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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
Understanding High and Low Patient Experience Scores in Primary Care: Analysis of Patients' Survey Data for General Practices and Individual Doctors
Aggregating patients' ratings of doctors' communication skills at practice level can mask considerable variation in the performance of individual doctors, particularly in lower performing practices.
Jan 1, 2014
Commentary
Is There Really a Physician Shortage?
Large coverage expansions under the ACA have reignited concerns about physician shortages. These estimates result from models that forecast future supply and demand for physicians based on past trends and current practice. While useful exercises, they do not necessarily imply that intervening to boost physician supply would be worth the investment.
Dec 6, 2013
Journal Article
Giving EMS Flexibility in Transporting Low-Acuity Patients Could Generate Substantial Medicare Savings
If Medicare had the flexibility to reimburse EMS for managing selected 911 calls in ways other than transport to an ED, we estimate that the federal government could save $283–$560 million or more per year, while improving the continuity of patient care.
Dec 1, 2013
Research Brief
New Approaches for Delivering Primary Care Could Reduce Predicted Physician Shortage
Growth of patient-centered medical homes and nurse-managed health centers could halve projected U.S. physician shortages by 2025—without training a single additional physician.
Nov 27, 2013
Blog
The Future of the Health Care Workforce: RAND Researchers Well Represented in Health Affairs Special Issue
In “Redesigning the Health Care Workforce,” a new special issue of the journal Health Affairs, RAND researchers contribute to several timely examinations of challenges, opportunities, and potential solutions relating to the future of health care staffing in the U.S. and abroad.
Nov 7, 2013
Announcement
Announcing the RAND Professorship of Health Services Research
The Professorship of Health Services Research, held by Professor Martin Roland CBE, has been retitled to the RAND Professorship of Health Services Research in recognition of the successful collaboration between the University of Cambridge and RAND Europe to develop a center of excellence and innovation in health services research.
Nov 6, 2013
News Release
New Models of Primary Care Could Ease U.S. Physician Shortage
Much of the shortage of primary care physicians expected over the next decade could be eliminated if the nation increases use of new models of medical care that expand the role of nurse practitioners and physician assistants.
Nov 4, 2013
News Release
Foreign-Educated Health Workers Play Vital Role, but Changes May Be Needed to Stabilize U.S. Health Workforce
Foreign-educated and foreign-born health professionals fill important gaps in the U.S. health care workforce, but strategic shifts such as changes in immigration laws may be needed to stabilize the nation's health workforce.
Nov 4, 2013
Journal Article
Primary Care Technicians: A Solution to the Primary Care Workforce Gap
Efforts to close the primary care workforce gap typically employ one of three basic strategies: train more primary care physicians; boost the supply of nurse practitioners or physician assistants, or both; or use community health workers to extend the reach of primary care physicians.
Nov 1, 2013
Journal Article
New Models of Primary Care Could Ease U.S. Physician Shortage
Much of the shortage of primary care physicians expected over the next decade could be eliminated if the nation increases use of new models of medical care that expand the role of nurse practitioners and physician assistants.
Nov 1, 2013
Journal Article
US Military Primary Care: Problems, Solutions, and Implications for Civilian Medicine
The US Military Health System (MHS) faces challenges in delivering cost-effective, high-quality primary care while maintaining a provider workforce capable of meeting both peacetime and wartime needs.
Nov 1, 2013
Journal Article
Operating Characteristics of the PTSD Checklist in a Military Primary Care Setting
The PTSD Checklist–Civilian Version (PCL-C; Weathers, Litz, Herman, Huska, & Keane, 1993) is used for the identification of posttraumatic stress disorder (PTSD).
Sep 1, 2013
Journal Article
Review of Experiences in Three Countries Informs England's Patient Choice Scheme
The experiences of Finland, Norway, and Sweden in offering patient choice schemes highlight England's need to carefully monitor the impact of enhanced choice in primary care to ensure that related policies truly enhance access to and improve the quality of care, and not inadvertently benefit those who are more able to exercise choice.
Sep 1, 2013
Brochure
Evaluating Medicare Demonstration Projects
RAND works closely with the Centers for Medicare & Medicaid Services to design, test, implement, and evaluate demonstration projects that span a wide range of care settings and issues.
Jun 26, 2013
Journal Article
Changing Practice as a Quality Indicator for Primary Care: Analysis of Data on Voluntary Disenrollment from the English GP Patient Survey
Changing family practice (voluntary disenrollment) without changing address may indicate dissatisfaction with care. We investigate the potential to use voluntary disenrollment as a quality indicator for primary care.
Jun 1, 2013
Journal Article
Training Tomorrow's Comprehensive Primary Care Internists: A Way Forward for Internal Medicine Education
Our article focuses on the specific implications of US health reform for internal medicine GME. We describe the required competencies that will allow tomorrow's comprehensive primary care internist to thrive in a proactive US care system.
Jun 1, 2013
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

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RAND Topic:
Primary Care

Research conducted by

RAND Health Care

Researcher Spotlight

Sangeeta C. Ahluwalia

Associate Research Department Director, Behavioral and Policy Sciences Department

Sangeeta Ahluwalia (she/her/hers) is associate research department director for the Behavioral and Policy Sciences Department and a senior policy researcher at the RAND Corporation. She is also an adjunct associate professor of health policy at the UCLA Fielding School of Public Health.…
Lisa V. Rubenstein

Adjunct Physician Policy Researcher

Lisa V. Rubenstein is an adjunct physician policy researcher at the RAND Corporation and professor emeritus of medicine and public health at the University of California, Los Angeles (UCLA). She is a former Robert Wood Johnson Clinical Scholar, past president of the Society of General Internal…

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