was how these decision-making activities, hospital characteristics, pharmacy characteristics, and pharmacy director demographics might be associated with the number and quality of clinical pharmacy services provided, as well as the number of clinical services implemented under the current pharmacy director. Hospital pharmacy directors reported considering a relatively large number of perceived goals for a clinical service and also indicated they use a rather broad range of decision-making methodologies in evaluating those goals when determining clinical services. Numerous variables were found to be significantly associated with the number of clinical services provided by the pharmacy department and the number of clinical services implemented under the current pharmacy director. However, relatively few variables were found to be significantly related to the quality of clinical pharmacy services being provided.

Introduction: Expanding the role of community pharmacists within primary care has become an important policy agenda in the UK. To ensure that pharmacy services are delivered to their full potential, services need to be better tailored to consumers' needs and preferences. The discrete choice experiment (DCE), a technique rooted in economic theory, has been used extensively to elicit consumers' preferences and values in healthcare. However, despite its popularity, there is limited empirical evidence on the external validity of DCEs. Aims: The aim of this thesis was to assess consumers' preferences for a community pharmacyled health check using a DCE with a methodological focus to investigate the external validity of DCE. Method: This thesis employed a four-phased mixed methods study design. In Phase I, a convenience sample of participants was recruited from within a community pharmacy, a colocated dental practice and nearby public spaces and invited to complete a DCE questionnaire to assess preferences for a community pharmacy-led health-check. The DCE comprised twelve choices examining preferences for six attributes of the health check. Additionally, the questionnaire included post-choice certainty questions and attitudinal measures developed from the Theory of Planned Behaviour (TPB). Four weeks later, these participants were offered a real choice between two actual health-checks (Phase II). Their actual choices were compared with DCE-predicted choices; if these differed, participants were invited to an in-depth, face-toface interview (Phase III). In Phase IV, leaflets promoting the service were handed out to the local population and uptake was compared with that predicted by the DCE. Results: The DCE was completed by 423 individuals; 133 (31.4%) were contactable in Phase II and 10 were interviewed in Phase III. The DCE suggested that consumers preferred a healthcheck that was: cheaper; delivered by experienced personnel; with follow-up; available by appointment; lasted 30-minutes; with weekend availability. The estimated value of the health check was £49. The DCE correctly predicted 42.1% of participants' actual choices in Phase II. Calibration of the DCE with certainty questions and incorporation of the TPB into DCE improved DCE-prediction. From the interviews in Phase III, reasons for discrepancies in stated choice and actual behaviour included differences in decision-making processes in DCE and real life, attitudinal and other contextual factors (e.g. timing, location). Discussion & Conclusion: Consumers valued the role of community pharmacists in providing public health services targeted at disease prevention. This finding supports government policies to increase community pharmacists' contribution to public health. Whilst the results raised questions about the external validity of DCE in this study context, different choice modelling approaches (i.e. incorporation of TPB and certainty calibration) improved external validity of DCE. Qualitative findings provided deeper insights into why participants did not do as they said and do not necessarily invalidate DCE findings. The findings from this study should not act as a deterrent to future use of DCEs but more to raise awareness of the need to take into account how choices are made in real life. Ideally the development of DCE and the modelling of choice responses should mimic as closely as possible the decision-making process individuals face in reality.

Thesis (Ph. D.)--University of Texas at Austin, 2002. / Vita. Includes bibliographical references. Available also from UMI Company.

Thesis (Ph. D.)--University of Washington, 1998. / Vita. Includes bibliographical references (leaves [141]-150).

Thesis (M.H.P.A.)--Washington State University, May 2009. / Title from PDF title page (viewed on Apr. 13, 2010). "Department of Health Policy and Administration." Includes bibliographical references (p. 37-46).

Thesis (Ph. D.)--University of Rhode Island, 2003. / Typescript. Includes bibliographical references (leaves 204-227).

Thesis (M.H.P.A.)--Washington State University, May 2010. / Title from PDF title page (viewed on July 20, 2010). "Department of Health Policy and Administration." Includes bibliographical references (p. 30-35).

Thesis (M.H.P.A.)--Washington State University, May 2010. / Title from PDF title page (viewed on July 22, 2010). "Department of Health Policy and Administration." Includes bibliographical references (p. 42-51).