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Primary Care

Primary care providers are often the first point of contact for patients attempting to navigate a complex health care delivery system and seeking referrals to specialists. RAND has explored the increasing use of emergency departments as a primary care setting, the influence of primary care on health care spending, shared decisionmaking between patients and primary care providers, the emergence of retail health clinics, and more.

Report

Report

Transforming Urgent and Emergency Care and the Vanguard Initiative: Learning from Evaluation of the Southern Cluster

Three Urgent and Emergency Care (UEC) vanguards, aiming to improve UEC services, have progressed, driven by funding, status, leadership and support for joint working. Public engagement, workforce and data interoperability challenges need addressing.

Oct 16, 2017
Journal Article

Journal Article

Barriers to Integrating the Continuum of Care for Opioid and Alcohol Use Disorders in Primary Care: A Qualitative Longitudinal Study

Some perceived barriers to implementing the continuum of care for opioid and alcohol use disorders in primary care clinics persist over time, but most barriers decreased.

Oct 13, 2017
Commentary

Doing More with Less: Lessons from Cuba's Health Care System

High U.S. health care costs do not yield corresponding health outcomes for its citizens. But Cuba, for less than a tenth of U.S. costs, has attained comparable outcomes on many indicators, such as life expectancy and infant mortality. Cuba prioritizes primary care and prevention and addresses social determinants of health.

Oct 6, 2017
Report

Health Sector Reform in the Kurdistan Region — Iraq: Primary Care Management Information System, Physician Dual Practice Finance Reform, and Quality of Care Training

Since 2010, RAND has worked with the Kurdistan Regional Government to improve its health care system. This phase focused on a primary care management information system, physician dual practice reform, and patient safety training.

Oct 5, 2017
Journal Article

Journal Article

An Emergency Medicine-Primary Care Partnership to Improve Rural Population Health: Expanding the Role of Emergency Medicine

Working in partnership, emergency medicine and primary care can address rural populations' most pressing social and medical needs.

Sep 26, 2017
Journal Article

Journal Article

Impact of a Mental Health Based Primary Care Program on Quality of Physical Health Care

Programs to integrate physical health care services into specialty mental health clinics improved monitoring of psychiatric medication side effects, but did not improve other aspects of care among the seriously mentally ill.

Sep 19, 2017
Journal Article

Journal Article

Barriers and Facilitators to Implementation of VA Home-Based Primary Care on American Indian Reservations: A Qualitative Multi-Case Study

Common experiences among Veterans Affairs medical centers expanding their home-based primary care services to rural American Indian reservations provide lessons learned for future expansions.

Sep 19, 2017
Journal Article

Journal Article

Internalized Stigma as an Independent Risk Factor for Substance Use Problems Among Primary Care Patients: Rationale and Preliminary Support

High rates of internalized stigma - self-applied negative stereotypes - among primary care patients with opioid or alcohol use disorders were significantly related to greater substance use problems.

Sep 19, 2017
Journal Article

Journal Article

Standardizing the Measurement of Commercial Health Plan Primary Care Spending

Primary care is often acknowledged as the foundation of any high-performing health care delivery system. But how much of our health dollars go to supporting it?

Sep 15, 2017
Journal Article

Journal Article

Primary Care Providers with More Experience and Stronger Self-Efficacy Beliefs Regarding Women Veterans Screen More Frequently for Interpersonal Violence

Some primary care provider experiences and beliefs regarding women's health care influence rates of screening for military sexual trauma (MST) and/or intimate partner violence (IPV) .

Sep 6, 2017
Journal Article

Journal Article

Age Differences in Death and Suicidal Ideation in Anxious Primary Care Patients

One in three older adults with anxiety reported feeling like they were better off dead, which underscores the importance of assessing for suicidality in this population during primary care visits.

Aug 31, 2017
Journal Article

Journal Article

Challenges to Teaming for Pain in Primary Care

Better understanding task distribution related to chronic pain assessment and management can help improve team-based pain care.

Aug 23, 2017
Journal Article

Journal Article

Utilization of Registered Nurses in Primary Care Teams: A Systematic Review

Embedding registered nurses into primary care teams can increase patient access to primary care services and alleviate organizational workload.

Aug 4, 2017
Journal Article

Journal Article

Trends in Visits to Specialist Physicians Involving Nurse Practitioners and Physician Assistants, 2001 to 2013

While the number of NPs and PAs involved in the care of patients of specialist physicians has increased, visits involving NPs or PAs remain a small proportion of overall specialty visits.

Aug 2, 2017
Journal Article

Safety-Net Providers Can Adopt Medical Home Models and Improve Primary Care; Cost Reductions Harder

Most of the federally qualified health centers that participated in a program to help them adopt a “medical home” model of advanced primary care were successful in doing so. These changes improved access to primary care, but did not decrease the use of specialty care, acute care services or Medicare expenditures.

Jun 27, 2017
Report

Evaluation of CMS's Federally Qualified Health Center (FQHC) Advanced Primary Care Practice (APCP) Demonstration: Final Report

This report contains an independent evaluation of the Federally Qualified Health Center Advanced Primary Care Practice Demonstration for the Centers for Medicare and Medicaid.

Jun 26, 2017
Journal Article

Journal Article

Provision of Peer Specialist Services in VA Patient Aligned Care Teams: Protocol for Testing a Cluster Randomized Implementation Trial

Assessing the impact of outside assistance on the deployment of peer specialists in Veterans Health Administration Patient Aligned Care Teams will provide critical data to administrators and policy makers.

Jun 7, 2017
Journal Article

Journal Article

High-Price And Low-Price Physician Practices Do Not Differ Significantly On Care Quality Or Efficiency

Higher-priced providers do not necessarily provide higher-quality care.

Jun 6, 2017
Journal Article

Journal Article

Patient Experiences with Care Differ with Chronic Care Management in a Federally Qualified Community Health Center

Adults receiving primary care at federally qualified health centers were more likely to positively rate their patient experience if their health center scored highly on adoption of chronic care management.

May 23, 2017
Journal Article

Journal Article

Physician Breast Cancer Screening Recommendations Following Guideline Changes: Results of a National Survey

Physicians' recommendations for when to start and end breast cancer screening vary, depending on their level of trust with the guideline-issuing organization.

May 23, 2017

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RAND Topic:
Primary Care

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