Urban-Rural Disparities in Spatio-Temporal Accessibility of Pharmacy Care: A Case Study of Vermont, USA
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Background
Pharmacies are more accessible than other health care services, providing front-line primary and preventative health care. Recent research has underscored the importance of pharmacy access for reaching underserved and rural populations. However, minimal attention has been given to the spatial and temporal dimensions of access to pharmacy care despite the evidence suggesting that geographic accessibility impacts the utilization of various healthcare services.
Methods
In this study, we measured spatiotemporal variation in access to pharmacy care across Vermont using the Enhanced 2-step Floating Catchment Area (E2SFCA) method. We surveyed pharmacies during Fall 2023 in Vermont to collect data on staffing levels and hours of operation and paired this data with population and an OpenStreetMap road network. We computed hourly spatial accessibility scores by town geographic units across for weekdays, Saturdays, and Sundays, and compared results for metropolitan, micropolitan, and rural areas, testing for significance using the Kruskal-Wallis H Test.
Results
Our findings reveal significant disparities in pharmacy access between rural and urban areas across virtually all temporal segments. Accessibility was diminished during weekends across all locations, highlighting challenges in accessing care outside of conventional business hours. Accessibility gaps between rural and non-rural towns were exacerbated outside of standard weekday business hours.
Conclusions
Our study revealed important urban-rural differences in the spatial accessibility of pharmacies across Vermont and characterized how these accessibility differences vary temporally, with increasing disparities outside normal working hours. The results are useful for informing public health policy and the provision of health services. We have also demonstrated the importance of data on pharmacy operating hours and service levels for modeling spatiotemporal pharmacy accessibility, highlighting the need for further research and improving centralized databases to facilitate research in this field.
