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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

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
Journal Article

Leveraging Telehealth to Bring Volunteer Physicians Into Underserved Communities

Organizations that use telehealth to address safety net clinic needs by recruiting retired or semi-retired doctor volunteers can help improve access to physicians in underserved areas while enriching the professional lives of clinicians.

Mar 16, 2017
Journal Article

Attitudes, Practices, and Experiences with Implementing a Patient-Centered Medical Home for Women Veterans

Strengthening positive attitudes toward female veterans may matter more than changing women’s health practice characteristics alone.

Mar 14, 2017
Journal Article

Discharge Handoff Communication and Pediatric Readmissions

Improving the transition from a hospital stay to primary care may benefit patient outcomes but the impact on unplanned 30-day readmissions is unclear.

Mar 14, 2017
Journal Article

How Does Incarcerating Young People Affect Their Adult Health Outcomes?

Youth who spend time in jail may need extra support from pediatricians to minimize long-term physical and mental health effects of incarceration.

Mar 13, 2017
Journal Article

Implementation and Sequencing of Practice Transformation in Urban Practices with Underserved Patients

The comprehensiveness of the patient centered medical home model requires coordination among many care components as well as time and effort for thorough and systematic changes in delivering care.Â

Feb 7, 2017
Journal Article

Fostering Evidence-Based Quality Improvement for Patient-Centered Medical Homes: Initiating Local Quality Councils to Transform Primary Care

Primary care quality councils – consisting of local leaders from medicine, nursing, administration, and a local Veteran patient representative – successfully cultivated quality improvement leadership in 6 VA patient-centered medical homes.

Jan 10, 2017
Commentary

Moving Outpatient Care into the Community

A prominent feature of NHS England policy, “moving care into the community” means that care traditionally provided in hospitals is moved into primary care, such as general practice. This can benefit patients, but it is also important to look at the costs.

Dec 8, 2016
Commentary

Need a Doctor Now? Solve the Acute Care Crisis

Many Americans struggle to receive acute care when they need it. The health care system is not focused on meeting unscheduled needs. Reforming acute care delivery will require making it a policy and research priority.

Nov 17, 2016
Report

Evaluation of Policy Options for Increasing the Availability of Primary Care Services in Rural Washington State

To address a perceived shortage in rural primary care providers, RAND Corporation researchers projected the effects that various policy options could have on Washington State's rural primary care workforce through 2025.

Nov 15, 2016
Journal Article

Rating Communication in GP Consultations: The Association Between Ratings Made by Patients and Trained Clinical Raters

Patients are less likely than professional evaluators to rate physician communication as poor.

Oct 20, 2016
Journal Article

The Fracture of Relational Space in Depression: Predicaments in Primary Care Help Seeking

A disease-oriented concept of depression locates pathology within the individual but depressed individuals describe depression as a burden for their larger social context and seek to hide both diagnosis and treatment.

Oct 7, 2016
Journal Article

Rescaling the Post-Traumatic Stress Disorder Checklist for Use in Primary Care

Changing the response scale for the Posttraumatic Stress Disorder (PTSD) Checklist (PCL), a measure of PTSD symptom severity, yields comparable results to the original version and may improve its clinical utility.

Sep 22, 2016
Journal Article

Enrollment of Specialty Mental Health Clinics in a State Medicaid Program to Promote General Medical Services

A policy to promote mental health-based general medical care--specifically health monitoring and health physicals--was embraced by specialty mental health clinics in New York State.

Sep 22, 2016
Journal Article

Understanding Negative Feedback from South Asian Patients: An Experimental Vignette Study

Ethnic minority participants rated communication in simulated primary care visits substantially higher than White British participants, suggesting that lower scoring from minorities on the English GP Patient Survey reflects real quality differences.

Sep 15, 2016
Journal Article

Behavioral Interventions to Reduce Inappropriate Antibiotic Prescribing: A Randomized Pilot Trial

This experimental study observed large reductions in inappropriate antibiotic prescribing regardless of whether participants received an intervention.

Sep 13, 2016
Journal Article

General Medical Outcomes from the Primary and Behavioral Health Care Integration Grant Program

Rigorous integration of primary and preventive medical services into behavioral health settings may help improve medical outcomes for people with serious mental illness.

Aug 29, 2016
Journal Article

Implementing Exercise Programs to Prevent Falls: Systematic Descriptive Review

Identifying key characteristics of successful fall prevention exercise programs can help clinicians and health system leaders link patients to appropriate community-based programs.

Aug 29, 2016

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RAND Topic:
Primary Care

Research conducted by

RAND Health Care