The Woodwork Effect: Estimating It and Controlling the Damage
Bibliographic record
Abstract
Many patients in home- and community-based services (HCBS) are not people who, without HCBS, would be in nursing homes. Those attracted to HCBS tend to be people who are younger, better supported, less dependent, and more mentally intact than their nursing home counterparts. Studies show that only about a quarter of the clients selected as likely to enter nursing homes within the coming year are likely to do so, even though they receive no HCBS. Of the 43 studies reported, more than two-thirds had rates of control group nursing home admission of less than 20%. Most patients would also be likely to have experienced only a short nursing home stay even if they were admitted. The result: Receiving HCBS reduced nursing home use rates on average by only a small percentage, not enough to offset the costs of HCBS. Moreover, both older and more recent studies show only small to insignificant effects on most adverse patient outcomes.
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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 | 0.037 | 0.086 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.005 |
| Bibliometrics | 0.004 | 0.005 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.004 | 0.002 |
| Research integrity | 0.002 | 0.004 |
| Insufficient payload (model declined to judge) | 0.010 | 0.002 |
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".