School of Pharmacy, Newcastle University, Newcastle upon Tyne, UK.
Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK.
BMJ Open. 2018 Aug 1;8(7):e022109. doi: 10.1136/bmjopen-2018-022109.
To (1) explore the clustering of community pharmacies in England and (2) determine the relationship between community pharmacy clustering, urbanity and deprivation.
An area-level analysis spatial study.
England.
Community pharmacy clustering determined as a community pharmacy located within 10 min walking distance to another community pharmacy.
Addresses and postal codes of each community pharmacy in England were used in the analysis. Each pharmacy postal code was assigned to a lower layer super output area, which was then matched to urbanity (urban, town and fringe or village, hamlet and isolated dwellings) and deprivation decile (using the Index of Multiple Deprivation score).
75% of community pharmacies in England were located in a 'cluster' (within 10 min walking distance of another pharmacy): 19% of community pharmacies were in a cluster of two, while 56% of community pharmacies were in clusters of three or more. There was a linear relationship between community pharmacy clustering and social deprivation-with clustering more prevalent in areas of higher deprivation: for community pharmacies located in areas of lowest deprivation (decile 1), there was a significantly lower risk of clustering compared with community pharmacies located in areas of highest deprivation (relative risk 0.12 (95% CI 0.10 to 0.16)).
Clustering of community pharmacies in England is common, although there is a positive trend between community pharmacy clustering and social deprivation, whereby clustering is more significant in areas of high deprivation. Arrangements for future community pharmacy funding should not solely focus on distance from one pharmacy to another as means of determining funding allocation, as this could penalise community pharmacies in our most deprived communities, and potentially have a negative effect on other healthcare providers, such as general practitioner and accident and emergency services.
（1）探索英格兰社区药店的集聚情况，（2）确定社区药店集聚、城市化和贫困程度之间的关系。
基于区域层面的分析性空间研究。
英格兰。
社区药店集聚度通过在 10 分钟步行距离内有另一家社区药店来确定。
使用英格兰每家社区药店的地址和邮政编码进行分析。每个药店的邮政编码被分配到一个较低层次的超级输出区，然后与城市化（城市、城镇和边缘区或村庄、小村庄和孤立住所）和贫困程度十分位数（使用多维度贫困指数得分）相匹配。
英格兰 75%的社区药店位于“集聚”区域（距离另一家药店 10 分钟步行距离内）：19%的社区药店位于 2 家药店的集聚区，而 56%的社区药店位于 3 家或更多药店的集聚区。社区药店集聚与社会贫困程度之间存在线性关系——集聚在贫困程度较高的地区更为普遍：与位于贫困程度最低（十分位 1）地区的社区药店相比，位于贫困程度最高（十分位 10）地区的社区药店集聚的风险显著更高（相对风险 0.12（95%CI 0.10 至 0.16））。
英格兰社区药店的集聚现象很普遍，尽管社区药店集聚与社会贫困程度之间存在正相关趋势，但在贫困程度较高的地区，集聚程度更为显著。未来社区药店资金安排不应仅仅关注每家药店之间的距离，作为确定资金分配的手段，因为这可能会使贫困社区的社区药店处于不利地位，并可能对其他医疗保健提供者（如全科医生和急症服务）产生负面影响。
