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Pharmacy density in rural and urban communities in the state of Oregon and the association with hospital readmission rates

Published:August 01, 2016DOI:https://doi.org/10.1016/j.japh.2016.05.008

      Abstract

      Objectives

      To characterize the pharmacy density in rural and urban communities with hospitals and to examine its association with readmission rates.

      Design

      Ecologic study.

      Setting

      Forty-eight rural and urban primary care service areas (PCSAs) in the state of Oregon.

      Participants

      All hospitals in the state of Oregon.

      Intervention

      Pharmacy data were obtained from the Oregon Board of Pharmacy based on active licensure. Pharmacy density was calculated by determining the cumulative number of outpatient pharmacy hours in a PCSA.

      Main outcome measures

      Oregon hospital 30-day all-cause readmission rates were obtained from the Centers for Medicare and Medicaid Services and were determined with the use of claims data of patients 65 years of age or older who were readmitted to the hospital within 30 days from July 2012 to June 2013.

      Results

      Readmission rates for Oregon hospitals ranged from 13.5% to 16.5%. The cumulative number of pharmacy hours in PCSAs containing a hospital ranged from 54 to 3821 hours. As pharmacy density increased, the readmission rates decreased, asymptotically approaching a predicted 14.7% readmission rate for areas with high pharmacy density.

      Conclusion

      Urban hospitals were in communities likely to have more pharmacy access compared with rural hospitals. Future research should determine if increasing pharmacy access affects readmission rates, especially in rural communities.
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      Biography

      Sarah Bissonnette, PharmD, Postdoctoral Fellow, College of Pharmacy, Oregon State University/Oregon Health and Science University, Portland, OR

      Biography

      Leah Goeres, PharmD, Postdoctoral Fellow, College of Pharmacy, Oregon State University/Oregon Health and Science University, Portland, OR; Ambulatory Care Clinical Coordinator, CareOregon, Portland, OR

      Biography

      David S. H. Lee, PharmD, PhD, Assistant Professor, College of Pharmacy, Oregon State University/Oregon Health and Science University, Portland, OR