outcomes of healthcare in kosrae, pohnpei and f.s.m. emily leutgeb ellie steiner ryan johnsen adam...
TRANSCRIPT
Outcomes of Healthcare in Kosrae, Pohnpei and F.S.M.
Emily LeutgebEllie Steiner
Ryan Johnsen Adam Koenig
Tyler Aronstein
Introduction to Outcomes of Healthcare
• Outcomes are defined by:o What happens after care has been provided
Perceived Quality of Care by Patients How healthy is the Population Customer Satisfaction
o How to improve it
Three Stages of Health and Illness in Micronesia
1. Introduction of infectious diseaseo Increased ship contact during the 1800so Considerable population loss on all islands
2. Introduction of western medicineo Following WWIo Improved santitationo Brought infectious disease under control
3. Shifting burden of illnesso Jobs multiplied, disposable income grewo Westernization of dietso Focus more on non-communicable diseases
Today: Micronesia still faces the lingering effects of the older disease burden while trying to combat the new illnesses associated with the modern life style.
The Numbers
Stat Old New
Life Expectancy (1994) 65.2 Years (2009) 69 Years
Infant Mortality (1994) 46/1,000 (2009) 39/1,000
Diabetes (1956) 8 (1976) 522
Heart Disease (1956) 192 (1976) 1,494
Categories of Disease1990-1994 1995-1999 2000-2003
Circulatory system disease
111.35 103.60 119.62
Respiratory Disease 62.04 52.08 59.81
Endocrine, Nutritional, and Metabolic Diseases
34.83 59.20 57.24
Digestive System Disease
16.83 15.55 18.46
Mental and Behavioral Disorders
0.78 0.75 0.47
Source: Vital Statistics Unit, FSM Department of Health and Social Affairs
The Dentist in Kosrae
• They have good access but how is it being used?o Transportation Problems
• They are receiving the same quality care that people in the United States are.
• Beatle Nut
The President of F.S.M.
• Health care is the third most funded by the government
• His opinion on the NEW nursing program at the F.S.M.
• Mis-allocation of funds due to Compact Free Association
• Exercise
Adam’s Pharmacy Visit• Constipation + Pills = Diarrhea• Cost Effective• Physiological Response• No questions asked, no health history considered
Suicide Rate/Psych issues in Micronesia
• Number of suicides has risen sharply in Micronesia since the 1960so Suicide rates now being amongst the highest in
the world• Lack of mental health facilities• "Burden of mental health goes hand-in-hand with
rapid urbanization and social changes such as poverty and physical illness" (Global Health Care)
• Suicide prevention programs in high schools• Leading cause of death for 15-24 age group
Kathy Benjamin
• Coordinator of the new nursing program at the College of Micronesia
• Preceived vs. Actualo Traveling abroad for medical care
Tour Guide in Kosrae Hospital
• Have surveys worked for responses?• New ideas for receiving input on healthcare
Various Locals - JoJo the Bus Driver
Various Locals - Josh the teacher• 10th Grade Earth Science Teacher• From California• Avoided Kosrea medical help at all costs
o Preventativeo Found help from family in the States
Various Locals - Airplane dude
"I think they're doing the best they can"
Misuse of Resources
• Old Ambulance vs. New Ambulance• HIV/AIDS Surveillance and HIV Prevention Projects for the
Pacific Islandso $203,006 in Grantso Condoms in bathroom
The Facts
• CDC reported that the FSM does not require vaccines for any person.
• Healthcare is at a higher level than the rest of the pacific region related to United States focus.
What Should The FSM Do To improve Outcomes?• Increase Diabetes Resources• Expand “Go Local” and Other Educational Programs about Staying Healthy
o Preventative services like exercise facilities and changing the mindset of “normal” living
• Better Medical Documentationo Birth Certificateso Death Certificates
• Make a Cancer Registry• Better Education Programs to Defer Social Stigmas
What Should Future Researchers Do?
• Surveys DO NOT WORK!o Strive for personal contacto Face-to-Face Surveyingo Incentive Based Surveyingo Invest in the areas being researched
• Enjoy your time!
Sources
• CDCo http://www.cdc.gov/HIV/topics/funding/state-awards/
fm.htm• WHO
o FSM Health Profile http://www.who.int/gho/countries/fsm.pdf
• Health Issues in the Federated States of Micronesiao Mortality Analysis of Registered Deaths in the FSM from
1990-2003o Disease in Micronesia: A Historical Survey
• Cancer in Kosrae• Cancer in Micronesia• Global Health Care by Carol Holtz