A new report into veterans’ access to health care in the Pacific found some delays relating to primary and mental health services and “sometimes lengthy” times for specialty care after referrals to non-Veterans Affairs providers.

But the U.S. Government Accountability Office also emphasized that among the veterans’ medical records reviewed, most received primary and mental health care from the VA Pacific Islands Health Care System within established timeliness goals.

The GAO report issued Thursday said Pacific Islands referred nearly all specialty care to non-VA providers on time, but the time taken to provide that care “was variable and sometimes lengthy.”

According to the GAO:

>> For veterans reviewed, the time to receive specialty care through the Veterans Choice Program was 75 days on average. Under the Choice Program, eligible veterans can receive care from non-VA health care providers when they experience long wait times or lengthy travel distances.

>> It took an average of 37 days to receive specialty care for the cases reviewed from Maui, American Samoa and Guam clinics that were referred to Tripler Army Medical Center. It took an average of 47 days for Guam clinic veterans to receive specialty care at Naval Hospital Guam.

Pacific Islands “has generally provided primary and mental health care within (VA Veterans Health Administration) timeliness goals for most veterans reviewed, but there are weaknesses in the referral process for specialty care services,” the GAO said.

The organization said to arrive at its findings, it reviewed a sample of 164 medical records of veterans enrolled at clinics on Maui, American Samoa and Guam.

“This report confirms that despite unique challenges, VA Pacific Islands Health Care System has made significant improvements to its processes and practices,” the VA system said in a release in response Friday.

The recommendation was made that Pacific Islands review its referral process to Defense Department providers, and the VA system said it did that and revised its procedure.

The GAO also noted that the “remote nature” of the Pacific islands “creates some unique challenges” for the Pacific Islands system that might affect its ability to provide timely care for about 50,000 veterans it serves in Hawaii, American Samoa, Guam and the Commonwealth of the Northern Mariana Islands.

Pacific Islands “is committed to improving our veterans’ experience. We want them to choose VA to receive their care because they want to, not because they have to,” said Jennifer Gutowski, the system’s director.

GAO also found that Pacific Islands faces challenges recruiting and retaining doctors. As of October, 17 of about 100 Pacific Islands physician positions were vacant.