Law Michael R, Dijkstra Anna, Douillard Jay A, Morgan Steven G
Assistant Professor, Centre for Health Services and Policy Research, School of Population and Public Health, University of British Columbia, Vancouver, BC.
Healthc Policy. 2011 Feb;6(3):36-46. doi: 10.12927/hcpol.2011.22097.
Proximity is an important component of access to healthcare services. Recent changes in generic pricing in Ontario have caused speculation about pharmacy closures. However, there is little information on the current geographic accessibility of pharmacies. Therefore, we studied geographic access to pharmacies and modelled the impact of possible closures.
We used location data on the 3,352 accredited community pharmacies from the Ontario College of Pharmacists and population estimates at the census dissemination block level. Using network analysis, we determined the share of Ontario's population who reside in a census dissemination block within three road travel distances of a community pharmacy: 800 m (walking), 2 km and 5 km (driving). We then simulated the effects on these measures of 10% to 50% reductions in the number of community pharmacies in Ontario.
Approximately 63.6% of the Ontario population reside in a dissemination block located within walking distance of one or more pharmacies; 84.6% and 90.7% reside within 2-km and 5-km driving distances, respectively. Randomly removing 30% of Ontario's community pharmacies reduces these estimates to 56.0%, 81.4% and 89.0% for each distance, respectively; a 50% reduction results in 48.3%, 77.1% and 87.2%, respectively.
Pharmacies are geographically accessible for a majority of the Ontario population. Moreover, it appears that modest closures would have only a small impact on geographic access to pharmacies. However, closures may have other impacts on access, such as cost, waiting time and reduced patient choice.
距离是获得医疗保健服务的一个重要因素。安大略省近期通用药品定价的变化引发了对药房关闭的猜测。然而，关于当前药房的地理可及性信息却很少。因此，我们研究了药房的地理可及性，并对可能的关闭影响进行了建模。
我们使用了安大略省药剂师学院提供的3352家经认可的社区药房的位置数据以及人口普查传播区一级的人口估计数。通过网络分析，我们确定了居住在社区药房三个道路出行距离（800米步行距离、2公里和5公里驾车距离）内人口普查传播区内的安大略省人口比例。然后，我们模拟了安大略省社区药房数量减少10%至50%对这些指标的影响。
大约63.6%的安大略省人口居住在距离一家或多家药房步行距离内的传播区内；分别有84.6%和90.7%的人口居住在2公里和5公里驾车距离内。随机移除安大略省30%的社区药房会使这些比例分别降至56.0%、81.4%和89.0%；减少50%则分别降至48.3%、77.1%和87.2%。
对于大多数安大略省人口来说，在地理上能够方便地到达药房。此外，似乎适度的关闭对药房的地理可及性只会产生较小的影响。然而，关闭可能会对就医产生其他影响，如成本、等待时间和患者选择减少等。
