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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.

Commentary

Applying What Works to Reduce Non-Urgent Emergency Department Use

It is likely that communities with low rates of non-urgent ED use not only have better access to primary care, but patients who are educated about appropriate care seeking and convenient alternatives for acute care, writes Lori Uscher-Pines.

May 22, 2013
Journal Article

A Positive Deviance Approach to Understanding Key Features to Improving Diabetes Care in the Medical Home

The medical home has gained national attention as a model to reorganize primary care to improve health outcomes. Pennsylvania has undertaken one of the largest state-based, multipayer medical home pilot projects.

May 1, 2013
Journal Article

Grand Challenges: Integrating Mental Health Care Into the Non-Communicable Disease Agenda

Collaborative care models, where care for chronic disease and mental health care are integrated and provided in the primary care setting, benefit patients, strengthen health care systems, and reduce costs.

May 1, 2013
Journal Article

Insomnia: Can't Sleep, Can't Get Diagnosed

Insomnia is very common, but most of its sufferers don't receive a diagnosis or treatment. However, educating primary care providers and other professionals about insomnia can help.

Mar 1, 2013
Blog

Are You a 'Wise' Health Care Consumer?

To be wise purchasers of health care services, consumers need access to accurate and understandable information about health plans and providers. They wrongly assume that more expensive providers are better than less expensive ones, despite inconsistent evidence that there is any link between health care cost and quality.

Feb 5, 2013
News Release

Shared Decision Making Between Patients and Doctors Will Require Investment by Health Systems

Health care providers are encouraged to implement “shared decision making” in which patients and doctors together choose the treatment that is best for each patient. However, doctors need more instruction on how to engage patients and better information systems to make sure patients know their options and receive individualized care.

Feb 4, 2013
Journal Article

Effects of Medical Comorbidity on Anxiety Treatment Outcomes in Primary Care

Evaluates the effects of medical comorbidity on anxiety treatment outcomes.

Jan 1, 2013
Journal Article

Trajectories of Change in Anxiety Severity and Impairment During and After Treatment with Evidence-Based Treatment for Multiple Anxiety Disorders in Primary Care

This study aimed to identify (1) clusters of participants with similar patterns of change in anxiety severity and impairment (trajectory groups); and (2) characteristics that predict trajectory group membership.

Jan 1, 2013
Journal Article

Integrating Primary Care Into Community Behavioral Health Settings: Programs and Early Implementation Experiences

Describes the experiences of community behavioral health agencies that received PBHCI grants from the Substance Abuse and Mental Health Services Administration to integrate primary care into programs for adults with serious mental illness.

Jan 1, 2013
Journal Article

Incorporating Evidence Review Into Quality Improvement: Meeting the Needs of Innovators

Achieving quality improvement (QI) aims often requires local innovation.

Jan 1, 2013
Journal Article

Thirty-Seven Percent of U.S. Emergency Department Visits Are for Nonurgent Conditions

Patients' use of emergency departments (ED) for nonurgent conditions may lead to excessive health care spending, unnecessary testing and treatment, and weaker primary care relationships. These patients tend to be younger and may visit the ED due to a physician referral or for convenience.

Jan 1, 2013
Journal Article

Drivers of Overall Satisfaction with Primary Care: Evidence from the English General Patient Survey

We aim to identify those aspects of patient experience that show the strongest relationship with overall satisfaction and examine the extent to which these relationships vary by socio-demographic and health characteristics.

Jan 1, 2013
Journal Article

When a Whole Practice Model Is the Intervention: Developing Fidelity Evaluation Components Using Program Theory-Driven Science for an Integrative Medicine Primary Care Clinic

This paper provides a rationale for the use of practice theory and fidelity evaluation in studies of integrative practices and describes the approach and protocol used in fidelity evaluation of the University of Arizona Integrative Health Center.

Jan 1, 2013
Journal Article

Do We Really Need More Physicians? Responses to Predicted Primary Care Physician Shortages

Predicted primary care shortages have spurred action to increase the number of primary care physicians.

Jan 1, 2013
Journal Article

Response: Effectiveness in Primary Care Is Paramount, but Need Not Come at the Expense of Efficiency

Effective primary care is vital to sustainable provision of primary care for the US population.

Jan 1, 2013
Journal Article

Primary Care Providers' Initial Treatment Decisions and Antidepressant Prescribing for Adolescent Depression

This study examined the impact of symptom severity and provider characteristics on initial depression treatment decisions in a setting with fewer structural barriers, an integrated behavioral health network.

Jan 1, 2013
Journal Article

Implications of New Insurance Coverage for Access to Care, Cost-Sharing, and Reimbursement

Many physician practices will face a set of critical decisions in the coming years that may contribute to the ultimate success or failure of the ACA.

Jan 1, 2013
Journal Article

Diagnostic Overlap of Generalized Anxiety Disorder and Major Depressive Disorder in a Primary Care Sample

This study addresses the symptom overlap of people meeting DSM-IV-TR diagnostic criteria for GAD, MDD, or both to investigate whether comorbidity might be explained by overlapping diagnostic criteria.

Dec 1, 2012
Research Brief

Providers Influence the Bulk of Health Care Spending in the U.S.

Providers can dramatically improve American health care by focusing on “value” instead of “volume,” eliminating wasteful and inappropriate care, applying the best available evidence to their practices, and enhancing patient safety.

Nov 15, 2012
News Release

Evidence About Whether Retail Medical Clinics Disrupt Doctor-Patient Relationships Is Mixed

People who visit retail medical clinics are less likely to return to a primary care physician for future illnesses and have less continuity of care. However, no evidence suggests that retail medical clinics disrupt preventive care or management of diabetes, two important measures of quality of primary care.

Oct 31, 2012

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RAND Topic:
Primary Care

Research conducted by

RAND Health Care