An adapted two-step floating catchment area method accounting for urban-rural differences in spatial access to...

Area of Science:

• Geographic Information Systems (GIS)
• Spatial analysis
• Health services research

Background:

• Assessing geographic access to healthcare services like pharmacies is crucial for public health.
• Traditional spatial access measures may not adequately capture urban-rural disparities.
• The Centers for Medicare & Medicaid Services (CMS) has specific criteria for service access.

Purpose of the Study:

• To adapt the two-step floating catchment area (2SFCA) approach to incorporate urban-rural variations in pharmacy access.
• To evaluate the performance of this adapted method compared to traditional approaches.

Main Methods:

• Developed a novel urban-rural 2SFCA (UR-2SFCA) method, classifying census tracts and pharmacies as urban, suburban, or rural.
• Applied differential catchment area sizes (2, 5, 15 miles) based on CMS criteria for different zones.
• Compared UR-2SFCA measures with traditional 2SFCA measures using spatial distribution analysis and Spearman correlations with socio-demographics.

Main Results:

• The UR-2SFCA method demonstrated superior performance over fixed-size catchment area measures.
• It showed stronger correlations with selected census variables, indicating better representation of accessibility.
• UR-2SFCA reduced the number of areas classified as having 'no access' and provided more granular spatial variations.

Conclusions:

• The findings support the hypothesis that spatial pharmacy access assessments must account for regional urbanicity and rurality.
• The adapted UR-2SFCA method offers a more refined tool for understanding and addressing disparities in pharmacy access.