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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

Impact of Telephone Triage on Access to Primary Care for People Living with Multiple Long-Term Health Conditions: Rapid Evaluation

We aimed to evaluate whether or not the increased use of telephone triage would affect access to primary care differently for people living with multimorbidity than for other patients.

Aug 12, 2022
Journal Article

Digital Facilitation to Support Patient Access to Web-Based Primary Care Services: Scoping Literature Review

This study aimed to identify, characterize, and differentiate between different approaches to digital facilitation in primary care, establish what is known about the effectiveness of different approaches, and understand the enablers of digital facilitation.

Jul 19, 2022
Journal Article

Clinical Pathway for Suicide Risk Screening in Adult Primary Care Settings: Special Recommendations

This paper describes a clinical suicide risk screening pathway for adult primary care practices. We also provide guidance to aid primary care practices in their decisions about how to implement the clinical pathway.

Jun 22, 2022
Journal Article

The Impact of the COVID-19 Pandemic and Policy Response on Health Care Utilization: Evidence from County-Level Medical Claims and Cellphone Data

Shelter-in-place policies during the COVID-19 pandemic were associated with reductions in the use of preventive care, elective care, and the number of weekly visits to physician offices, hospitals and other health care-related industries.

Mar 31, 2022
News Release

Audio-Only Telehealth Remains Common at Safety Net Health Clinics; Trend Raises Questions About Quality

Rapid adoption of telehealth helped safety net clinics in California to maintain consistent levels of service after the onset of the COVID-19 pandemic, but the use of audio-only care has persisted in the clinics longer than in other types of health care settings.

Mar 15, 2022
Report

Audio-Only Telehealth Remains Common at Safety Net Clinics; Raises Questions About Quality

Early in the COVID-19 pandemic, rapid adoption of telehealth helped safety net clinics in California maintain service. But the use of audio-only care has persisted in the clinics, raising questions about the quality of care and equity for low-income patients.

Mar 14, 2022
Journal Article

Physician Compensation Arrangements and Financial Performance Incentives in US Health Systems

This study was a cross-sectional mixed-methods analysis of in-depth multimodal data from 31 POs affiliated with 22 purposefully selected health systems in 4 states. Data were analyzed from June 2019 to September 2020.

Feb 8, 2022
Journal Article

Vertical Integration of Primary Care Practices with Acute Hospitals in England and Wales: Why, How and So What? Findings from a Qualitative, Rapid Evaluation

Qualitative evaluation at two locations in England and one in Wales of where acute hospitals have taken on the running of primary care medical practices.

Jan 12, 2022
Journal Article

Early Development of Primary Care Networks in the NHS in England: A Qualitative Mixed-Methods Evaluation

Primary care networks were introduced to improve care and help address sustainability issues in general practice. The purpose of this study was to collect early evidence on their implementation and development.

Jan 5, 2022
Journal Article

Physician Compensation In Physician-Owned And Hospital-Owned Practices

Vertical integration of physician practices with hospitals or health systems was associated with lower income for nonsurgical specialists, no difference in income for primary care physicians, and slightly higher income for surgical specialists.

Dec 10, 2021
Journal Article

Tiered Cost-Sharing for Primary Care Gatekeeper Clinics

We analyze data from a long-standing tiered cost-sharing system for primary care gatekeeper clinics. We find that when choosing a primary care clinic, consumers are responsive to the clinic's tier.

Sep 9, 2021
Report

Health Services and Primary Care Research Study: Comprehensive Report

This report provides an independent assessment of the breadth, scope, and impact of health services and primary care research funded by the U.S. Department of Health and Human Services and U.S. Department of Veterans Affairs from FYs 2012 to 2018.

Jul 19, 2021
Blog

Veteran Journeys: Where Mental Health Research Meets Opera

Kenneth Wells, a psychiatrist, librettist, and composer, has written a documentary disguised as an opera. He drew on Partners in Care, a 10-year RAND-UCLA study that was one of the first to use a multisite collaborative primary care approach to treat veterans and others experiencing depression.

Jul 6, 2021
Multimedia

Digital Technologies to Improve Health and Care

John Campbell, professor of general practice and primary care at the University of Exeter, and Brandi Leach, senior analyst at RAND Europe, discuss how primary care practices can support patients' use of digital services.

Jun 18, 2021
Journal Article

Provider and Coach Perspectives on Implementing Shadow Coaching to Improve Provider-Patient Interactions

We aimed to characterize lessons and barriers to implementing shadow coaching as a mechanism to improve interactions with patients and change organizational culture.

May 21, 2021
Journal Article

Project SLIP: Implementation of a PrEP Screening and Linkage Intervention in Primary Care

The study developed and pilot-tested a PrEP screener for use in primary care clinics to help facilitate PrEP uptake. Findings suggest that brief HIV risk screening in primary care is acceptable, feasible, and shows preliminary effects in increasing PrEP referral rates.

Mar 5, 2021
Report

Primary Care Productivity: Findings from the Literature and Perspectives from a Stakeholder Panel

To advance understanding of primary care clinic productivity, the authors reviewed relevant literature and convened stakeholders to explore definitions, identify relevant tools, and establish consensus on key aspects of primary care productivity.

Feb 17, 2021
Journal Article

Association of Primary and Specialty Care Integration on Physician Communication and Cancer Screening in Safety-Net Clinics

This study aimed to describe strategies CHCs use to integrate care with specialists and examine whether more strongly integrated CHCs have higher rates of screening for colorectal and cervical cancers and report better communication with specialists.

Feb 12, 2021
Journal Article

Primary Care Physician Migration Patterns and Their Implications for Workforce Distribution

Using primary care physician practice locations, we described physician migration between 2008 and 2013. We found very little physician migration; however, among those who did change, net movement was away from rural counties and HPSAs.

Feb 12, 2021
Journal Article

Telehealth Use Among Safety-Net Organizations in California During the COVID-19 Pandemic

During the COVID-19 pandemic, visit volume at a sample of FQHCs declined modestly for primary care visits and remained stable for behavioral health visits because telehealth visits replaced in-person visits.

Feb 4, 2021

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RAND Topic:
Primary Care

Research conducted by

RAND Health Care