SELF-CARE AND PHARMACEUTICAL ACCESS

专业药学服务可能受到限制的程度 以及这种限制对充分的卫生保健的影响， 农村老年人仍然是一个悬而未决的问题。 主要目标 研究内容包括：（1）提供一个详细、客观的农村老年人生活质量的测量方法 地理上接近医生和药房;（2）确定是否 地理限制导致个人替代家庭 处方药的补救措施和非处方药;以及 (3)来产生关于个人属性对 症状自我护理 本研究的设计是横断面和基于人群的。 一 270名爱荷华州农村65岁居民的空间分层随机样本 年龄较大的将被选中。 卫生部财务管理署 随机抽取爱荷华州医疗保险公司的名单和地址 将使用登记者作为抽样框架。 个人的距离 最近的药房和医生的住所将由 将地址与地理坐标联系起来。 采样框架将是 分层使用三个级别的距离最近的药店和 距离最近的医生。 这些将被排列以定义九个 地层。 将从每个分层中选择相同的样本量（n=30）。 访谈将收集所有症状、咨询和治疗 前七天发生的事件以及 个体

The extent to which professional pharmaceutical care access may be limited and the implications of such limitations for adequacy of health care among the rural elderly remain unanswered questions. Principal goals of this study are: (1) to provide a detailed, objective measure of rural elders' geographical access to physicians and pharmacies; (2) to determine whether restricted geographical access leads individuals to substitute home remedies and nonprescription medications for prescription medications; and (3) to generate hypotheses about the effects of individuals' attributes on symptom self-care. The design for the study is cross-sectional and population-based. A spatially stratified random sample of 270 rural Iowa residents aged 65 years and older will be selected. Health Care Financing Administration tapes that list name and address of a random sample of Iowa Medicare enrollers will be used as the sampling frame. The distance of individuals' residences from the nearest pharmacy and physician will be determined by linking addresses to geographical coordinates. The sampling frame will be stratified using three levels of distance to the nearest pharmacy and of distance to the nearest physician. These will be permuted to define nine strata. Equal sample sizes (n=30) will be selected from each stratum. Interviews will collect all symptoms, consultations, and treatments occurring in the preceding seven days as well as data on attributes of individuals.