Change in public satisfaction with community pharmacy services in Tartu, Estonia, between 1993 and 2005

Background: The health care systems of Estonia and other Baltic States underwent major reforms between restoration of independence from the USSR and admittance to the European Union. These reforms included changes to the regulations regarding the ownership, location, and number of community pharmacies. Objectives: The objective of this study was to analyze changes in access to, image of, and satisfaction with community pharmacy services in Tartu, Estonia, between 1993 and 2005. Methods: A survey instrument was mailed to a stratified random sample of 713 Estonians aged 20-69 years living in Tartu in 1993 and again to 1000 Estonians aged 20-69 years living in Tartu in 2005. Completed survey instruments were returned by 448 (63%) respondents in 1993 and 386 (39%) respondents in 2005. Results: Respondents in 2005 reported more frequent visits to pharmacies than respondents in 1993 (P=.012) and were more likely to indicate that pharmacies have more appropriate locations and opening hours (P < .001). In 2005, 71% of respondents reported always visiting the same pharmacy compared to 35% in 1993. The perceived trustworthiness of pharmacists remained constant. Respondents believed that the role of the pharmacist as a provider of drug information should be expanded; however, demand for extended community pharmacy services was low. Conclusion: Postindependence reforms to health care and pharmacy systems in Estonia have coincided with greater utilization of community pharmacy services. Higher rates of utilization and continued good standing within the community suggest that pharmacies are potentially well placed to make additional contributions to the evolving primary health care system in Estonia. (C) 2009 Elsevier Inc. All rights reserved.