Factors Associated with Regional Disparities in Advanced Pharmacy Services in Japan

Regional disparities in pharmacy service provision are critical issues in aging societies. In Japan, home healthcare and aseptic preparation services are increasingly required because of population aging. However, the factors associated with inter-prefectural disparities remain poorly elucidated. In this study, service provision was standardized by estimated demand by using nationwide data at the prefectural level, and accessibility was evaluated as population coverage within a 6-km radius by using a geographic information system. Multiple regression and path analyses were performed to examine the associations among supply, accessibility, and workload. Considerable inter-prefectural variations were observed for home healthcare and aseptic preparation services compared with general dispensing. Accessibility was significantly associated with home healthcare service provision, whereas supply was significantly associated with the provision of aseptic preparation services. The path analysis further suggested that workload was indirectly associated with home healthcare services through supply and accessibility, whereas no such association was observed for aseptic preparation services. These findings suggest that factors associated with service provision may differ between service types and that different approaches may be required to address regional disparities.