J Am Pharm Assoc (2003). 2024 May-Jun;64(3):102052. doi: 10.1016/j.japh.2024.102052. Epub 2024 Feb 23.
Community pharmacies are a critical part of the health care provision system. Yet less is understood about the spatial accessibility to pharmacies and how people travel to reach these services.
This study compared spatial accessibility and actual travel to different types of pharmacies among selected neighborhoods in the Detroit region.
Three types of neighborhoods were selected and compared, including two lower income Black urban neighborhoods of high-density and four upper income White suburbs (two of low density and two of high density). Spatial accessibility was computed by pharmacy type and compared among neighborhoods using ANOVA. Pharmacy trips reported in a travel survey were geocoded and linked with community pharmacies in a list generated from ReferenceUSA business data. Destination choices were mapped and the relationship between spatial accessibility and actual distance traveled was examined using ordinary least squares regressions.
On average, urban residents in Detroit had higher access to local independent pharmacies (0.74 miles to the nearest one) but relatively lower access to national chains (1.35 miles to the nearest one), which most residents relied on. Urban residents also tended to shop around more for services even among national chains. In fact, they bypassed nearby local independent pharmacies and traveled long distances to use farther pharmacies, primarily national chains. The average trip distance to pharmacy was 2.1 miles for urban residents, but only 1.1 miles and 1.5 miles for residents in high-density suburbs and low-density suburbs, respectively.
Supposedly good spatial access considering all pharmacies together may mask excessive burden in reaching the pharmacy services needed in low-income minority urban communities, as shown in the case of Detroit. Thus, when mapping pharmacy deserts, it is important to distinguish spatial accessibility among different pharmacy types.
社区药店是医疗服务提供系统的重要组成部分。然而，人们对药店的空间可达性以及人们如何前往这些服务的了解较少。
本研究比较了底特律地区选定社区中不同类型药店的空间可达性和实际出行情况。
选择并比较了三种类型的社区，包括两个高密度低收入的黑人城市社区和四个高收入白人郊区（两个低密度和两个高密度）。通过药店类型计算空间可达性，并使用方差分析比较社区之间的可达性。在旅行调查中报告的药店旅行被地理编码，并与从 ReferenceUSA 商业数据生成的列表中的社区药店链接。目的地选择进行了映射，并使用普通最小二乘回归检查空间可达性与实际行驶距离之间的关系。
平均而言，底特律的城市居民到当地独立药店的可达性更高（到最近的一家药店为 0.74 英里），但到全国连锁店的可达性相对较低（到最近的一家药店为 1.35 英里），而大多数居民依赖于全国连锁店。城市居民也倾向于在服务方面进行更多的购物，即使在全国连锁店中也是如此。事实上，他们绕过附近的当地独立药店，长途跋涉去使用更远的药店，主要是全国连锁店。城市居民到药店的平均出行距离为 2.1 英里，但高密度郊区和低密度郊区的居民分别为 1.1 英里和 1.5 英里。
考虑到所有药店，假设的良好空间可达性可能掩盖了低收入少数族裔城市社区中获得所需药店服务的过度负担，就底特律的情况而言就是如此。因此，在绘制药店荒漠图时，区分不同药店类型之间的空间可达性很重要。
