American Samoa has informed a US congressional panel that the territory is exploring building a new hospital to accommodate an increase in demand.
The executive director of the territory's only medical facility, LBJ hospital, is Taufete'e John Faumuina.
He told a US House subcommittee about the challenges faced by the centre, which is currently operating under a $US50 million budget.
Taufete'e said LBJ needed to address a number of issues and also offer better salaries to recruit doctors, nurses and other staff.
He said the hospital struggled acquire new equipment and to maintain its facilities, which were built in 1968.
Despite a recent renovation, Taufete'e said LBJ was still under pressure because of the overwhelming number of patient visits, with the emergency room receiving an average of over 2500 per month.
"One of the solutions that we are presenting exploring is a new 200 bed hospital to accomodate increases in population as well as in patient and outpatient visits," he said.
"Space in the present location is severely limited and we are unable to expand the existing building, which in turn limits services."
Taufete'e said it could cost about $US20 million for a new hospital.