Skip to page content

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

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
Journal Article

Centrally Assisted Telecare for Military Members with PTSD and Depression

Military members who visited a primary care clinic while suffering from PTSD and depression reported fewer symptoms and better mental health functioning a year after enrolling in a treatment program that included specially trained care managers and telephone therapy options.

Jun 24, 2016
Journal Article

Association Between Primary Care Visits and Colorectal Cancer Screening Outcomes in the Era of Population Health Outreach

Patients who visited their primary care provider one or more times were almost twice as likely to be screened for colorectal cancer and about 30 percent more likely receive a follow-up colonoscopy after a positive screening result.

Jun 24, 2016
Report

Agreement with, and feasibility of, the emerging recommendations from the Living with Breathlessness study: Findings from an online stakeholder survey

This report contains the findings from an online survey of stakeholders who work with people living with advanced COPD to explore agreement with, and feasibility of the recommendations from the Living with Breathlessness study.

Jun 6, 2016
Commentary

Can Hospital Services Work in Primary Care Settings?

Shifting health care from hospitals to the community will only be justified if patient satisfaction and convenience is valued above costs to the NHS, or if this shift reduces health care costs in the long term.

Jun 2, 2016
Journal Article

Outpatient Services and Primary Care: Scoping Review, Substudies and International Comparisons

Strategies to improve the effectiveness and efficiency of outpatient services.

May 11, 2016
Journal Article

Relationship Between Adolescent Report of Patient-Centered Care and of Quality of Primary Care

This study supports the use of patient-centered care, self-reported by adolescents, as a measure of primary care quality for adolescents.

Apr 21, 2016
Journal Article

Barriers to Engaging Service Members in Mental Health Care Within the U.S. Military Health System

Despite efforts to integrate behavioral health care into primary care in the military health system, members of the military continue to perceive barriers to mental health care access. Issues remain with capacity, culture, and care quality.

Apr 1, 2016
Journal Article

Care Management Processes Used Less Often for Depression Than for Other Chronic Conditions in US Primary Care Practices

U.S. primary care physicians make less use of care management for depression than for asthma, congestive heart failure, or diabetes, suggesting that primary care practices are not well equipped to manage depression as a chronic illness, despite the high proportion of depression care they provide.

Mar 14, 2016
Journal Article

Accuracy of the Safer Dx Instrument to Identify Diagnostic Errors in Primary Care

We aimed to test the accuracy of an instrument to help detect presence or absence of diagnostic error through record reviews.

Mar 2, 2016
Journal Article

The Facilitators and Barriers Associated with Implementation of a Patient-Centered Medical Home in VHA

We used a 2012 survey of primary care employees in the Veterans Health Administration to perform cross-sectional, respondent-level multinomial regressions.

Mar 2, 2016
Journal Article

Effect of Behavioral Interventions on Inappropriate Antibiotic Prescribing Among Primary Care Practices: A Randomized Clinical Trial

This study assesses the effects of behavioral interventions and rates of inappropriate (not guideline-concordant) antibiotic prescribing during ambulatory visits for acute respiratory tract infections.

Feb 18, 2016
Journal Article

Association of Medical Home Team-Based Care Functions and Perceived Improvements in Patient-Centered Care at VHA Primary Care Clinics

Team-based care is central to the patient-centered medical home (PCMH), but most PCMH evaluations measure team structure exclusively. We assessed team-based care in terms of team structure, process and effectiveness, and the association with improvements in teams' abilities to deliver patient-centered care.

Jan 26, 2016
News Release

Significant Costs Involved with Converting Primary Care Medical Practices to 'Medical Homes'

While there are financial incentives available to primary care practices that transform into medical homes, such investments might be especially challenging for small practices and those not associated with a larger health network. The costs include one-time startup costs and ongoing costs, the greatest being adding new staff to help better coordinate patients' care.

Jan 11, 2016
Journal Article

Availability of Primary Care Team Members Can Improve Teamwork and Readiness for Change

This study conducted a survey of 766 adult primary care providers and staff in 34 California safety net practices to assess primary care team structure (team size, team member availability, and access to interdisciplinary expertise), teamwork, and readiness for change.

Nov 20, 2015
Journal Article

Innovative Approach to Patient-Centered Care Coordination in Primary Care Practices

Embedding non-licensed care coordinators in primary care practices significantly reduced emergency department visits.

Nov 13, 2015
Journal Article

The Relationship Between Same-Day Access and Continuity in Primary Care and Emergency Department Visits

This study examines how emergency department (ED) visits for potentially preventable, mental health, and other diagnoses were related to same-day access and provider continuity in primary care.

Oct 29, 2015

Previous
1
2
3
4
5
6
7
8
9
10
Next

RAND Topic:
Primary Care

Research conducted by

RAND Health Care