Intégrer les soins de santé et les services sociaux du Québec : la réforme Couillard de 2003
Bibliographic record
Abstract
En décembre 2003, le gouvernement québécois sous la gouverne du parti Libéral de Jean Charest, adopte sous bâillon, le projet de loi 25.La Loi sur les agences de développement de réseaux locaux de santé et de services sociaux vise à réformer la structure du système de santé du Québec.L'idée principale de cette réforme est de créer des Centres de santé et de services sociaux (CSSS), qui, sous la responsabilité des Agences de santé et de services sociaux (ASSS), seront responsables de développer des soins de santé adaptés à la santé de la population des territoires qu'ils doivent couvrir.L'approche de la santé des populations proposée depuis la Commission Rochon est appliquée plus de 20 ans plus tard.Cette transformation se réalisera toutefois dans le contexte du plan de modernisation de l'État du gouvernement Charest qui vise alors la réduction de la taille et des dépenses de l'État.Ceci teintera la réforme du système de santé qui se verra imposer de manière plus marquée qu'auparavant des mesures issues de la nouvelle gestion publique telle que la gestion par résultats ainsi que la reddition de compte.In December 2003, the Liberal Government of Quebec, under the leadership of Jean Charest, adopted Bill 25 under closure.This Bill, an Act respecting the development of local health and social services networks was aimed at reforming the structure of the health system in Quebec.The main idea driving the reform was to create Centres for Health and Social Services (CSSS), which, under the authority of regional Health and Social Service Agencies (ASSS), would provide direct health care services fitting the needs of the local population.This approach to public health had been proposed since the Rochon Commission, but was not implemented until more than twenty years later-a transformation that was to take place in the context of a strategy to modernize government services proposed by the Charest government with the goal of downsizing government intervention and cutting public budgets.This context has coloured the reform of the health system, the latter being under increasing pressure from demands of outcome-based management or accountability inspired by the new public management (NGP) approach.
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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 | 0.003 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.005 | 0.003 |
| Scholarly communication | 0.005 | 0.001 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.011 | 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".