Compliance/Healthcare Utilization

Establishing a relationship based on mutual understanding and trust will help to increase compliance with treatment. Take the time to answer questions, educate and explain. Involvement of the ‘ohana is important to ensuring success.

Compliance may be adversely affected by health care access and limitations of insurance coverage. Many patients live in rural communities and/or rural neighbor islands and may not have access to primary care clinicians, specialists and hospitals (Taira, Gronley, & Chung, 2004). Native Hawaiians have one of the poorest socioeconomic conditions in the State. Barriers to care such as

  • insurance status,
  • ability to pay,
  • homelessness,
  • transportation,
  • childcare, and
  • school and work responsibilities,

must be considered when planning medical tests and treatment interventions. This is particularly important if the patient is dependent upon family members for transportation, medication, housing and food. Costs for medications are sometimes weighed against other family expenses such as food, rent and utility bills.

Non-compliance may also be a consequence of abandoning medical treatment in favor of traditional remedies, especially if the patient’s condition does not improve immediately with conventional medical treatments (Palafox & Warren A., 1980).