A model for a drug distribution system in remote Australia as a social determinant of health using event structure analysis
Abstract Background The social determinants of health include the health systems under which people live and utilize health services. One social determinant, for which pharmacists are responsible, is designing drug distribution systems that ensure patients have safe and convenient access to medicati...
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| Format: | Article |
| Language: | English |
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BMC
2017-09-01
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| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12913-017-2629-x |
| _version_ | 1818424531030638592 |
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| author | John P. Rovers Michelle D. Mages |
| author_facet | John P. Rovers Michelle D. Mages |
| author_sort | John P. Rovers |
| collection | DOAJ |
| description | Abstract Background The social determinants of health include the health systems under which people live and utilize health services. One social determinant, for which pharmacists are responsible, is designing drug distribution systems that ensure patients have safe and convenient access to medications. This is critical for settings with poor access to health care. Rural and remote Australia is one example of a setting where the pharmacy profession, schools of pharmacy, and regulatory agencies require pharmacists to assure medication access. Studies of drug distribution systems in such settings are uncommon. This study describes a model for a drug distribution system in an Aboriginal Health Service in remote Australia. The results may be useful for policy setting, pharmacy system design, health professions education, benchmarking, or quality assurance efforts for health system managers in similarly remote locations. The results also suggest that pharmacists can promote access to medications as a social determinant of health. The primary objective of this study was to propose a model for a drug procurement, storage, and distribution system in a remote region of Australia. The secondary objective was to learn the opinions and experiences of healthcare workers under the model. Methods Qualitative research methods were used. Semi-structured interviews were performed with a convenience sample of 11 individuals employed by an Aboriginal health service. Transcripts were analyzed using Event Structure Analysis (ESA) to develop the model. Transcripts were also analyzed to determine the opinions and experiences of health care workers. Results The model was comprised of 24 unique steps with seven distinct components: choosing a supplier; creating a list of preferred medications; budgeting and ordering; supply and shipping; receipt and storage in the clinic; prescribing process; dispensing and patient counseling. Interviewees described opportunities for quality improvement in choosing suppliers, legal issues and staffing, cold chain integrity, medication shortages and wastage, and adherence to policies. Conclusion The model illustrates how pharmacists address medication access as a social determinant of health, and may be helpful for policy setting, system design, benchmarking, and quality assurance by health system designers. ESA is an effective and novel method of developing such models. |
| first_indexed | 2024-12-14T13:59:31Z |
| format | Article |
| id | doaj.art-5c18105ed5984747b78c06b0571794e3 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-12-14T13:59:31Z |
| publishDate | 2017-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-5c18105ed5984747b78c06b0571794e32022-12-21T22:58:45ZengBMCBMC Health Services Research1472-69632017-09-0117111310.1186/s12913-017-2629-xA model for a drug distribution system in remote Australia as a social determinant of health using event structure analysisJohn P. Rovers0Michelle D. Mages1College of Pharmacy and Health Sciences, Drake UniversityCollege of Pharmacy and Health Sciences, Drake UniversityAbstract Background The social determinants of health include the health systems under which people live and utilize health services. One social determinant, for which pharmacists are responsible, is designing drug distribution systems that ensure patients have safe and convenient access to medications. This is critical for settings with poor access to health care. Rural and remote Australia is one example of a setting where the pharmacy profession, schools of pharmacy, and regulatory agencies require pharmacists to assure medication access. Studies of drug distribution systems in such settings are uncommon. This study describes a model for a drug distribution system in an Aboriginal Health Service in remote Australia. The results may be useful for policy setting, pharmacy system design, health professions education, benchmarking, or quality assurance efforts for health system managers in similarly remote locations. The results also suggest that pharmacists can promote access to medications as a social determinant of health. The primary objective of this study was to propose a model for a drug procurement, storage, and distribution system in a remote region of Australia. The secondary objective was to learn the opinions and experiences of healthcare workers under the model. Methods Qualitative research methods were used. Semi-structured interviews were performed with a convenience sample of 11 individuals employed by an Aboriginal health service. Transcripts were analyzed using Event Structure Analysis (ESA) to develop the model. Transcripts were also analyzed to determine the opinions and experiences of health care workers. Results The model was comprised of 24 unique steps with seven distinct components: choosing a supplier; creating a list of preferred medications; budgeting and ordering; supply and shipping; receipt and storage in the clinic; prescribing process; dispensing and patient counseling. Interviewees described opportunities for quality improvement in choosing suppliers, legal issues and staffing, cold chain integrity, medication shortages and wastage, and adherence to policies. Conclusion The model illustrates how pharmacists address medication access as a social determinant of health, and may be helpful for policy setting, system design, benchmarking, and quality assurance by health system designers. ESA is an effective and novel method of developing such models.http://link.springer.com/article/10.1186/s12913-017-2629-xDrug distributionSocial determinants of healthMedication accessAustraliaRural and remote healthPharmacy services |
| spellingShingle | John P. Rovers Michelle D. Mages A model for a drug distribution system in remote Australia as a social determinant of health using event structure analysis BMC Health Services Research Drug distribution Social determinants of health Medication access Australia Rural and remote health Pharmacy services |
| title | A model for a drug distribution system in remote Australia as a social determinant of health using event structure analysis |
| title_full | A model for a drug distribution system in remote Australia as a social determinant of health using event structure analysis |
| title_fullStr | A model for a drug distribution system in remote Australia as a social determinant of health using event structure analysis |
| title_full_unstemmed | A model for a drug distribution system in remote Australia as a social determinant of health using event structure analysis |
| title_short | A model for a drug distribution system in remote Australia as a social determinant of health using event structure analysis |
| title_sort | model for a drug distribution system in remote australia as a social determinant of health using event structure analysis |
| topic | Drug distribution Social determinants of health Medication access Australia Rural and remote health Pharmacy services |
| url | http://link.springer.com/article/10.1186/s12913-017-2629-x |
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