Fewer Pharmacies May Mean More Readmissions

Oregon study correlates pharmacy density with return rates

A study conducted by the University of Oregon has found that hospital readmission rates are higher in Oregon communities with limited access to pharmacy services, according to an article posted on the HealthLeaders Media website.

The study involved 507 hospitals in 48 rural and urban primary care service areas (PCSAs) in the state of Oregon. Pharmacy density was calculated by determining the cumulative number of outpatient pharmacy hours in a PCSA. 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 from patients 65 years of age or older who were readmitted to hospitals within 30 days from July 2012 to June 2013.

The cumulative number of outpatient pharmacy hours (the total number of hours pharmacies were open) in PCSAs containing a hospital ranged from 54 to 3,821. PCSAs with fewer than 350 outpatient pharmacy hours were defined as low density. Areas with more than 1,000 cumulative pharmacy hours were considered high density.

All rural hospitals fell into the low-density range, while most urban hospitals were in high-density PCSAs. People in low-density areas were older, had less education, and were more likely than residents of high-density areas to be “non-Hispanic white.”

The researchers found that readmission rates for Oregon hospitals ranged from 13.5% to 16.5%. As pharmacy density increased, readmission rates decreased, approaching a predicted 14.7% readmission rate for areas with high pharmacy density.

The authors suggested that community pharmacists can reduce readmission rates because they are able to “assess medication adherence, provide education, and offer self-care recommendations.”

The authors also noted that they could not identify whether pharmacy access or population characteristics were independently associated with readmissions. They called for more research, pointing out that hospitals in Maine, Michigan, and New York have opened outpatient pharmacies to improve access to care.

The study was published in the Journal of the American Pharmacists Association.

Sources: HealthLeaders Media; August 16, 2016; and JAPhA; August 2, 2016.