Bibliographic record
Abstract
BACKGROUND: Health care reform, through innovative health delivery systems, has been a high priority to address staff shortages, increasingly complex care needs of the aging population, and fragmentation of care. Community health centers have been promoted as one service delivery model with large potential for integration and collaboration. The South Calgary Health Centre (SCHC) opened in June 2004 with the mandate to provide a new model for accessible, accountable, integrated, and community-based health services. PURPOSE: The primary objective was to determine the performance of the SCHC; and further, to establish the value of the evaluation framework used in measuring organizational performance of an integrated service delivery model. METHODOLOGY: Multiple stakeholders were involved in the evaluation in a utilization-focused, participatory way. A comprehensive evaluation framework was developed and implemented to assess the performance of the SCHC at system, provider, and patient levels. Functional, clinical, and community integration were key systems outcomes within this framework. Case-study methodology with mixed methods drawing on multiple data sources (both qualitative and quantitative) was used. FINDINGS: The evaluation findings suggest that the center is functioning well and that staff and client satisfaction are high. Although the model has not achieved all that was originally intended (i.e., fully realized clinical integration), participants felt that the model has been successful and has great potential for integration. The comprehensive evaluation framework developed for this project proved useful in assessing different aspects of integration as well as provider and client perceptions of the center's performance. PRACTICE IMPLICATIONS: Evaluation findings and recommendations have been used to inform operations at the SCHC and for the planning of future health centers. The evaluation framework may help to standardize evaluation approaches across projects and can be used for monitoring progress of the SCHC as well as future evaluations of integrated service delivery models.
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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 | 0.024 | 0.042 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.006 | 0.005 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.001 | 0.005 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.007 | 0.001 |
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".