Impact of changes in pharmacy accessibility on patient utilization of prescription services.

摘要

The main objective of this study was to investigate if pharmacy closures had changed the distance patients traveled to their pharmacies and in turn affected patient prescription drug utilization. Iowa Medicaid claims data and pharmacy closing data were used. Sixteen pharmacies were randomly selected from all pharmacies that closed in 1994. Each of the closed pharmacies was matched by a pharmacy that had not closed for comparison. Patient cohorts were defined by patients receiving 100% of their prescriptions from a single pharmacy over a six month period prior to the month of closing. Andersen and Newman's Health Behavior Model served as the theoretical framework in the study. Correlation, t-test and multiple regression were applied for data analysis.;Major findings of this study include the following: (1) There were fewer pharmacies in more rural areas; (2) Rural areas tended to have more pharmacy closures; (3) On average, patients traveled 7 miles to their pharmacies; (4) Patients who previously used a closed pharmacy traveled longer distances to another pharmacy after the closing of the pharmacy; and (5) The number of prescription claims was negatively correlated to distance to pharmacy.;The results of the study raised a concern about pharmacy accessibility in rural areas. Especially the number of pharmacies in rural areas is decreasing and resulting in an increase of distance patients travel to pharmacies. As distance increased, use of prescription medication declines. The impact of change in rural environments with respect to pharmacies still needs to be examined for clinical outcomes.