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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
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
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
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
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
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
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
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
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
Journal Article
Primary Care-Mental Health Integration in the VA: Shifting Mental Health Services for Common Mental Illnesses to Primary Care
As assessed in 29 Southern California Veterans Affairs clinics, primary care—mental health integration programs can help ensure that primary care is providing evidence-based stepped care and that patients with more intensive mental health concerns (e.g., psychosis) are appropriately referred to specialty services.
Jan 16, 2018
Journal Article
Care Coordination for Youth With Mental Health Disorders in Primary Care
More frequent contact with the mental health system, educational system, and Child Protective Services after a behavioral health evaluation may inform development of integrated care systems for children.
Dec 14, 2017
Journal Article
Care Coordination and Provider Stress in Primary Care Management of High-risk Patients
Providing adequate support to PCPs and nurses may help reduce the stress they experience when coordinating care for high-risk patients.
Dec 7, 2017
Journal Article
Primary Care Tasks Associated with Provider Burnout: Findings from a Veterans Health Administration Survey
Sharing responsibility among a PCMH team for behavioral counseling and self-management education may reduce primary care physician burnout.
Dec 7, 2017
Research Brief
Strengthening Health Care in the Kurdistan Region of Iraq
Since 2010, RAND researchers have 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 25, 2017
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
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
Journal Article
Evaluation of Telephone First Approach to Demand Management in English General Practice: Observational Study
For clinicians, this study provides clear evidence that a considerable part of patient workload can be dealt with through phone consultations.
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
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
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

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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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