North Carolina Medical Journal

Our long-term services and supports needs are growing, and North Carolinians have an opportunity to respond by working together across all sectors of care. Furthering steps we have taken to increase direct care worker wages, and taking additional steps to support these services, can help us respond to the needs and improve quality.

Lack of access to high-quality primary care has been shown to contribute to urban-rural health disparities. We describe a model in which an academic health system made targeted primary care investments to address rural health disparities while building the health workforce to ensure sustainability.

School-based telehealth programs have shown potential to address both educational and health needs of elementary students in North Carolina. A Cone Health prototype in areas of endemic poverty and low health literacy allowed for the creation of on-demand care that kept children in school, decreased early dismissals, and reduced the burden and cost of urgent health care on families.

North Carolina has some of the country's best health workforce supply data through cooperation with licensing boards, but the data don't encompass all health care workers. Workforce demand data are more difficult to track, and it's even harder to know how many health care workers are truly needed to improve the state's health.

North Carolina faces a significant health workforce shortage exacerbated by the COVID-19 pandemic. To meet this challenge, the Department of Commerce and the Department of Health and Human Services are prioritizing equity, creativity, and collaboration.

COVID-19 exposed and exacerbated the historical shortages and maldistribution of the health workforce in North Carolina. This edition of the North Carolina Medical Journal highlights the work being done in our state to address these needs, and calls for an intentional and persistent approach to planning for and developing the workforce needed to produce health.

BACKGROUND Transitional care and medical respite programs provide assistance to people experiencing homelessness as they move from acute care into community settings. These programs can address issues that may fall outside the reach of traditional medical care yet have a profound impact on the health of vulnerable populations. This article focuses on the cost-effectiveness of the Durham Homeless Care Transitions (DHCT) program. METHOD This intervention study of the DHCT program uses a comparison group of people experiencing homelessness who were referred but did not participate...

BACKGROUND For quite some time, many North Carolina practitioners and health care leaders have advocated for whole-person care. There has been significant movement toward a whole-person approach to health in the state; however, challenges remain despite continuous momentum building over the years. This article reports an exploratory survey with North Carolina primary care and behavioral health providers. METHODS Providers were recruited statewide through professional associations and networks to participate in a survey regarding their experience delivering whole-person care...

Two new North Carolina Institute of Medicine task force reports make recommendations for bolstering the state's public health workforce through new funding and partnerships in an effort to prepare for future health crises, achieve health equity, and support the growing economy.

To build a resilient, high-performing primary care infrastructure for North Carolina, primary care networks and policymakers should align efforts to create pathways for students, trainees, and new physicians to thrive in primary care. We describe the shifting primary care landscape, current workforce initiatives, and policy options for achieving this goal.

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Addressing community needs improves population health and the well-being of health care providers. The development of the health care workforce requires faculty to address the needs of North Carolina's diverse and rural populations. This can be best accomplished by building interdisciplinary and cross-functional service-learning experiences and developing community-academic partnerships and coalitions.

Changes in health care present many challenges and opportunities to North Carolina's exceptional graduate medical education programs. Steps to keep these programs exceptional include boosting leadership training, championing well-being, expanding rural training, and more described here.

To diversify the medical workforce, programs must be developed that enhance and prepare students from minoritized and underresourced communities to compete for admission to medical education. North Carolina has a rich history of providing pathway programs that assist minoritized students in developing into the physicians who will serve the communities from which they emerged.

Supporting the wellness needs of North Carolina's health care workforce is crucial for maintaining a robust health care delivery system for all North Carolinians. Organizations and policymakers can provide needed supports to ensure the well-being of health care workers.

No abstract text is available yet for this article.

BACKGROUND Nationally, multiple barriers lead only 50% of women who request postpartum tubal ligation to receive it prior to discharge. We aimed to identify characteristics associated with unfulfilled requests for postpartum tubal ligation at a tertiary medical center in the South. METHODS We conducted a retrospective chart review of all women delivering a live infant with a documented desire for postpartum sterilization between September 1, 2018, and November 30, 2018. The primary outcome was receipt of postpartum sterilization prior to discharge...