Primary care

Jump to navigation Jump to search

WikiDoc Resources for Primary care

Articles

Most recent articles on Primary care

Most cited articles on Primary care

Review articles on Primary care

Articles on Primary care in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Primary care

Images of Primary care

Photos of Primary care

Podcasts & MP3s on Primary care

Videos on Primary care

Evidence Based Medicine

Cochrane Collaboration on Primary care

Bandolier on Primary care

TRIP on Primary care

Clinical Trials

Ongoing Trials on Primary care at Clinical Trials.gov

Trial results on Primary care

Clinical Trials on Primary care at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Primary care

NICE Guidance on Primary care

NHS PRODIGY Guidance

FDA on Primary care

CDC on Primary care

Books

Books on Primary care

News

Primary care in the news

Be alerted to news on Primary care

News trends on Primary care

Commentary

Blogs on Primary care

Definitions

Definitions of Primary care

Patient Resources / Community

Patient resources on Primary care

Discussion groups on Primary care

Patient Handouts on Primary care

Directions to Hospitals Treating Primary care

Risk calculators and risk factors for Primary care

Healthcare Provider Resources

Symptoms of Primary care

Causes & Risk Factors for Primary care

Diagnostic studies for Primary care

Treatment of Primary care

Continuing Medical Education (CME)

CME Programs on Primary care

International

Primary care en Espanol

Primary care en Francais

Business

Primary care in the Marketplace

Patents on Primary care

Experimental / Informatics

List of terms related to Primary care

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Please Take Over This Page and Apply to be Editor-In-Chief for this topic: There can be one or more than one Editor-In-Chief. You may also apply to be an Associate Editor-In-Chief of one of the subtopics below. Please mail us [2] to indicate your interest in serving either as an Editor-In-Chief of the entire topic or as an Associate Editor-In-Chief for a subtopic. Please be sure to attach your CV and or biographical sketch.

Primary care is a term used for the activity of a health care provider who acts as a first point of consultation for all patients. Generally, primary care physicians, nurse practitioners and physician assistants are based in the community, as opposed to the hospital. Alternative names for the field are "general practice" and "family medicine", although the terms are not synonymous.

General practitioners in the United Kingdom are physicians who have completed four to five years of post-medical school training including three to four years based in hospitals and one year attached to a training general practitioner in the community.

Primary care physicians usually include family practice, internal medicine, pediatrics, and at times OB/GYN physicians. It is important to note, however, that the last three of the above specialties are not technically general medicine specialties. These specialties are primary care, but NOT general medicine.

Continuity of care

The importance of continuity of care has been studied in a systematic review[1].

Continuity of care is also important for after hospitalizations and emergency department visits (see hospital readmission). Follow-up visits after emergency department visits may also be important[2].

Frequency of visits

Physicians vary widely in their setting revisit intervals[3].

Shorter revisit intervals is associated with better care of hypertension[4][5] Aand may be associated with better care of diabetes[6].

Limitations

Time

There is insufficient time in primary care to address

Financing

Medicare has created G-codes to support billing for the increasing burden of non-face-to-work to help patients. Examples include:

  • CPT codes 99358 and 99359 (Prolonged service without direct patient contact)
  • CPT codes 99415 and 99416 (Prolonged clinical staff services)
  • CPT code 99417 (Prolonged office/outpatient E/M services with or without direct patient contact).
  • HCPCS add-on code G2212 (Prolonged office/outpatient E/M services)[9][10]

Primary care practices underuse these codes[8].

Interventions to improve primary care

Interventions to improve primary care via replacement (clinic-based or home-based) or augmentation have been studied[11].

Consoliding and integrating small practices to larger systems

Primary card practices are shifting to being part of larger systems[12][13].

See also

External links

References

  1. Baker R, Freeman GK, Haggerty JL, Bankart MJ, Nockels KH (2020). "Primary medical care continuity and patient mortality: a systematic review". Br J Gen Pract. 70 (698): e600–e611. doi:10.3399/bjgp20X712289. PMC 7425204 Check |pmc= value (help). PMID 32784220 Check |pmid= value (help).
  2. Lin MP, Burke RC, Orav EJ, Friend TH, Burke LG (2020). "Ambulatory Follow-up and Outcomes Among Medicare Beneficiaries After Emergency Department Discharge". JAMA Netw Open. 3 (10): e2019878. doi:10.1001/jamanetworkopen.2020.19878. PMC 7547366 Check |pmc= value (help). PMID 33034640 Check |pmid= value (help).
  3. Schwartz LM, Woloshin S, Wasson JH, Renfrew RA, Welch HG (1999). "Setting the revisit interval in primary care". J Gen Intern Med. 14 (4): 230–5. doi:10.1046/j.1525-1497.1999.00322.x. PMC 1496560. PMID 10203635.
  4. Turchin A, Goldberg SI, Shubina M, Einbinder JS, Conlin PR (2010). "Encounter frequency and blood pressure in hypertensive patients with diabetes mellitus". Hypertension. 56 (1): 68–74. doi:10.1161/HYPERTENSIONAHA.109.148791. PMC 3752696. PMID 20497991.
  5. Guthmann R, Davis N, Brown M, Elizondo J (2005). "Visit frequency and hypertension". J Clin Hypertens (Greenwich). 7 (6): 327–32. doi:10.1111/j.1524-6175.2005.04371.x. PMID 16088295.
  6. Asao K, McEwen LN, Crosson JC, Waitzfelder B, Herman WH (2014). "Revisit frequency and its association with quality of care among diabetic patients: Translating Research Into Action for Diabetes (TRIAD)". J Diabetes Complications. 28 (6): 811–8. doi:10.1016/j.jdiacomp.2014.06.006. PMC 4252480. PMID 25044233.
  7. Yarnall KS, Pollak KI, Østbye T, Krause KM, Michener JL (2003). "Primary care: is there enough time for prevention?". Am J Public Health. 93 (4): 635–41. doi:10.2105/ajph.93.4.635. PMC 1447803. PMID 12660210.
  8. 8.0 8.1 Agarwal SD, Basu S, Landon BE (2022). "The Underuse of Medicare's Prevention and Coordination Codes in Primary Care : A Cross-Sectional and Modeling Study". Ann Intern Med. doi:10.7326/M21-4770. PMID 35759760 Check |pmid= value (help).
  9. CMS. Fact Sheet - Physician Fee Schedule (PFS) Payment for Office/Outpatient Evaluation and Management (E/M) Visits. January 11. 2021. vailable at https://www.cms.gov/files/document/physician-fee-schedule-pfs-payment-officeoutpatient-evaluation-and-management-em-visits-fact-sheet.pdf
  10. ACP. The case for G2211, Medicare's visit complexity code. May, 2023. Availabe at: https://acpinternist.org/archives/2023/05/the-case-for-g2211-medicares-visit-complexity-code.htm
  11. Edwards ST, Peterson K, Chan B, Anderson J, Helfand M (2017). "Effectiveness of Intensive Primary Care Interventions: A Systematic Review". J Gen Intern Med. 32 (12): 1377–1386. doi:10.1007/s11606-017-4174-z. PMC 5698228. PMID 28924747.
  12. Machta RM, D Reschovsky J, Jones DJ, Kimmey L, Furukawa MF, Rich EC (2020). "Health system integration with physician specialties varies across markets and system types". Health Serv Res. 55 Suppl 3: 1062–1072. doi:10.1111/1475-6773.13584. PMID 33284522 Check |pmid= value (help).
  13. Furukawa MF, Kimmey L, Jones DJ, Machta RM, Guo J, Rich EC (2020). "Consolidation Of Providers Into Health Systems Increased Substantially, 2016-18". Health Aff (Millwood). 39 (8): 1321–1325. doi:10.1377/hlthaff.2020.00017. PMID 32744941 Check |pmid= value (help).


Template:WikiDoc Sources