Prescribing power and equitable access to care: Evidence from pharmacists in Ontario, Canada
研究加拿大安大略省2023年允许药剂师为小病开处方的政策，发现该政策使药店访问量增加16%，其他医疗机构访问量增加3%，且集中在物质匮乏社区，但非少数族裔、非移民群体受益最大。
Allowing pharmacists to directly treat patients may increase equitable access to healthcare and improve patient outcomes, but raises concerns about supply-side moral hazard or patient substitution away from regular physician-based care. We study the effects of a 2023 policy allowing pharmacists to prescribe for minor ailments in Ontario, Canada. We use Advan foot traffic data to measure how this policy affected visits to pharmacies and generated spillover effects on visits to non-pharmacy medical facilities (Research, 2022). Allowing pharmacists to prescribe led to a 16% increase in total visits to pharmacies and a 3% increase in visits to other providers. These increases were concentrated in materially deprived neighborhoods and benefited non-minority, non-immigrant populations the most. We use the policy as exogenous variation to identify substitution elasticities between pharmacy visits and traffic to other medical facilities. Overall, 20% of the increase in traffic to pharmacies spills over into increased use of outpatient-based care. Pharmacy traffic is a substitute for visits to hospitals and emergency departments, potentially as patients rely on pharmacists for triaging rather than emergency care.