Open research questions in Primary Care and Health Outcomes

What the literature leaves open

• The lack of empirical evaluation of group adaptations for inpatient care. The need for guidance on what works and what does not in adapting evidence-based treatments for inpatient care. The gap in integrating evidence-based psychological models and techniques into the existing multimodal approach to inpatient care.

  Adapting evidence-based psychological treatments for inpatient care: Commentary on Rudd (2025) · 2025 · DOI

• Given these complexities and limitations, inpatient psychotherapy necessarily looks very different than outpatient psychotherapy. Considering the short length-of-stay and scheduling inconsisten- cies, inpatient psychotherapy needs to be very brief and flexible. Furthermore, the heterogeneity and overall severity of patient presentations paradoxically pull for treatment that is both highly individualized and generalized. No single treatment can meet all of these needs. Thus, we suggest that the best approach to psycho- logical treatment in inpatient care is a multimodal approach that incorporates multiple types of psychotherapies delivered in various formats. This approach has long been applied to other aspects of inpatient care. In addition to the emphasis on psychopharmaco- logical treatment, unit schedules are packed with psychoeduca- tional and life skills groups, peer support groups, art and physical exercise activities, and unit/community meetings (Yalom, 1983). Each activity targets different patient needs, and together they holistically support patients’ wellness. Many of these activities are labeled as ‘therapies’; however, few are based on psychological EBTs, and, as outlined in our editorial, hardly any of these group adaptations have been empirically evaluated (Hawes et al., 2025). There is also precedent from outpatient treatment models, such as the coupling of individual therapy and skills group in dialectical behavioral therapy (Linehan, 2015). There is a clear need to inte- grate evidence-based psychological models and techniques into the existing multimodal approach to inpatient care. What could this look like in practice? As we have reiterated, group therapy is the dominant and most practical format for inpatient psychological treatment. In our editorial, we argued that inpatient groups should be open (no restrictions on who attends), designed in a single-session format (knowledge from prior group sessions is not required to benefit from the current session), and based on transdiagnostic treatment models. In contrast to the problem-specific treatment add-ons suggested by Rudd (2025), inpatient groups are more appropriate for addressing generalized patient needs. Groups are an ideal format to teach transdiagnostic conceptual models from EBTs, such as the organization of experi- ence into thoughts, feelings, and behaviors, and understanding of how these interact with each other and the environment from the CBT model. Strategic treatment add-ons, on the other hand, have the poten- tial to allow for greater individualization of treatment, targeting specific patient problems such as suicide risk, substance use, or eating pathology. One of the strengths of BCBT-I that Rudd (2025) highlights, which could apply to strategic treatment add-ons in general, is that, because it is based on the fundamental CBT model, it can easily be integrated with other CBT-based treatments within the unit. For example, when paired with a group teaching, a

  Adapting evidence-based psychological treatments for inpatient care: Commentary on Rudd (2025) · 2025 · DOI

• Abstract Background Voluntary empanelment is widely adopted as a primary care strategy across diverse health systems to promote continuity of care and early disease detection, yet its equity implications remain underexplored, particularly in Asian multi-ethnic settings.

  Beyond financial access: socioeconomic and ethnic disparities in preventive care engagement under Singapore’s Healthier SG programme · 2026 · DOI

• Despite these efforts, how demographic and socio-economic factors shape engagement from programme awareness to screening remains poorly understood.

  Beyond financial access: socioeconomic and ethnic disparities in preventive care engagement under Singapore’s Healthier SG programme · 2026 · DOI

• PURPOSE: Little is known about factors driving rural providers-who face unique challenges-to participate and remain in accountable care organization models.

  Factors Influencing Rural Hospitals to Participate and Remain in Accountable Care Organizations · 2026 · DOI

• The Patient Centered Medical Home (PCMH) model of care is intended to provide accessible and comprehensive care, but little is known about how practicing in a PCMH is associated with rural family physicians’ scope of practice.

  Rural Family Physicians in Patient Centered Medical Homes Have a Broader Scope of Practice · 2026 · DOI

• Although the Person-Centered Primary Care Measure (PCPCM) is a comprehensive and concise measure for evaluating PX in PC, the association between the score and clinical outcomes remains unclear.

  Higher person-centered primary care measure score is associated with better influenza vaccine uptake: a nationwide cross-sectional study · 2025 · DOI

• BACKGROUND: Limited information exists on whether virtual training is equivalent to traditional in-person training in supporting the development of clinical providers.

  An evaluation of virtual supervision effectiveness within department of veterans affairs (VA) health professionals training programs · 2025 · DOI

• Despite Idaho’s predominantly rural geography, limited research exists assessing barriers to providing care within the state.

  Barriers to Providing Optimal Care in Idaho from the Perspective of Healthcare Providers: A Descriptive Analysis · 2025 · DOI

• Conclusions: Few studies have assessed rural interprofessional providers’ perceived barriers to providing optimal, high-quality, care, specifically in the rural state of Idaho, where healthcare services are often not equitable compared to urban regions.

  Barriers to Providing Optimal Care in Idaho from the Perspective of Healthcare Providers: A Descriptive Analysis · 2025 · DOI

• Common key obstacles to continuity of care included resource shortages, insufficient information transfer, and privacy regulations.

  Conditions for and potential solutions associated with continuity of care for patients with complex care needs across Swedish regions with differing population densities · 2025 · DOI

• RAIN’s intervention model could be replicated to address addiction-related harms in other rural communities.

  A novel rural hospital/clinic-system practice-based research network: the Rural Addiction Implementation Network (RAIN) initiative and its goals, implementation, and early results · 2024 · DOI

• However, knowledge in primary care settings, especially in developing countries, such as China, is lacking.

  Managing the quality of primary health care in urban China: the impact of organizational and physician features · 2024 · DOI

• This article addresses the limited knowledge on collaborations between CHW and primary health and well-being providers in Belgium's CHW program.

  Facilitators and Barriers in Collaborations Between Community Health Workers with Primary and Well-Being Providers in Primary Healthcare in Belgium · 2024 · DOI

• BACKGROUND: Limited research has explored the performance of health centers (HCs) compared to other primary care settings among children in the United States.

  Utilization, quality, and spending for pediatric Medicaid enrollees with primary care in health centers vs non-health centers · 2024 · DOI

• There is a gap between aspiration and implementation in academic family medicine. Advanced topics such as research methodology and dissemination strategies are only briefly introduced in existing resources.

  New Faculty Guide to Academic Family Medicine: A Collaboration of STFM Collaboratives: Faculty Development and New Faculty · 2026 · DOI

• Family medicine–specific; rooted in continuity clinic, resident education, and community partnerships Modular “Know/Do” framework with basics, timelines, barriers, and resources Collection of concise pearls, reflections, and practical advice Early career family medicine faculty; program directors and mentors Early career faculty in academic medicine across disciplines Actionable checklists, barrier-mitigation tips, curated resources; strong mentorship guidance Breadth of advice, variety of perspectives, timeless lessons from seasoned educators Supportive and practical, with strategies for navigating the hidden curriculum Inspirational, reflective, and pragmatic, emphasizing career wisdom Departmental orientation, mentorship programs, structured faculty development First chapters dense; limited depth on advanced research/dissemination; no…

  New Faculty Guide to Academic Family Medicine: A Collaboration of STFM Collaboratives: Faculty Development and New Faculty · 2026 · DOI

• Expanding the FMSTP to produce more graduates. Improving rural training and retaining health workers through mentorship and community engagement.

  Family medicine and primary health care in Liberia · 2026 · DOI

• Theoretical developments in general medicine have not delved deep enough to clarify what constitutes and differentiates the general practitioner. Contextualization is necessary to clarify what constitutes and differentiates the general practitioner.

  Contextualization of Clinical Care in General Medicine · 2026 · DOI

• Lack of adherence to the referral system is a challenge contributing to patient bypassing. Negative healthcare worker attitudes are a challenge contributing to patient bypassing. Perceptions of poor quality at PHC facilities are a challenge contributing to patient bypassing.

  Healthcare workers’ perspectives on patient bypassing of Primary Health Care facilities in Mpumalanga province, South Africa · 2026 · DOI

• There is a limited understanding of the factors influencing patients to bypass PHC facilities in Mpumalanga province. The study aims to address this gap by exploring healthcare workers' perspectives on patient bypassing.

  Healthcare workers’ perspectives on patient bypassing of Primary Health Care facilities in Mpumalanga province, South Africa · 2026 · DOI

• The transformation of academic family medicine in corporate America is affecting physicians' ability to connect with patients. The paper argues that private offices are essential for identity and professionalism.

  From private office to locker room: how corporate America is transforming academic family medicine · 2026 · DOI

• There is a need to evaluate whether SRFCs are located in objectively defined areas of need. There is a lack of research on the geographic alignment of SRFCs with medically underserved and underinsured areas.

  A Cross-Sectional Study on Geographic Alignment of Student-Run Free Clinics with Medically Underserved and Underinsured Areas in the United States. · 2026 · DOI

• Capturing the multidimensional and context-dependent nature of health needs. Developing a participatory, multidimensional, and context-sensitive instrument. Integrating stakeholder-derived insights with statistical validation of measurement constructs.

  Development and Validation of the Primary Care Needs Assessment (PCNA) Questionnaire: A Participatory Multidimensional Approach to Identifying Health Needs · 2026 · DOI

• Existing approaches to health needs assessment have largely relied on biomedical or service-centered frameworks. These approaches may not adequately capture the multidimensional and context-dependent nature of health needs. There is a need for a more participatory, multidimensional, and context-sensitive instrument.

  Development and Validation of the Primary Care Needs Assessment (PCNA) Questionnaire: A Participatory Multidimensional Approach to Identifying Health Needs · 2026 · DOI

Most-cited papers in Primary Care and Health Outcomes

• Contribution of Primary Care to Health Systems and Health · Milbank Quarterly · 2005 · 3,468 citations
• Improving Primary Care for Patients With Chronic Illness · JAMA · 2002 · 2,081 citations
• Organizing Care for Patients with Chronic Illness · Milbank Quarterly · 1996 · 2,069 citations
• Developing and evaluating complex interventions: The new Medical Research Council guidance · International Journal of Nursing Studies · 2012 · 1,242 citations
• The Medical Home · PEDIATRICS · 2002 · 723 citations
• The key informant technique · Family Practice · 1996 · 489 citations
• Patient Self-Management: A Key to Effectiveness and Efficiency in Care of Chronic Disease · Public Health Reports · 2004 · 438 citations
• Effects of pay for performance in health care: A systematic review of systematic reviews · Health Policy · 2013 · 430 citations
• Institutional Work to Maintain Professional Power: Recreating the Model of Medical Professionalism · Organization Studies · 2012 · 381 citations
• Disparities in Health Care Are Driven by Where Minority Patients Seek Care · Archives of Internal Medicine · 2007 · 275 citations

Most recent work

• Experiences of access to general practice in England: qualitative study and implications for the NHS 10 year plan · BMJ · 2026
• Patient-reported outcome and experience measures in primary care: a scoping review of systematic collection and use · BMC Health Services Research · 2026
• Practice Variability in the SHARING Choices Pragmatic Trial of Primary Care Advance Care Planning · Journal of the American Geriatrics Society · 2026
• The impact of primary health care services, continuity of care and patterns of care on mortality and hospitalisation-related outcomes in residents of long-term care facilities: a comprehensive national evaluation · Age and Ageing · 2026
• Has denigration of career choice within medicine improved in the UK over the last decade? · Education for Primary Care · 2026
• Geriatricians as Primary Care Providers in Payvider Programs: A Strategic Solution · Journal of the American Geriatrics Society · 2026
• Determinants of Wait Times in the Veterans Health Administration: Implications for Capacity Expansion and Workforce Optimization to Improve Access to Care · Health Services Research · 2026
• Why bringing back the family doctor might not be so simple · BMJ · 2026
• General practitioners’ incentives and practice style: A descriptive registry study of earnings variation in Norway · Health Policy · 2026
• Caring for the institution: An ethnography of quality assurance policy in U.S. rural primary care · Medical Anthropology Quarterly · 2026

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