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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.

Journal Article

Journal Article

Rural And Nonrural Primary Care Physician Practices Increasingly Rely On Nurse Practitioners

Data from 2008-2016 show that both rural and non-rural primary care practices increasingly involve nurse practitioners (NPs) to deliver care.

Jul 6, 2018
Journal Article

Opening School-Based Health Clinics Can Lower Teacher Health Costs

Opening onsite health clinics to provide comprehensive primary care to teachers and their families can lower a school district's health care costs and decrease teacher absenteeism.

Jul 3, 2018
Journal Article

Journal Article

Hospital-Based Quality Measures for Pediatric Mental Health Care

The study developed new pediatric mental health care quality measures and used them to identify sex and race disparities and substantial hospital variation.

Jul 3, 2018
Journal Article

Journal Article

Patient Predictors of Substance Use Disorder Treatment Initiation in Primary Care

Primary care clinics are opportune settings for the delivery of substance use disorder treatment, but little is known about which patients initiate treatment in these settings.

Jun 28, 2018
Journal Article

Journal Article

Delivery and Impact of the NHS Health Check in the First 8 Years: A Systematic Review

Since 2009 all eligible persons in England have been entitled to an NHS Health Check. Uncertainty remains about who attends and the health-related impacts. This report reviews quantitative evidence on coverage, uptake and impact of NHS Health Checks.

Jun 27, 2018
Report

Patient-Centered Medical Home Implementation in Indian Health Service Direct Service Facilities

In 2008, the Indian Health Service launched a patient-centered medical home (PCMH) initiative to improve the quality of care in its clinics. RAND researchers identified barriers and strategies to assist clinics on the path to PCMH recognition.

May 25, 2018
Report

Report

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

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.

Apr 19, 2018
Journal Article

Journal Article

Care Experiences Among Medicare Beneficiaries With and Without a Personal Physician

Medicare patients without a personal physician reported worse patient experiences, and were 3 times more likely than those with a physician not to have seen any health care provider in the last 6 months.

Apr 12, 2018
Journal Article

Journal Article

"It Encourages Them to Complain": A Qualitative Study of the Unintended Consequences of Assessing Patient-Reported Pain

This article describes potential unintended consequences of implementing routine pain screening in primary care.

Apr 11, 2018
Journal Article

Journal Article

Impact of a Mental Health Based Primary Care Program on Emergency Department Visits and Inpatient Stays

Introducing primary care services into mental health clinics may increase utilization of inpatient services, perhaps due to newly identified unmet medical need.

Apr 10, 2018
Journal Article

Effects of Motivational Interviewing Fidelity on Substance Use Treatment Engagement in Primary Care

Motivational interviewing is used extensively to improve health and substance use-related outcomes, but therapists may need more training in strategic use of the approach.

Apr 3, 2018
Journal Article

Journal Article

Integrating Behavioral Health and Primary Care Services for People with Serious Mental Illness: A Qualitative Systems Analysis of Integration in New York

Effective integration of behavioral and physical health care does not advance along a single continuum from minimally to fully integrated care but along several, parallel pathways.

Mar 22, 2018
Journal Article

Journal Article

Impact of Issuing Longer- Versus Shorter- Duration Prescriptions: A Systematic Review

UK recommendations to provide shorter prescriptions are not substantiated by the current evidence base.

Mar 14, 2018
Report

Report

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

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.

Mar 14, 2018
Journal Article

Journal Article

Utilization of Health Care Services Among Medicare Beneficiaries Who Visit Federally Qualified Health Centers

Fee-for-service Medicare beneficiaries who received their care at federally qualified health centers had fewer ambulatory visits and more visits to the ED compared to a matched comparison group of beneficiaries who received primary care from another source.

Mar 1, 2018
Journal Article

Journal Article

Influence of Mental Health and Alcohol or Other Drug Use Risk on Adolescent Reported Care Received in Primary Care Settings

Adolescents at risk for alcohol or other drug use and poor mental health are most likely to benefit from a brief intervention delivered in primary care.

Feb 14, 2018
Dissertation

Dissertation

The Impact of Nurse Practitioner Scope-of-Practice Regulations in Primary Care

The dissertation assesses the impact of nurse practitioner scope-of-practice regulations in primary care.

Feb 14, 2018
Journal Article

Implementing the Chronic Care Model for Opioid and Alcohol Use Disorders in Primary Care

This paper describes the process of planning and developing an intervention for delivering treatment for opioid and alcohol use disorders in primary care.

Feb 14, 2018
Journal Article

Journal Article

Integrating Physical Health: What Were the Costs to Behavioral Health Care Clinics?

Delivering physical health care in specialty mental health clinics was a promising strategy for improving the care that adults with SMI receive for their physical health conditions, but financial feasibility remains a major challenge.

Feb 13, 2018
Journal Article

Journal Article

Assessing and Improving Organizational Readiness to Implement Substance Use Disorder Treatment in Primary Care: Findings from the SUMMIT Study

An organizational readiness intervention improved some implementation outcomes related to integrating treatment for opioid and alcohol use disorders in primary care, but not all.

Feb 13, 2018

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RAND Topic:
Primary Care

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