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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
Developing Citizen Report Cards for Primary Care: Evidence from Qualitative Research in Rural Tajikistan
Transparency interventions, such as public reporting, have emerged as a potential policy approach to improving the performance of health care providers in resource-constrained settings.
Jun 24, 2015
Commentary
Nature and Nurture: What's Behind the Variation in Recent Medical Home Evaluations?
As demonstrated in Pennsylvania, conveners of medical home pilots are drawing from their early experiences to refine their intervention designs and improve their effectiveness. Such a learning process is likely to be a critical part of successfully implementing any new model of payment and care delivery.
Jun 19, 2015
News Release
Medical Home Intervention with Shared Savings Shows Quality and Utilization Improvements
A medical home intervention that paid bonuses to physician practices based on financial savings showed significant improvements in quality and use of some medical services relative to comparison practices.
Jun 1, 2015
News Release
Antibiotics Prescribed as Often During Telemedicine Appointments as During Face-to-Face Examinations
Patients treated for acute respiratory infections by a doctor on a telephone or live video are as likely to be prescribed an antibiotic as those treated in person. However, patients treated virtually are more often prescribed a broad-spectrum antibiotic, which is concerning because overuse of the drugs increases costs and contributes to antibiotic resistance.
May 27, 2015
Journal Article
An Organizational Readiness Intervention and Randomized Controlled Trial to Test Strategies for Implementing Substance Use Disorder Treatment Into Primary Care: SUMMIT Study Protocol
Millions of people who need treatment for substance use disorders (SUD) do not receive it.
May 21, 2015
Journal Article
The Most Used and Most Helpful Facilitators for Patient-Centered Medical Home Implementation
Like other transformative healthcare initiatives, patient-centered medical home (PCMH) implementation requires substantial investments of time and resources.
May 14, 2015
Journal Article
Beyond Health Equity: Achieving Wellness Within American Indian and Alaska Native Communities
Indigenous peoples across the globe have higher morbidity and mortality rates than their non-Indigenous counterparts.
May 14, 2015
Commentary
More Long-Term Health Conditions, Poorer Health Care Experiences
Patients with multiple long-term health conditions are more likely to report poorer experiences in primary care than those with fewer health problems. A patient-centered model that takes into account the severity of disease — and the impact of combinations of diseases, on patient quality of life and health care experiences — could make a difference.
Apr 23, 2015
Journal Article
Why Do Patients with Multimorbidity in England Report Worse Experiences in Primary Care? Evidence from the General Practice Patient Survey
Authors describe and explain the primary care experiences of people with multiple long-term conditions in England.
Apr 13, 2015
Report
Evaluation of CMS' FQHC APCP Demonstration: Final First Annual Report
RAND was asked to evaluate a demonstration of federally qualified health centers becoming advanced primary care practices for Medicare beneficiaries and to assess the effects on care provided. This is the first report in a series of three.
Apr 9, 2015
Report
Best practice: Medizinische Aus- und Weiterbildung aus internationaler Perspektive
This is a German translation of a report that seeks to inform the further development of medical education and training for primary care in Germany.
Mar 19, 2015
Report
Best practice: Medical training from an international perspective
This report seeks to inform the further development of medical education and training for primary care in Germany. It concludes with a presentation of policy options that arise from comparison with experiences in England, France and the Netherlands.
Mar 19, 2015
Journal Article
Collaborative Care: Mitigating Stigma and Other Barriers to Care Through Mental Health Service Delivery in Primary Care Settings
In this chapter, the authors draw attention to the link between barriers to care (particularly stigma associated with mental health care) and suppressed treatment seeking and service delivery rates.
Mar 5, 2015
Journal Article
Emotional Exhaustion in Primary Care During Early Implementation of the VA's Medical Home Transformation: Patient-Aligned Care Team (PACT)
Transformation of primary care to new patient-centered models requires major changes in healthcare organizations, including interprofessional expectations and organizational policies.
Feb 25, 2015
Journal Article
Categories of Practice Transformation in a Statewide Medical Home Pilot and Their Association with Medical Home Recognition
Healthcare purchasers have created financial incentives for primary care practices to achieve medical home recognition.
Feb 25, 2015
Journal Article
The Impact of Alcohol Use Severity on Anxiety Treatment Outcomes in a Large Effectiveness Trial in Primary Care
The current study examined the impact of alcohol use symptom severity on anxiety disorder treatment outcomes in a multi-site primary care effectiveness study of anxiety disorder treatment.
Jan 23, 2015
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

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RAND Topic:
Primary Care

Research conducted by

RAND Health Care