Population Health and Health Reform: Needs-Based Funding in Five Provinces
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
A key component of provincial health reform plans in the 1990s (and directly linked to the process of health system regionalization) was the attempt to move funding for service delivery to new models based on some notion of ‘population needs’. The intent of these models was to fund newly created regional health authorities relative to the health service needs of the population as determined by demographic, socio-economic and other measures of the population. This was done in the belief that it would facilitate the reorganization of service delivery to focus on ‘upstream’ determinants of health rather than merely treating ‘downstream’ illness and injury. This paper, part of a larger multi-faceted examination of provincial health reform decision makers involving researchers from across the country, summarizes and compares the experiences of five provinces (AB, SK, ON, QC and NF). Drawing on lengthy interviews with policy makers, political actors and stakeholder organizations the paper to the strong institutional and interest-based barriers that have blunted efforts to reform system financing at the regional level. Overcoming these barriers continues to be a key challenge for advocates of reorienting the delivery of health services to upstream determinants of population health.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it