Adam Todd
Cutting care clusters: the creation of an inverse pharmacy care law? An area-level analysis exploring the clustering of community pharmacies in England
Todd, Adam; Thomson, Katie; Kasim, Adetayo; Bambra, Clare
Authors
Katie Thomson
Adetayo Kasim
Clare Bambra
Abstract
Objectives To (1) explore the clustering of community pharmacies in England and (2) determine the relationship between community pharmacy clustering, urbanity and deprivation. Design An area-level analysis spatial study. Setting England. Primary and secondary outcome measures Community pharmacy clustering determined as a community pharmacy located within 10 min walking distance to another community pharmacy. Participants Addresses and postal codes of each community pharmacy in England were used in the analysis. Each pharmacy postal code was assigned to a lower layer super output area, which was then matched to urbanity (urban, town and fringe or village, hamlet and isolated dwellings) and deprivation decile (using the Index of Multiple Deprivation score). Results 75% of community pharmacies in England were located in a ‘cluster’ (within 10 min walking distance of another pharmacy): 19% of community pharmacies were in a cluster of two, while 56% of community pharmacies were in clusters of three or more. There was a linear relationship between community pharmacy clustering and social deprivation—with clustering more prevalent in areas of higher deprivation: for community pharmacies located in areas of lowest deprivation (decile 1), there was a significantly lower risk of clustering compared with community pharmacies located in areas of highest deprivation (relative risk 0.12 (95% CI 0.10 to 0.16)). Conclusions Clustering of community pharmacies in England is common, although there is a positive trend between community pharmacy clustering and social deprivation, whereby clustering is more significant in areas of high deprivation. Arrangements for future community pharmacy funding should not solely focus on distance from one pharmacy to another as means of determining funding allocation, as this could penalise community pharmacies in our most deprived communities, and potentially have a negative effect on other healthcare providers, such as general practitioner and accident and emergency services.
Citation
Todd, A., Thomson, K., Kasim, A., & Bambra, C. (2018). Cutting care clusters: the creation of an inverse pharmacy care law? An area-level analysis exploring the clustering of community pharmacies in England. BMJ Open, 8(7), Article e022109. https://doi.org/10.1136/bmjopen-2018-022109
Journal Article Type | Article |
---|---|
Acceptance Date | May 23, 2018 |
Online Publication Date | Aug 1, 2018 |
Publication Date | Aug 1, 2018 |
Deposit Date | Sep 21, 2018 |
Publicly Available Date | Sep 21, 2018 |
Journal | BMJ Open |
Publisher | BMJ Publishing Group |
Peer Reviewed | Peer Reviewed |
Volume | 8 |
Issue | 7 |
Article Number | e022109 |
DOI | https://doi.org/10.1136/bmjopen-2018-022109 |
Files
Published Journal Article
(5.5 Mb)
PDF
Publisher Licence URL
http://creativecommons.org/licenses/by-nc/4.0/
Copyright Statement
© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
You might also like
Multisite educational trials: estimating the effect size and its confidence intervals
(2021)
Journal Article
Downloadable Citations
About Durham Research Online (DRO)
Administrator e-mail: dro.admin@durham.ac.uk
This application uses the following open-source libraries:
SheetJS Community Edition
Apache License Version 2.0 (http://www.apache.org/licenses/)
PDF.js
Apache License Version 2.0 (http://www.apache.org/licenses/)
Font Awesome
SIL OFL 1.1 (http://scripts.sil.org/OFL)
MIT License (http://opensource.org/licenses/mit-license.html)
CC BY 3.0 ( http://creativecommons.org/licenses/by/3.0/)
Powered by Worktribe © 2024
Advanced Search