Running to Stand Still: <i>Change and Management in Canadian Healthcare</i>
Bibliographic record
Abstract
There is a pervasive belief among health system reformers that new public management techniques such as decentralization and market-based approaches will provide the answers to what ails healthcare systems. In this first installment of a two-part discussion, the assumptions and empirical evidence underpinning these techniques are scrutinized, and the effect of their implementation on those who manage the healthcare system is assessed. Other paradigms for delivering healthcare will be considered and described in the second article of this series. Healthcare systems around the world have been buffeted by rising costs, perceived inefficient use of resources, and consumer and provider dissatisfaction with the delivery and outcomes of 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 | 0.005 | 0.017 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.003 | 0.008 |
| Science and technology studies | 0.020 | 0.011 |
| Scholarly communication | 0.011 | 0.004 |
| Open science | 0.003 | 0.003 |
| Research integrity | 0.005 | 0.003 |
| Insufficient payload (model declined to judge) | 0.008 | 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".