Evaluation of Risk for Loss of Pharmacy Services in Small Rural Communities
Funded by the Community Pharmacy Foundation.
Stacey Stark (GAC), Jon Schommer (UM Pharmacy)
Changes in health utilization patterns, discounted third party reimbursement and an increased reliance on expensive technology combined with tenuous rural economies have and will continue to challenge the accessibility of pharmacy services in rural communities. A significant change in any critical factor or the introduction of a new risk factor has the potential to result in pharmacy closure. This is particularly detrimental to communities with only one community pharmacy and may result in increased travel distances to pharmacies and lower prescription refill rates.
The Geographic Information System (GIS) component of this research included the delineation of ‘service areas’ for each rural pharmacy. In order to conduct this analysis, census block data (US Census 2000) and road network data (TeleAtlas 2005, obtained as ESRI Streetmap) were used in ESRI ArcGIS Network Analyst. Pharmacies were located on the road network using geocoding, the process of assigning an x,y coordinate based on address information in the road spatial dataset. Following the necessary assumption that patrons will travel to the nearest pharmacy, non-overlapping service areas were derived for each pharmacy based on travel distance.
The resulting service areas for the non-rural pharmacies were eliminated. For each remaining service area polygon, census block demographics were summarized for the census blocks that have their center contained by that service area. The service area region was used to summarize metrics such as the number of persons served in that service area, the number of persons served with a given distance to that pharmacy, and the maximum distance traveled to that pharmacy.