How community pharmacies decide how and whether to provide immunization services
Community pharmacies, including chain and supermarket pharmacies, usually begin offering immunization services by bringing in outside groups to provide the service. A new study has identified some of the factors that influence a pharmacy to bring these services in-house, continue to outsource immunizations, or drop such services. Among the 119 pharmacies surveyed, 56 "fence sitters" continued to outsource their immunizations, 24 "backward movers" had dropped offering immunizations, and 26 "forward movers" had brought the services in-house. Pharmacy ownership type appeared to influence which group the pharmacy belonged to—the majority of independent stores (52 percent) were backward movers, while both chain/mass merchant and supermarket pharmacies were primarily fence sitters (50 percent and 67 percent, respectively). Supermarkets were the least likely to be backward movers (4 percent) and most likely to be forward movers (29 percent).
When comparing outsourced and in-house immunization services, fence sitters perceived in-house services to be more technically beneficial in terms of profitability, but less compatible with their pharmacy's operations and more complex to put into practice. Forward movers saw greater technical benefit, social benefit (in terms of impact on the community and profession), and compatibility with the pharmacy's operations from in-house services.
The researchers chose pharmacies in Washington State, which has been a leader in permitting trained pharmacists to deliver immunizations. The researchers analyzed responses of 106 of the 244 pharmacies that received survey packets about their perceptions of outsourced and in-house immunization services.
The study was funded in part by the Agency for Healthcare Research and Quality (HS14512). More details are in "Forward and backward transitions in pharmacy-based immunization services," by Salisa C. Westrick, Ph.D., in the March 2010 Research in Social and Administrative Pharmacy 6(1), pp. 18-31.
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