Service to the State
As part of the University of North Carolina and the State of North Carolina, the Sheps Center is committed to investigating public health issues of interest to the people of North Carolina. The following are a few examples of Sheps Center projects that benefit North Carolinians.
North Carolina Health Professions Data System
The North Carolina Health Professions Data System (HPDS) collects and disseminates comprehensive and timely data on health professionals licensed in North Carolina. Data have been collected annually since 1979, and include the demographic and practice characteristics of: physicians, registered nurses, certified nurse midwives, nurse practitioners, licensed practical nurses, chiropractors, optometrists, pharmacists, physician assistants, physical therapists, physical therapy assistants, podiatrists, psychologists, psychological associates, respiratory therapists, dentists and dental hygienists. These data are utilized by researchers and policy makers in evaluating the state of the health workforce in NC. North Carolina is one of a select few states to have such a data system, and we serve as a national model for health workforce data collection and analyses.
Funded by: The North Carolina Area Health Education Centers (NC AHEC) Program and the Office of the Provost (Health Affairs),UNC-CH.
Contact: Erin Fraher
Covering the Uninsured
More than 1.3 million nonelderly people in North Carolina lacked health insurance coverage in 2004, or more than one sixth of the states nonelderly population. The percentage of the state's population without health insurance is growing more rapidly in North Carolina than in most of the rest of the country. The NC Department of Health and Human Services (NC DHHS) received a one-year State Planning Grant to study options to expand coverage to the uninsured. The effort was a collaborative of four agencies and organizations. Two of these organizations are administritively housed within the Sheps Center. The Program on Health Care Economics and Finance analyzed existing data on the uninsured from national data sources and obtained data from focus groups of small and large employers, insurance agents/brokers, and the uninsured to find out more about their willingness to pay, the policy options that are most attractive, and the trade-offs that may be reasonable to make health insurance coverage more affordable. The North Carolina Institute of Medicine convened a Task Force, consisting of a variety of stakeholders, that used those data to develop recommendations for ways to expand coverage.
Funded by: Health Resources and Services Administration, United States Department of Health and Human Services
Contacts: Sandra Greene (Health Economics) and Pam Silberman (NC IOM)
A Primary Health Care Management Support Package for People With Developmental Disabilities
This project is a demonstration and evaluation project in five counties (Duplin, Sampson, Lenoir, Wayne, and Pitt) in eastern North Carolina aimed at improving the quality of health care for adults with developmental disabilities. The project intervention consists of three components: (1) collaboration between case managers employed by two different public sector entities (i.e., developmental disabilities agencies and community networks that assume responsibility for managing medical care for Medicaid recipients) involved in helping adults with developmental disabilities to proactively and effectively utilize health care services; (2) assistance from trained family members, residential staff persons, or other caregivers in adults with developmental disabilities to proactively and effectively utilize health care services; (3) training of adults with developmental disabilities and their direct caregivers in routine preventative oral health care. The knowledge gained during the evaluation of the intervention will be transferred to other communities in North Carolina through training, technical assistance, and consultation.
Funded by: North Carolina Council on Developmental Disabilities and The Duke Endowment
Contact: Kathryn Moss
County-level Estimates of the Uninsured Rate
Sheps Center staff have created estimates of county-level rates of health insurance coverage. These estimates are widely used in media reports and grant applications to characterize insurance coverage across our state. In 2004, county uninsured rates ranged from 14% in Wake County to 28% in Tyrrell County.
Funded by: Health Resources and Services Administration, United States Department of Health and Human Services
Contact: Mark Holmes
North Carolina Nursing Home Medication Error Quality Initiative
In 1999 the Institute of Medicine issued a report that placed a national focus on patient safety and quality of care. Since that time, increasing attention has been paid to patient safety and medication errors, primarily focused on hospitals but also in other health care settings. In 2003, individual cases of serious medication error in nursing homes were brought to the attention of the North Carolina General Assembly and in late 2003, the Assembly passed a law addressing medication management and errors in North Carolina Nursing Homes. North Carolina is the first state to implement mandatory reporting of all medication errors in nursing homes, including near misses and potential errors, rather than focusing on only serious adverse medical events. In early 2004, the Sheps Center helped implement a mandatory annual medication error reporting system for nearly all nursing homes in the State. The Sheps Center has just completed the second year of annual reporting. In the second year of reporting, a total of more than 16,000 errors or potential errors were reported, an average of 34 per 100 nursing home beds. Most (86 %) did not reach or did not harm the patient, but over 1600 (10%) led to a situation that required monitoring and/or further intervention.
Funded by: Division of Facility Services, North Carolina Department of Health and Human Services
Contact: Sandra Greene
