Le classement des hôpitaux : une nouvelle manière de rendre des comptes
Bibliographic record
Abstract
Demander des comptes à ceux qui détiennent le savoir, dans un domaine où la confiance est essentielle : voilà toute la difficulté de l’application de l’ accountability au monde médical. Non pas que ce milieu s’y refuse, mais on est passé de l’opacité de l’autoévaluation à la surexposition des classements, ceux des médias étant les plus visibles. Qui plus est, les comptes doivent être rendus non seulement sur les dépenses, mais aussi sur la qualité des soins. Face à la multiplication des classements d’hôpitaux (en France, en Angleterre, aux États-Unis, au Canada), les auteurs déterminent quatre formes d’ accountability , selon que les comptes doivent être rendus aux citoyens, aux payeurs, aux patients ou aux professionnels. Mais le mouvement ne cesse pas. Les avantages, les dérives et les contournements des classements incitent à se tourner vers une nouvelle forme d’ accountability qui serait un compromis entre la maîtrise d’un contrôle interne et le maintien d’une exigence démocratique.
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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 | 0.011 | 0.032 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.007 | 0.015 |
| Scholarly communication | 0.014 | 0.010 |
| Open science | 0.001 | 0.007 |
| Research integrity | 0.004 | 0.006 |
| Insufficient payload (model declined to judge) | 0.022 | 0.003 |
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".