Self-reported vs RUCA rural-urban classification among North Carolina pharmacists

Main Article Content

Keywords

Rural Population, Rural Health, Delivery of Health Care, Resource Allocation, Workplace, Pharmacists, Pharmacies, Pharmaceutical Services, Surveys and Questionnaires, North Carolina

Abstract

Background: The various ways in which rurality is defined can have large-scale implications on the provision of healthcare services.


Objective: The purpose of this study was to identify the relationship between self-perceived urban-rural distinction and the United States (US) Census tract-based Rural-Urban Commuting Area (RUCA) scheme that defines rurality among pharmacists.


Methods: This was a secondary analysis of data collected through a web-based survey of licensed pharmacists in North Carolina. Respondents self-reported their workplace settings, zip codes, and the pharmacy services offered in their place of work. Zip codes were replaced with the corresponding RUCA codes. The relationship between self-reported classification and RUCA codes was analyzed and a chi square test was performed to measure statistical significance.


Results: Of the original survey, 584 participants reported their workplace zip code and 579 reported their workplace setting (urban, rural). A significant difference was found between pharmacists who self-reported working in rural areas and the RUCA classifications – 94 (56.6%) of the 166 participants who reported working in “rural” areas were considered “urban” according to RUCA.


Conclusions: A significant discordance between pharmacists’ self-reported classification and the RUCA codes was found, with more respondents self-reporting their workplace area as “rural” as compared to the RUCA classification. Decision-makers examining the pharmacy workforce and pharmacy services should be aware of this discordance and its implications for resource allocation. We recommend the use of standardized metrics, when possible.

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