Paula Rossignoli, Roberto Pontarolo, Fernando Fernandez-Llimos
{"title":"Reducing the Travel Burden for Patients to Access Specialized Medicines in Paraná, Brazil.","authors":"Paula Rossignoli, Roberto Pontarolo, Fernando Fernandez-Llimos","doi":"10.1016/j.vhri.2024.101065","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate the potential reduction in distance and travel time with a hypothetical municipal distribution of specialized component medicines in the state of Paraná.</p><p><strong>Methods: </strong>This was a cross-sectional study. Distances and travel times from all the 1025 residential locations in the state of Paraná to dispensing pharmacies were calculated in 2 different models: centralized model with drugs dispensed in the 22 state-owned pharmacies and decentralized model with drugs dispensed in the 399 municipal pharmacies. Road routes were calculated using the Google Maps Distance Matrix API and Euclidean distance using the haversine formula for the southern hemisphere. A sinuosity index was computed by the quotient between these 2 distances. Differences were evaluated through bivariate analyses and effect size measures were reported.</p><p><strong>Results: </strong>In the centralized model, the mean distance to the pharmacy was 59.5 km (SD 34.1), with a travel time of 1.0 hour (SD 0.5) and 579 residential locations (56.7%) more than 50 km away from the pharmacy, 286 (28.0%) between 25 and 50 km, and 156 (15.3%) less than 25 km. In the decentralized model, the mean distance was 10.8 km (SD 16.6), with a travel time of 0.2 hours (SD 0.3) and 14 locations (1.4%) more than 50 km away from the pharmacy, 96 (9.4%) between 25 and 50 km, and 911 (89.2%) less than 25 km. The decentralized model significantly reduced the sinuosity index.</p><p><strong>Conclusions: </strong>Implementing a decentralized dispensing of the specialized component drugs in the state of Paraná would produce a significant reduction in distance and travel time for patients enhancing drug accessibility.</p>","PeriodicalId":23497,"journal":{"name":"Value in health regional issues","volume":" ","pages":"101065"},"PeriodicalIF":1.4000,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Value in health regional issues","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1016/j.vhri.2024.101065","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 0
Abstract
Objectives: This study aimed to evaluate the potential reduction in distance and travel time with a hypothetical municipal distribution of specialized component medicines in the state of Paraná.
Methods: This was a cross-sectional study. Distances and travel times from all the 1025 residential locations in the state of Paraná to dispensing pharmacies were calculated in 2 different models: centralized model with drugs dispensed in the 22 state-owned pharmacies and decentralized model with drugs dispensed in the 399 municipal pharmacies. Road routes were calculated using the Google Maps Distance Matrix API and Euclidean distance using the haversine formula for the southern hemisphere. A sinuosity index was computed by the quotient between these 2 distances. Differences were evaluated through bivariate analyses and effect size measures were reported.
Results: In the centralized model, the mean distance to the pharmacy was 59.5 km (SD 34.1), with a travel time of 1.0 hour (SD 0.5) and 579 residential locations (56.7%) more than 50 km away from the pharmacy, 286 (28.0%) between 25 and 50 km, and 156 (15.3%) less than 25 km. In the decentralized model, the mean distance was 10.8 km (SD 16.6), with a travel time of 0.2 hours (SD 0.3) and 14 locations (1.4%) more than 50 km away from the pharmacy, 96 (9.4%) between 25 and 50 km, and 911 (89.2%) less than 25 km. The decentralized model significantly reduced the sinuosity index.
Conclusions: Implementing a decentralized dispensing of the specialized component drugs in the state of Paraná would produce a significant reduction in distance and travel time for patients enhancing drug accessibility.
目的：本研究旨在评估潜在的距离和旅行时间的减少与一个假设的城市分布的专业成分药物在帕拉纳州。方法：采用横断面研究。采用集中式模式（22家国有药店）和分散式模式（399家市属药店）两种不同的模式计算从帕拉南州1025个居民点到调剂药店的距离和出行时间。道路路线计算使用谷歌地图距离矩阵API和欧几里得距离使用哈弗斯公式南半球。通过这两个距离之间的商计算出一个曲度指数。通过双变量分析和效应量测量来评估差异。结果：集中式模型中，居民到药店的平均距离为59.5 km (SD为34.1)，出行时间为1.0 h (SD为0.5)；579个居民点（56.7%）距离药店大于50 km， 286个居民点（28.0%）在25 ~ 50 km之间，156个居民点（15.3%）距离药店小于25 km。在分散式模型中，平均距离为10.8 km (SD为16.6)，出行时间为0.2 h (SD为0.3)，距离药店超过50 km的有14个（1.4%），距离25 ~ 50 km的有96个（9.4%），距离药店小于25 km的有911个（89.2%）。分散模型显著降低了弯曲度指数。结论：在帕拉纳州实施分散式专业成分药的配药，将大大减少患者的路程和出行时间，提高药品可及性。
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
