Report on the 1990 - 2018 John A. Burns School of Medicine Medical Student Specialty Match and Residency Position Data.

The physician shortage is expected to worsen both in Hawai'i and nationally, with primary care remaining the most needed medical specialty. The University of Hawai'i John A. Burns School of Medicine (JABSOM) plays a critical role in physician workforce development through its undergraduate (Medical School) and graduate medical education (Residency) programs.

COVID-19 Containment Ship Model: A Case Study for Pacific Island Response.

The Republic of the Marshall Islands, American Samoa, the Federated States of Micronesia, and the Republic of Palau have been without any COVID-19 community transmission since the beginning of the global pandemic. The Commonwealth of the Northern Mariana Islands has experienced modest community transmission, and Guam has had significant COVID-19 community transmission and morbidity. Although several of these United States Affiliated Pacific Island jurisdictions made difficult strategic choices to prevent the spread of COVID-19 which have been largely successful, the built environment and the population density in the urban areas of the Pacific remain inherently conducive to rapid COVID-19 transmission.

Racial/ethnic differences in health-related quality of life among Hawaii adult population.

Background: This study examined racial/ethnic differences in health-related quality of life (HRQOL) among adults and identified variables associated with HRQOL by race/ethnicity.

Methods: This study was conducted under a cross-sectional design. We used the 2011-2016 Hawaii Behavioral Risk Factor Surveillance System data.

Racial/Ethnic and County-level Disparity in Inpatient Utilization among Hawai'i Medicaid Population.

We investigated racial/ethnic and county-level disparities in inpatient utilization for 15 clinical conditions among Hawaii's Medicaid population. The study was conducted using inpatient claims data from more than 200,000 Hawai'i Medicaid beneficiaries, reported in the year 2010. The analysis was performed by stratifying the Medicaid population into three age groups: children and adolescent group (1-20 years), adult group (21-64 years), and elderly group (65 years and above).

GIS residency footprinting: analyzing the impact of family medicine graduate medical education in Hawai'i.

Background: Access to care for patients in Hawai'i is compromised by a significant primary care workforce shortage. Not only are there not enough primary care providers, they are often not practicing in locations of high need such as rural areas on the neighbor islands or in the Pacific.

Methods: This study used geographic information systems (GIS) spatial analysis to look at practice locations for 86 University of Hawai'i Family Medicine and Community Health graduates from 1993 to the 2010.

Health consequences of disparity: the US Affiliated Pacific Islands.

Health disparities and the social determinants of health are often discussed, but their relationship to political forces, the integrity of cultures, social and environmental change, and mental health outcomes are not well understood. Specifically the US Affiliated Pacific Islands Jurisdictions (USPAIJ) is an area of profound isolation and deprivation with a unique sociocultural history. This article provides an overview of health disparities in the US Affiliated Pacific in the context of the environment, and international and state policies.

Developing the rural primary care workforce in Hawaii--a 10-point plan.

The shortage of physicians and resultant lack of access to care particularly on the rural neighbor islands of Hawaii has been well described. A recent report in the December issue of this journal by Withy, et al. documents a current shortage of 45 physicians on the Big Island.

The "compact impact" in Hawaii: focus on health care.

The political, economic, and military relationship between the former Pacific Trust Territories of the United States is defined by the Compact of Free Association (COFA) treaty. The respective COFA treaties allow the United States military and strategic oversight for these countries, while COFA citizens can work, reside, and travel with unlimited lengths of stay in the United States. The unforeseen consequences of the diaspora of the people of the COFA nations to the United States and its territories is called the "Compact Impact.

Health information technology and physicians' knowledge of drug costs.

Objective: To examine whether physicians' use of information technology (IT) was associated with better knowledge of drug costs.

Study Design/methods: A 2007 statewide survey of 247 primary care physicians in Hawaii regarding IT use and self-reported knowledge of formularies, copayments, and retail prices.

Results: Approximately 8 in 10 physicians regularly used IT in clinical care: 60% Internet, 54% e-prescribing, 43% electronic health records (EHRs), and 37% personal digital assistants (PDAs).

Elderly patients' knowledge of drug benefit caps and communication with providers about exceeding caps.

Objectives: Many elderly persons have drug benefits with coverage gaps, such as in Medicare Part D. Because beneficiaries who have such gaps must pay all drug costs, an accurate knowledge of gap thresholds and communication with providers about exceeding caps is important for elderly persons to manage out-of-pocket drug costs.

Design: Cross-sectional survey.

The Declaration of Alma Ata on its 30th anniversary: relevance for family medicine today.

The Declaration of Alma Ata, issued on September 12, 1978, provides a moral vision for primary care that remains valuable today at a time of transformation of the specialty of family medicine. The Declaration asserts a comprehensive definition of health that recognizes health as a fundamental human right, argues persuasively that gross inequalities in health status are politically, socially, and economically unacceptable, and identifies primary health care as the key to improving health and reducing health status inequalities. The values of Alma Ata can guide the specialty of family medicine to lead positive health system change through renewed collaboration, addressing inequalities, efficient use of resources and appropriate technology, and advocacy in the spirit of social justice.

Going global: considerations for introducing global health into family medicine training programs.

Medical students and residents have shown increasing interest in international health experiences. Before attempting to establish a global health training program in a family medicine residency, program faculty must consider the goals of the international program, whether there are champions to support the program, the resources available, and the specific type of program that best fits with the residency. The program itself should include didactics, peer education, experiential learning in international and domestic settings, and methods for preparing learners and evaluating program outcomes.

Health consequences and health systems response to the Pacific U.S. Nuclear Weapons Testing Program.

Between 1946 and 1958, the United States detonated 67 thermonuclear devices in the Pacific as part of their U.S. Nuclear Weapons Testing Program (USNWTP).

Physicians' willingness and barriers to considering cost when prescribing.

Many patients have difficulty affording medication. This pilot study examined physicians' willingness and barriers to considering cost when prescribing. Of 54 physicians surveyed, nearly all said considering cost was important (98%) but many reported lacking formulary (65%) or copayment information (59%).

Risk management in obstetric care for family physicians: results of a 10-year project.

Background: Malpractice issues within the United States remain a critical factor for family physicians providing obstetric care. Although tort reform is being widely discussed, little has been written regarding the malpractice crisis from a risk management perspective.

Methods: Between 1989 and 1998, a 10-year risk management study at the UC Davis Health System provided a unique collaboration between researchers, a mutual insurance carrier and family physicians practicing obstetrics.