Mapping pharmacy deserts in North Carolina: a geospatial analysis and its implications for University of North Carolina Health’s catchment population

IF 2.5 4区医学 Q3 PHARMACOLOGY & PHARMACY Journal of the American Pharmacists Association Pub Date : 2024-08-19 DOI:10.1016/j.japh.2024.102215

Nivedha Poondi, Andrew Douglas, Philip McDaniel, Kate Naper, Kamakshi Rao, Stephanie Kiser, Ina Liu

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Abstract

Background

Pharmacy deserts represent areas where residents face notable challenges to accessing pharmacies. North Carolina (NC) presents an intriguing case study due to its diverse geographic landscape yet lacks extensive research regarding its pharmacy deserts.

Objectives

This study aims to map pharmacy deserts in NC using pharmacy location and social determinants of health (SDOH) data measured using the social vulnerability index (SVI) and descriptively characterize health care utilization statistics for University of North Carolina (UNC) Health’s catchment population.

Methods

Pharmacy location data was compiled from the NC Board of Pharmacy. Pharmacy deserts were defined based on SVI > 0.75 and distance thresholds aligned to United States Department of Agriculture standards. Residential characteristics were retrieved from PolicyMap and Social Explorer databases. UNC Health patient utilization data were collected by UNC Pharmacy Data Analytics group for 3 NC counties.

Results

Two thousand and two NC pharmacies met inclusion criteria. 17.2% urban tracts (1.3M residents) and 4.25% rural tracts (0.14M residents) were identified as pharmacy deserts (adj. P < 0.001). Those residing in deserts had significantly less internet access, annual medical cost per capita, and access to homeless relief services as well as significantly higher food insecurity rates and Medicare cost per capita (adj. P < 0.001). UNC-specific health care utilization statistics for the 3 assessed counties were all poorer in deserts compared to nondeserts within the same counties (P > 0.05).

Conclusion

A geospatial map with the location of pharmacy deserts in NC was created to highlight differences in patient health care utilization, affecting rural and urban areas. By incorporating SDOH predictors, this study provides a more nuanced map of NC pharmacy deserts compared to reviewing distance to pharmacies alone. Higher rates of emergency department and inpatient visits in counties with more residents in pharmacy deserts suggests potential health outcomes associated with limited pharmacy access.

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绘制北卡罗来纳州的药房荒漠图：地理空间分析及其对北卡罗来纳大学健康中心覆盖人群的影响。

背景：药房荒漠是指居民在获得药房服务方面面临重大挑战的地区。北卡罗来纳州（NC）因其多样的地理景观而成为一个引人入胜的案例研究，但却缺乏对其药房荒漠的广泛研究：本研究旨在利用药房位置和使用社会脆弱性指数（SVI）测量的健康社会决定因素（SDOH）数据绘制北卡罗来纳州的药房荒漠图，并描述北卡罗来纳大学（UNC）健康中心覆盖人群的医疗保健利用统计数据：方法：药房位置数据由北卡罗来纳州药房委员会提供。根据 SVI >0.75 和与美国农业部 (USDA) 标准一致的距离阈值定义药房荒漠。住宅特征来自 PolicyMap 和 Social Explorer 数据库。UNC Health 的患者使用数据由 UNC 药房数据分析小组收集，涉及北卡罗来纳州的三个县。17.2%的城市地区（130 万居民）和 4.25%的农村地区（14 万居民）被认定为药房荒漠（adj. p0.05）：我们绘制了北卡罗来纳州药房荒漠位置的地理空间地图，以突显影响城乡地区患者医疗保健利用率的差异。通过纳入可持续发展的健康和卫生状况的预测因素，这项研究提供了一张更细致的北卡罗来纳州药房荒漠地图，而不是仅仅审查药房的距离。在药房荒漠居民较多的县，急诊室和住院病人就诊率较高，这表明有限的药房使用可能会带来潜在的健康后果。

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来源期刊

Journal of the American Pharmacists Association 医学-药学

CiteScore

3.30

自引率

14.30%

发文量

336

审稿时长

46 days

期刊介绍： The Journal of the American Pharmacists Association is the official peer-reviewed journal of the American Pharmacists Association (APhA), providing information on pharmaceutical care, drug therapy, diseases and other health issues, trends in pharmacy practice and therapeutics, informed opinion, and original research. JAPhA publishes original research, reviews, experiences, and opinion articles that link science to contemporary pharmacy practice to improve patient care.