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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
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
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
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
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
Journal Article
Posttraumatic Stress Disorder in U.S. Military Primary Care: Trajectories and Predictors of One-Year Prognosis
Most military primary care patients with PTSD experienced persistent symptoms, and most indicators of clinical status offered little prognostic information beyond the brief assessment of combat exposure.
Aug 26, 2016
Journal Article
The Impact of Using Mid-Level Providers in Face-To-Face Primary Care on Health Care Utilization
When working under a physician's supervision, nurse practitioners and physician assistants do not increase utilization and spending.
Aug 25, 2016
Commentary
Can a Nurse Practitioner Replace a Physician?
The VA is considering expanding the role of nurse practitioners in order to provide veterans timely access to primary care services. Research has shown that nurse practitioners working in collaborative settings can provide high-quality care.
Jul 22, 2016
Journal Article
Impact of Medical Home Implementation Through Evidence-Based Quality Improvement on Utilization and Costs
Use of the evidence-based quality improvement approach to enhance medical home implementation in Veterans Affairs practices reduced ambulatory care and increased telephone-based care, but did not affect total costs relative to comparison practices.
Jun 27, 2016

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RAND Topic:
Primary Care

Research conducted by

RAND Health Care