Concurrent utilization of chiropractic, prescription medicines, nonprescription medicines and alternative health care.

This study examines the use of chiropractic, prescription medicines, nonprescription medicines and alternative health care for two independent samples representative of the population of Edmonton, Alberta, Canada in 1979 (n = 439) and again in 1988 (n = 464). While the usage of prescription medicines was unchanged from 1979 to 1988, utilization of nonprescription medicines, chiropractic and alternative health care increased. Users of chiropractic tended to be concurrent users of the conventional health care system, although they were also more likely to utilize alternative health care. This study shows that Edmontonians tend to select their health care concurrently from various health care modalities including both prescription and nonprescription medicines and conventional and alternative health care.

Hospital pharmacy in Canada.

The status of Canadian hospital pharmacy and the impact of national hospital insurance on its development are discussed. The provision of health care services for Canadians is shared by the federal and provincial governments. The federal government enacts protective and regulatory legislation, compiles health statistics, promotes research, and provides direct health care for those citizens for whom it is directly responsible. Each province is responsible for hospitals, the education and training of health care professionals, public health, and the financing and administration of health insurance for all its citizens. Largely because of line-item budget allocations and a bureaucratic tendency to equalize services for the whole population, funds for existing pharmaceutical services have been assured but the introduction of upgraded or innovative programs has been difficult to achieve. The result has been an even quality of health care services, including pharmacy, throughout the country and a deficiency in clinical pharmacy programs and the trained personnel to run them. The last decade has brought advances, however, as allocation methods have changed and both hospital and insurance administrators have recognized the patient benefits and cost effectiveness of many of the newer pharmacy programs. The main challenges facing Canadian hospital pharmacy are to upgrade clinical services and education and to improve managerial and bureaucratic competence among department directors.