Assessing spatial inequalities in accessing community pharmacies: a mixed geographically weighted approach

  • Alexander Domnich | alexander.domnich@gmail.com Department of Health Sciences, University of Genoa, Italy. http://orcid.org/0000-0001-9608-8892
  • Lucia Arata Department of Health Sciences, University of Genoa, Italy.
  • Daniela Amicizia Department of Health Sciences, University of Genoa, Italy.
  • Alessio Signori Department of Health Sciences, University of Genoa, Italy.
  • Roberto Gasparini Department of Health Sciences, University of Genoa, Italy.
  • Donatella Panatto Department of Health Sciences, University of Genoa, Italy.

Abstract

Geographical accessibility is an important determinant for the utilisation of community pharmacies. The present study explored patterns of spatial accessibility with respect to pharmacies in Liguria, Italy, a region with particular geographical and demographic features. Municipal density of pharmacies was proxied as the number of pharmacies per capita and per km2, and spatial autocorrelation analysis was performed to identify spatial clusters. Both non-spatial and spatial models were constructed to predict the study outcome. Spatial autocorrelation analysis showed a highly significant clustered pattern in the density of pharmacies per capita (I=0.082) and per km2 (I=0.295). Potentially under-supplied areas were mostly located in the mountainous hinterland. Ordinary least-squares (OLS) regressions established a significant positive relationship between the density of pharmacies and income among municipalities located at high altitudes, while no such association was observed in lower-lying areas. However, residuals of the OLS models were spatially auto-correlated. The best-fitting mixed geographically weighted regression (GWR) models outperformed the corresponding OLS models. Pharmacies per capita were best predicted by two local predictors (altitude and proportion of immigrants) and two global ones (proportion of elderly residents and income), while the local terms population, mean altitude and rural status and the global term income functioned as independent variables predicting pharmacies per km2. The density of pharmacies in Liguria was found to be associated with both socio-economic and landscape factors. Mapping of mixed GWR results would be helpful to policy-makers.

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Author Biographies

Alexander Domnich, Department of Health Sciences, University of Genoa
Department of Health Sciences
Lucia Arata, Department of Health Sciences, University of Genoa
Department of Health Sciences
Daniela Amicizia, Department of Health Sciences, University of Genoa
Department of Health Sciences
Alessio Signori, Department of Health Sciences, University of Genoa
Department of Health Sciences
Roberto Gasparini, Department of Health Sciences, University of Genoa
Department of Health Sciences
Donatella Panatto, Department of Health Sciences, University of Genoa
Department of Health Sciences
Published
2016-11-16
Section
Original Articles
Keywords:
Community pharmacies, Geographical accessibility, Access inequalities, Geographically weighted regression
Statistics
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How to Cite
Domnich, A., Arata, L., Amicizia, D., Signori, A., Gasparini, R., & Panatto, D. (2016). Assessing spatial inequalities in accessing community pharmacies: a mixed geographically weighted approach. Geospatial Health, 11(3). https://doi.org/10.4081/gh.2016.457