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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

The Invisible Homebound: Setting Quality-of-Care Standards for Home-Based Primary and Palliative Care

This article describes the current status of home-based medical care in the United States and offers a brief narrative of a fictional homebound patient and the health events and fragmented care she faces.

Jan 8, 2015
Journal Article

Clinician Advice to Quit Smoking Among Seniors

Little smoking research in the past 20 years includes persons 50 and older; herein we describe patterns of clinician cessation advice to US seniors, including variation by Medicare beneficiary characteristics.

Dec 15, 2014
Report

Health Sector Reform in the Kurdistan Region — Iraq: Financing Reform, Primary Care, and Patient Safety (Arabic-language version)

This report summarizes work on health financing, primary care, and quality and patient safety in Kurdistan: policy options, plans to achieve policy objectives, and implementation of a new management information system.

Dec 1, 2014
Report

Health Sector Reform in the Kurdistan Region — Iraq: Financing Reform, Primary Care, and Patient Safety

This report summarizes work on health financing, primary care, and quality and patient safety in Kurdistan: policy options, plans to achieve policy objectives, and implementation of a new management information system.

Dec 1, 2014
Journal Article

Nudging Physician Prescription Decisions by Partitioning the Order Set: Results of a Vignette-Based Study

Provider treatment choice appears to be influenced by the grouping of menu options, suggesting that the layout of electronic health record (EHR) order sets is not an arbitrary exercise.

Nov 25, 2014
Journal Article

Giving ''sadness'' a Name: The Need for Integrating Depression Treatment Into HIV Care in Uganda

Depression is common among people living with HIV/AIDS (PLWHA) in sub-Saharan Africa (SSA), and can have significant consequences for HIV disease progression, treatment response and prevention.

Nov 20, 2014
Commentary

Military Turns to Collaborative Care to Treat PTSD, Depression

Collaborative care has been an important part of Army efforts to reach out to those struggling with PTSD and depression. It has brought a science-based solution to an essential military problem and has helped thousands of men and women in uniform in ways that also nudge the larger mental health system toward greater effectiveness for all Americans.

Nov 19, 2014
Journal Article

Implementing Collaborative Primary Care for Depression and Posttraumatic Stress Disorder: Design and Sample for a Randomized Trial in the U.S. Military Health System

STEPS-UP will be the first large scale randomized effectiveness trial completed in the US military health system, assessing how an implementation model affects collaborative care impact on mental health outcomes. It promises lessons for health system change.

Oct 30, 2014
Journal Article

Examining the Value of Inpatient Nurse Staffing: An Assessment of Quality and Patient Care Costs

The study findings provide support for the value of inpatient nurse staffing as it contributes to improvements in inpatient care; increases in staff number and skill mix can lead to improved quality and reduced length of stay at no additional cost.

Oct 24, 2014
News Release

Lesbian, Gay and Bisexual Populations in England Report Poorer Health and Worse Experiences with Health Care

Lesbian, gay, and bisexual women and men in England are more likely to suffer from poor health than the general population and are more likely to report unfavorable experiences with the health care they received in general practices.

Sep 4, 2014
Commentary

RAND Helps to Develop From Coverage to Care, a New CMS Initiative

Health coverage is a means to an end: the aim is to help more Americans use their coverage to access routine primary care and preventive services. For many of the newly insured, however, the leap between obtaining insurance and establishing a regular source of care is substantial.

Jul 29, 2014
Journal Article

Primary Healthcare System and Practice Characteristics in Singapore

The main aim of this study was to acquire a comprehensive overview of the perceptions of primary care experts in Singapore about the state of primary care in Singapore, and to compare this with the state of primary care in other countries.

Jul 1, 2014
Journal Article

Design of the Violence and Stress Assessment (ViStA) Study: A Randomized Controlled Trial of Care Management for PTSD Among Predominantly Latino Patients in Safety Net Health Centers

The Violence and Stress Assessment (ViStA) study is the first randomized controlled trial (RCT) to test the impact of a care management intervention for treating PTSD in Federally Qualified Health Centers (FQHCs).

Jun 9, 2014
Research Brief

Improving the Physical Health of Adults with Serious Mental Illness

RAND's evaluation of the Primary and Behavioral Health Care Integration grants program found that programs improved access to integrated primary and behavioral health care for people with serious mental illness but had mixed success improving health.

May 28, 2014
Report

The Future of Health Care in the Kurdistan Region — Iraq: Toward an Effective, High-Quality System with an Emphasis on Primary Care (Arabic-language version)

Examines the health care system in the Kurdistan Region of Iraq, with an emphasis on primary care, and discusses what strategies can be pursued to move toward a more effective and higher-quality health care system.

May 19, 2014
Report

The Future of Health Care in the Kurdistan Region — Iraq: Toward an Effective, High-Quality System with an Emphasis on Primary Care (Kurdish-language version)

Examines the health care system in the Kurdistan Region of Iraq, with an emphasis on primary care, and discusses what strategies can be pursued to move toward a more effective and higher-quality health care system.

Apr 28, 2014
Report

Evaluation of the Primary and Behavioral Health Care Integration (PBHCI) Grant Program

The PBHCI grant program aims to improve the wellness of people with serious mental illness by making primary health care available in community-based settings. Evaluation of strategies, processes, improvements, and outcomes revealed diverse programs serving great needs but with lower than expected enrollment.

Apr 21, 2014
Commentary

Improving Physical Health Care for Adults with Serious Mental Illness

A promising strategy for helping adults with serious mental illness gain access to appropriate primary and preventive medical services is to integrate those services into a setting in which the population already receives care.

Apr 14, 2014
Report

The Future of Health Care in Iraq's Kurdistan Region

Focusing on primary care, experts conducted a year-long analysis of the health care system of the Kurdistan Region of Iraq. Recommendations for implementation and financing, as well as utilization of resources to improve the quality, access, effectiveness, and efficiency of primary care are included.

Apr 10, 2014
Commentary

How to Avert a Doctor Shortage

Within the next decade, the United States may face a shortage of 130,000 physicians due to a growing, aging population and the anticipated demands of those newly insured under the ACA. This shortage can be alleviated by early creative interventions.

Apr 2, 2014

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RAND Topic:
Primary Care

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RAND Health Care