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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
Internalized Stigma as an Independent Risk Factor for Substance Use Problems Among Primary Care Patients: Rationale and Preliminary Support
High rates of internalized stigma - self-applied negative stereotypes - among primary care patients with opioid or alcohol use disorders were significantly related to greater substance use problems.
Sep 19, 2017
Journal Article
Barriers and Facilitators to Implementation of VA Home-Based Primary Care on American Indian Reservations: A Qualitative Multi-Case Study
Common experiences among Veterans Affairs medical centers expanding their home-based primary care services to rural American Indian reservations provide lessons learned for future expansions.
Sep 19, 2017
Journal Article
Standardizing the Measurement of Commercial Health Plan Primary Care Spending
Primary care is often acknowledged as the foundation of any high-performing health care delivery system. But how much of our health dollars go to supporting it?
Sep 15, 2017
Journal Article
Primary Care Providers with More Experience and Stronger Self-Efficacy Beliefs Regarding Women Veterans Screen More Frequently for Interpersonal Violence
Some primary care provider experiences and beliefs regarding women's health care influence rates of screening for military sexual trauma (MST) and/or intimate partner violence (IPV) .
Sep 6, 2017
Journal Article
Age Differences in Death and Suicidal Ideation in Anxious Primary Care Patients
One in three older adults with anxiety reported feeling like they were better off dead, which underscores the importance of assessing for suicidality in this population during primary care visits.
Aug 31, 2017
Journal Article
Challenges to Teaming for Pain in Primary Care
Better understanding task distribution related to chronic pain assessment and management can help improve team-based pain care.
Aug 23, 2017
Journal Article
Utilization of Registered Nurses in Primary Care Teams: A Systematic Review
Embedding registered nurses into primary care teams can increase patient access to primary care services and alleviate organizational workload.
Aug 4, 2017
Journal Article
Trends in Visits to Specialist Physicians Involving Nurse Practitioners and Physician Assistants, 2001 to 2013
While the number of NPs and PAs involved in the care of patients of specialist physicians has increased, visits involving NPs or PAs remain a small proportion of overall specialty visits.
Aug 2, 2017
Journal Article
Safety-Net Providers Can Adopt Medical Home Models and Improve Primary Care; Cost Reductions Harder
Most of the federally qualified health centers that participated in a program to help them adopt a “medical home” model of advanced primary care were successful in doing so. These changes improved access to primary care, but did not decrease the use of specialty care, acute care services or Medicare expenditures.
Jun 27, 2017
Report
Evaluation of CMS's Federally Qualified Health Center (FQHC) Advanced Primary Care Practice (APCP) Demonstration: Final Report
This report contains an independent evaluation of the Federally Qualified Health Center Advanced Primary Care Practice Demonstration for the Centers for Medicare and Medicaid.
Jun 26, 2017
Journal Article
Provision of Peer Specialist Services in VA Patient Aligned Care Teams: Protocol for Testing a Cluster Randomized Implementation Trial
Assessing the impact of outside assistance on the deployment of peer specialists in Veterans Health Administration Patient Aligned Care Teams will provide critical data to administrators and policy makers.
Jun 7, 2017
Journal Article
High-Price And Low-Price Physician Practices Do Not Differ Significantly On Care Quality Or Efficiency
Higher-priced providers do not necessarily provide higher-quality care.
Jun 6, 2017
Journal Article
Physician Breast Cancer Screening Recommendations Following Guideline Changes: Results of a National Survey
Physicians' recommendations for when to start and end breast cancer screening vary, depending on their level of trust with the guideline-issuing organization.
May 23, 2017
Journal Article
Patient Experiences with Care Differ with Chronic Care Management in a Federally Qualified Community Health Center
Adults receiving primary care at federally qualified health centers were more likely to positively rate their patient experience if their health center scored highly on adoption of chronic care management.
May 23, 2017
Journal Article
Have Individual Medical Savings Accounts Accumulated Meaningful Balances After 10 Years of Enrolment? Empirical Evidence from China
China's medical savings accounts have not succeeded in promoting individual savings for medical care, especially among vulnerable groups such as women and the elderly.
May 11, 2017
Commentary
Beyond Medication Reconciliation: The Correct Medication List
Primary care clinicians are expected to reconcile a patient's medications at every visit. In practice, this has failed to have a demonstrable effect on patient outcomes. What is needed is not merely a reconciled list, but the correct list.
Apr 21, 2017
Journal Article
The Clinical Pharmacy Specialist: Part of the Solution
Efforts to create high-functioning primary care teams should take advantage of the knowledge and skills of clinical pharmacy specialists
Apr 19, 2017
Journal Article
Collaborative Mental Health Care for Pediatric Behavior Disorders in Primary Care: Does It Reduce Mental Health Care Costs?
Doctor-office collaborative care is more cost-effective than enhanced usual care for treating children with behavioral problems in primary care settings.
Apr 18, 2017
Report
Examining the Implementation of the Medicaid Primary Care Payment Increase
RAND researchers examined stakeholder experiences with an Affordable Care Act provision that qualifying providers of primary care services participating in the Medicaid program would receive enhanced federal payments for providing certain services.
Apr 4, 2017
Report
The Impact of Establishing a Full Scope of Practice for Advanced Practice Registered Nurses in the State of Indiana
This report examines the literature related to the relationship between state APRN SOP regulations and health care delivery, and it estimates the effect on the state of Indiana if the legislature were to define a full SOP for APRNs.
Mar 22, 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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