Access and Quality of Primary Care for People With Disabilities: A Comparison of Practice Factors
Bibliographic record
Abstract
This study shows how practice factors, particularly payment type, affect quality and accessibility of primary care for adults with disabilities. The study consisted of: (a) a survey of practice characteristics, including accessibility, accommodations for disabled patients, and payment type; and, (b) a retrospective chart audit for quality of care indicators. The sample consisted of 513 patients within 73 doctors within 47 practices. The study show that there are significant differences between payment types on location, number of physicians and other health professionals, caseloads and patient contacts. Salaried practices scored significantly higher on accessibility and willingness to make accommodations for patients with disabilities. Salary practices scored significantly higher than FFS or capitation for the treatment of diabetes, hypertension and urinary tract infections. Capitation practices scored significantly lower than the other two payment types on preventive care. These findings raise questions regarding the mix of salary to other models of practice, and incentives for ensuring that those with the greatest need receive the best possible primary care.
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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 | 0.002 | 0.021 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 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".