Improving US Virgin Islands' health system: "You get more benefits with your insurance in the States than you get here"
Wang, K. H.; Hendrikson, Z. M.; Friedman, H. R.; Nunez, M. A.; Nunez-Smith, M.
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BackgroundThe US Virgin Islands (USVI) are actively rebuilding their healthcare delivery system following destruction by Hurricanes Irma and Maria in 2017. MethodsIn 2013, we conducted a qualitative study in the US Virgin Islands using semi-structured one-on-one interviews to explore individuals decision-making regarding healthcare-seeking off-island. The coding team analyzed the transcripts using a constant comparative analysis, and Atlas.ti to organize our emerging thematic analysis. ResultsFive themes emerged from 19 interviews that illustrate healthcare system level factors that influence participants decisions about seeking healthcare off-island: 1) limited availability of services and desire for options, 2) limited accessibility of services, 3) healthcare system interactions and experiences, 4) healthcare system policies, and 5) trust in healthcare systems. ConclusionsThe experiences of care seeking off-island for our sample highlight several mechanisms through which the USVI healthcare delivery system could improve, including the adoption of telemedicine, changes in insurance, and healthcare workforce policies.
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