Bringing Canadian Healthcare Closer to Home: The Initial Stages of Change for Senior Managers within the Province of British Columbia
Bibliographic record
Abstract
This paper explores some recent healthcare reforms within the Canadian healthcare sector. As in most countries across the world, healthcare managers in Canada have been faced with the dilemma of how to achieve a balance between equity of provision and expenditure control. This study explores the external and internal pressures for change at the provincial and national levels within Canada. More significantly, it focuses on how the early stages of these changes have resulted in altered work roles and relationships for healthcare managers. A case study of British Columbia is described, where radical changes occurred in the healthcare sector in the mid-1990s. Interviews conducted with a sample of senior healthcare managers in the province illustrate how the restructuring of healthcare impacted upon management roles, structures and communication. The qualitative interview data is intended to provide an important addition to the body of largely quantitative, statistical data that is collected on international health systems on a regular basis. How the findings of the case study can contribute to learning and practice within the health services management arena is discussed.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.009 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.030 | 0.006 |
| Scholarly communication | 0.007 | 0.002 |
| Open science | 0.003 | 0.004 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 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 itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".