Les processus de restructuration des systèmes hospitaliers : tendances générales et variations nationales (États-Unis, Royaume-Uni, Québec)
Bibliographic record
Abstract
Résumé Dans la plupart des pays développés, les contraintes macroéconomiques pèsent sur le financement des dépenses de santé. Les incitations à la maîtrise des coûts sont à l’origine de processus de transformations qui affectent en profondeur la dynamique structurelle du secteur hospitalier, favorisent la concentration des ressources et de nouvelles relations entre les offreurs de soins. Cette tendance générale admet des variations nationales et les trajectoires de restructuration suivies par les différents pays ne sont pas linéaires. Ces deux constats ressortent de l’examen, qui constitue l’objet de cette contribution, des évolutions enregistrées par les États-Unis, la Grande-Bretagne et le Canada (Québec) au cours des vingt dernières années.
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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 | 0.008 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.004 | 0.009 |
| Science and technology studies | 0.003 | 0.002 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 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".