Law Michael R, Heard Deborah, Fisher Judith, Douillard Jay, Muzika Greg, Sketris Ingrid S
Centre for Health Services and Policy Research, School of Population and Public Health (Law, Heard), University of British Columbia, Vancouver, BC.
Can Pharm J (Ott). 2013 Jan;146(1):39-46. doi: 10.1177/1715163512473062.
Geographic proximity is an important component of access to primary care and the pharmaceutical services of community pharmacies. Variations in access to primary care have been found between rural and urban areas in Canadian and international jurisdictions. We studied access to community pharmacies in the province of Nova Scotia.
We used information on the locations of 297 community pharmacies operating in Nova Scotia in June 2011. Population estimates at the census block level and network analysis were used to study the number of Nova Scotia residents living within 800 m (walking) and 2 km and 5 km (driving) distances of a pharmacy. We then simulated the impact of pharmacy closures on geographic access in urban and rural areas.
We found that 40.3% of Nova Scotia residents lived within walking distance of a pharmacy; 62.6% and 78.8% lived within 2 km and 5 km, respectively. Differences between urban and rural areas were pronounced: 99.2% of urban residents lived within 5 km of a pharmacy compared with 53.3% of rural residents. Simulated pharmacy closures had a greater impact on geographic access to community pharmacies in rural areas than urban areas.
The majority of Nova Scotia residents lived within walking or short driving distance of at least 1 community pharmacy. While overall geographic access appears to be lower than in the province of Ontario, the difference appears to be largely driven by the higher proportion of rural dwellers in Nova Scotia. Further studies should examine how geographic proximity to pharmacies influences patients' access to traditional and specialized pharmacy services, as well as health outcomes and adherence to therapy. Can Pharm J 2013;146:39-46.
地理位置接近是获得初级保健和社区药房药品服务的一个重要因素。在加拿大及其他国家辖区的农村和城市地区，人们获得初级保健的机会存在差异。我们对新斯科舍省社区药房的可及性进行了研究。
我们利用了2011年6月在新斯科舍省运营的297家社区药房的位置信息。使用人口普查街区层面的人口估计数和网络分析来研究居住在距离药房800米（步行）、2公里和5公里（驾车）范围内的新斯科舍省居民数量。然后，我们模拟了药房关闭对城市和农村地区地理可及性的影响。
我们发现，40.3%的新斯科舍省居民居住在距离药房步行可达的范围内；分别有62.6%和78.8%的居民居住在距离药房2公里和5公里的范围内。城乡差异显著：99.2%的城市居民居住在距离药房5公里以内，而农村居民这一比例为53.3%。模拟的药房关闭对农村地区社区药房地理可及性的影响大于城市地区。
大多数新斯科舍省居民居住在距离至少一家社区药房步行或短距离驾车可达的范围内。虽然总体地理可及性似乎低于安大略省，但这种差异似乎主要是由新斯科舍省农村居民比例较高所致。进一步的研究应考察接近药房的地理位置如何影响患者获得传统和专业药房服务的机会，以及健康结果和治疗依从性。《加拿大药学杂志》2013年；146:39 - 46。
