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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
Sustaining Alcohol and Opioid Use Disorder Treatment in Primary Care: A Mixed Methods Study
Access to external funding and staff support are two important factors for the sustainability of substance use disorder treatment provision within primary care clinics.
Aug 24, 2018
Journal Article
The Evaluation of Physicians' Communication Skills From Multiple Perspectives
A divergence between physician and patient expectations of communication practices may be common in primary care.
Aug 23, 2018
Journal Article
Impact of Medicaid Policy on the Oral Health of Publicly Insured Children
State policies that support non-dental primary care providers' application of fluoride varnish treatment were associated with improvements in oral health for young children with public insurance.
Aug 21, 2018
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
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
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
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
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
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
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
"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
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
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
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

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RAND Topic:
Primary Care

Research conducted by

RAND Health Care

Researcher Spotlight

Jonathan S. Levin

Policy Researcher

Jonathan S. Levin (he/him) is a policy researcher at the RAND Corporation. He uses mixed methods to examine access, costs, and quality in public insurance programs, health care consolidation, prescription drugs, and treatment patterns for individuals with mental illness and substance use…
Rachel O. Reid

Physician Policy Researcher and Director of Health Care Division Public Sector Team

Rachel Reid is a physician policy researcher at the RAND Corporation and Director of the RAND Health Care Division Public Sector Team. A practicing primary care physician, her research focuses on measuring cost, quality, and value in health care. She has particular interest in the primary care…

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