Performance Improvement 1999. Expanding Access to Care


TITLE: Pacific Partnerships for Health: Charting a New Course for the 21st Century

ABSTRACT: The U.S.-Associated Pacific Basin consists of six island jurisdictions. Three of these--American Samoa, Commonwealth of the Northern Mariana Islands (CNMI), and Guam--are considered U.S. flag territories. The other three--Federated States of Micronesia (FSM), Republic of the Marshall Islands (RMI), and Republic of Palau--are independent countries, but are freely associated with the United States. The total population of all these jurisdictions is 454,118. Although the health system and health status measures vary within and among the islands, almost all health indicators for islanders are worse than those for mainland Americans. The purposes of this study were to examine these issues and suggest possible approaches to improve the situation. The study concluded that four approaches should be used simultaneously to improve health: (1) adopt and support a viable system of community-based primary care and preventive services; (2) improve coordination within and between the jurisdictions and the U.S.; (3) increase community involvement and investment in health care; and (4) promote education and training of the health care workforce. The first two of these were given the highest priority. The Health Resources and Services Administration (HRSA) convened the Pacific Basin Health Summit in March 1998 to discuss the agency's role in improving health care in the region. Subsequently, HRSA has implemented several study recommendations including: (1) creation of an intra-agency to improve jurisdictional coordination; (2) use of military hospitals in Guam for care coordination; (3) provision of continuing provider education in epidemiology, substance abuse, mental health, and HIV prevention and treatment; and (4) expansion of community involvement in planning federally-supported projects. Activities stemming from the report and the summit continue with HRSA participation.

AGENCY SPONSOR: Bureau of Primary Health Care

FEDERAL CONTACT: Thomas Coughlin

PHONE NUMBER: 301-594-4425

PIC ID: 7157

PERFORMER ORGANIZATION: Institute of Medicine, Washington, D.C.