Home Care Evolution in Alberta: How Have Palliative Clients Fared?
Bibliographic record
Abstract
This study compared palliative and non-palliative home care clients, services and providers, and described changes over a decade of health system reform (1991/92-2000/01).Complete individual-anonymous data from Alberta' s home care database were analyzed.Over these 10 years, 7.0% of all home care clients were classified as palliative.The proportion of home care clients who were classified as palliative varied from 2.2% to 9.6% among health regions.The number of palliative clients more than doubled, although this growth was less than that of short-term clients.Home support aides were the most common home care provider, and personal care was the most common service provided to all clients.Although the average number of care hours prior to death for palliative clients increased from 40.9 to 87.9 hours, the relatively small amount of home care provided to dying persons raises concerns about informal caregiver burden and possible overreliance on hospitals to provide end-of-life care. RésuméCette étude comparait des clients, des services et des fournisseurs de soins palliatifs et non palliatifs à domicile, et décrivait les changements survenus sur les dix ans de la réforme du système des soins de santé (1991/1992-2000/2001).Des données individuelles anonymes complètes tirées de la base de données sur les soins à domicile en Alberta ont été analysées.Au cours de ces dix années, 7 % de tous les patients bénéficiant de soins à domicile étaient classés comme recevant des soins palliatifs.La proportion de patients recevant des soins à domicile et classés comme bénéficiant de soins palliatifs a varié de 2,2 % à 9,6 % entre les régions sanitaires.Le nombre de clients en soins palliatifs a plus que doublé, bien que cette hausse soit moindre que chez les clients recevant des soins à court terme.Les aides de soutien à domicile étaient les fournisseurs de soins à domicile les plus courants, et les soins personnels étaient le service le plus courant fourni à tous les clients.Bien que le nombre moyen d'heures de soins avant décès consacrées aux patients en soins palliatifs ait augmenté de 40,9 à 87,9, la quantité relativement faible de soins à domicile fournie aux personnes mourantes soulève des préoccupations, notamment en ce qui concerne le fardeau
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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 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.004 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| 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".