Continuity in primary care and its impact on investments in health capital. an application and extension of the grossman model of the demand for health
Notice bibliographique
Résumé
This thesis examines continuity in primary care within the framework of an economic model of health. Grossman's Model of the Demand for Health explores how individual factors such as education affect the efficiency in the production of health investments and the resulting addition to one's stock of health. This thesis posits that continuity of care also increases the efficiency of investments in health and uses this theoretical framework to look at continuity of care and its impact on the demand for health. The main objectives of this study were to: determine what individual patient characteristics are associated with continuity of care; assess the relationship between continuity of care and health status; assess the relationship between continuity in primary care and ambulatory care utilization; and study the effect of the presence of a chronic condition. The study used data from the 1994 National Population Health Survey and linked it ambulatory care and hospitalization data. Continuity was measured by Bice and Boxerman's COC index. The analyses included multivariate regression to model continuity of care with individual-level variables and ambulatory care utilization. Stratification on the basis of whether or not a patient had a chronic condition was also used to look at the effect of this variable on the relationship in question. A strong relationship was found between continuity in primary care and patient age, retirement and income. Increasing continuity was associated with decreasing rates of medical hospitalizations, indicating a possible relationship between continuity and health. A negative association was found between continuity in primary care and the number of visits made per patient. This relationship was not affected by individuals' chronic disease status. Expenditures appeared to be unrelated to continuity of care, except among patients with chronic conditions, where the relationship was found to be negative. This study demonstrated an association between continuity of care and the demand for medical care. These findings support the hypothesis that with greater continuity, patients realize greater returns on the investments in their health capital. As a result, they derive more health benefits and experience a reduced demand for health and for further health care.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,008 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,002 | 0,002 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,007 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».