AHRQ Intensifies its Efforts to Strengthen Primary Care

Primary care is foundational to good health and well-being, providing services that span preventive care to diagnosis and treatment. Access to comprehensive primary care improves patient and population health outcomes across the lifespan.

Aimee Eden, Ph.D., M.P.H.

Yet in the U.S. today, primary care is underfunded, undervalued, and misunderstood. Primary care practices are struggling, clinicians are battling burnout, and patients are losing access to high-quality coordinated, comprehensive, and continuous primary care. At this moment in time, the need for boosting support for America's primary care practices has never been greater.

The challenge of providing high-quality care in today's healthcare landscape has significantly stressed the ranks of primary care professionals. Primary care doctors have the highest rate of turnover among physicians. As a result, more than 100 million Americans don't have usual access to primary care, a number that has nearly doubled since 2014.

As we celebrate National Primary Care Week, AHRQ continues to provide broad support for primary care improvement, not only with tools and resources for clinical teams, but with the evidence that policymakers need to make informed decisions. These activities underscore the agency's commitment to support the women and men who each day navigate steep challenges to deliver safe, effective, and equitable primary care.

A comprehensive report released earlier this year by AHRQ's National Center for Excellence in Primary Care Research (NCEPCR) describes AHRQ's recent investments in primary care research from throughout the Agency. Included in the report are research summaries on topics ranging from strategies for increasing preventive care in children, to prediction models for clinician burnout, to using an electronic screening tool to identify adolescents at risk for sexually transmitted infections.

NCEPCR also offers learning opportunities for primary care researchers. Webinar recordings posted this year from the Strengthening Primary Care Research webinar series feature AHRQ-funded studies aimed at strengthening primary care delivery. A three-part Practice-based Research Network (PBRN) learning series was launched this summer, and the final asynchronous e-learning course will be added soon.

Among additional resources to support improvements in primary care:

• Data now included in AHRQ's Compendium of U.S. Health Systems provides opportunities for researchers to explore trends primary care. Data on more than 283,000 outpatient sites in 2022 include information on practice type, specialty, and whether practices are in primary care shortage areas. A new data visualization allows policymakers to explore state-specific information on proportions of practices that are corporate owned, owned by integrated delivery networks, or independent-information that has implications for health outcomes, care quality, and the experience of delivering, accessing, and receiving primary care.
• A recently released how-to guide, Developing and Sustaining State-Based Infrastructure To Support Primary Care Quality Improvement, highlights effective approaches and lessons learned from AHRQ initiatives designed to provide external quality improvement support for primary care practices. The guide shares information to strengthen the capacity of healthcare systems, other healthcare organizations, and clinicians to deliver evidence-based whole-person care.
• A pair of topic briefs from AHRQ's Integration Academy offer guidance on how community engagement can support whole-person primary care and the role of behavioral-developmental health screening for young children in pediatric primary care.
• A technical brief identifies initial steps toward establishing a standardized approach to estimating primary care spending among federal, state, and private payers. A standardized approach would help policymakers make evidence-based decisions on investments aimed at increasing patient access to critical primary care services.

Tess Miller, Dr.PH.

It is imperative to understand how access to primary care, care coordination, continuity, comprehensiveness, person-centeredness, and trust can be improved and effectively delivered. In today's ever-changing social, political, and economic environments, the challenges to delivering this kind of high-quality primary care are complex, but opportunities to address these challenges await us.

Two current AHRQ funding opportunities-one soliciting large project proposals (R01), another for small research grants (R03)-are aimed at building evidence about the characteristics and value of primary care that influence patient outcomes and advance health equity. These research investments speak to AHRQ's belief that it is the energy and creative ideas from the health services research community that will ensure primary care evolves in ways that serve the needs of patients.

During National Primary Care Week, we are pleased to highlight AHRQ's continued investment in primary care research and the development of resources to understand and address today's challenges. These efforts signal the agency's commitment to ensuring that the U.S. can become a leader in providing foundational, high-quality primary healthcare to all if its citizens.

Dr. Miller is director of AHRQ's Center for Evidence and Practice Improvement. Dr. Eden is acting director of AHRQ's National Center for Excellence in Primary Care Research.

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