Community Assessments

Kelley Withy, MD, PhD withy@hawaii.eduHawaii State Rural Health Association Annual Conference

Maui Beach Hotel, April 5, 2011

Greatest Demand Specialties

Community Needs

Honolulu Everything

Kona Everything except CNA, lab tech, EMT, receptionist, midwife, OT/PT

Oceanview Needs a pharmacy! And dental hygienists (supervised)

North Hawaii Everything except CNAs, lab tech, PT/OT, PA, EMT, Receptionist and Midwife

West Kauai Health IT

Waianae Everything, but no funding

Wailuku Everything except EMT, lab tech, PA, pt navigator

Lanai Everything except receptionist, EMT, MW, translator

Molokai Everything except midwives and pharmacistsWaimanalo >1 translator, MA; 1 nurse, SW, nutrition,

reception

http://www.surveymonkey.com/s/

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Community Meetings

22 meetings in 11 communities in 2003 Stateside needs:

Dental Care Economy (jobs) Healthcare providers and technology Health Insurance Substance Abuse Treatment Transportation

Comprehensive Rural Health Plan

Hawaii: Substance Abuse Services for adolescents Transportation

Kauai Dental Healthcare Providers Transportation

Maui Dental Healthcare Providers Substance Abuse Services Transportation

Also: Lack of Community Leadership; Lack of Activities for Youth; Lack of Health Knowledge; Cultural and Environmental factors, Violence/Crime, Access to Services

County needs

Hawaii Health Survey: “Was there a time in the last 12 months that you felt you should see a healthcare provider but did not? If yes, why?”

12% surveyed were unable to see a doctor (includes an emergency room doctor) By island:

Big Island 15 % Maui 13 % Kauai 12 % Oahu 10 %

Why can’t they see a doctor? 38% financial reasons (which could include airfare) 23% access reasons

For primary care: 40% cost; 24% Access For specialists: 36% cost; 41% Access

What type of doctor did they have trouble getting in to see? 41% could not see primary care physicians 19% can’t see specialists **People without health insurance were 3 times more likely to NOT see doctor. **

Written and Oral Surveys-Hawaii Health Survey