Walk-in clinics in Quebec, Canada: patients and doctors do not agree on appropriateness of visits
Bibliographic record
Abstract
INTRODUCTION: Walk-in clinics aim to be highly accessible facilities, in particular for urgent primary care cases. A perceived increase of walk-in clinic visits in Canada could put this accessibility at risk. We aimed to study the appropriateness of walk-in clinic visits in Québec, Canada. METHODS: We performed a cross-sectional pilot study in Montréal and surrounding areas, Québec, in 2012, in which both patients and either family physicians or family medicine residents completed a questionnaire about the walk-in clinic visit, including the rating of appropriateness on a three-level scale and patients' motives. Patients' and doctors' surveys were matched for their corresponding visits and next analysed for their agreement on appropriateness of visits by kappa statistic. Influence of modifying factors on appropriateness ratings was analysed by Pearson's chi-square testing. RESULTS: A total of 142 visits were included. Physicians judged more than half of the visits as appropriate, whereas most patients scored their visits' urgency as low or medium. Agreement between both scores by kappa statistics was low (0.05) and non-significant. Visits were rated less appropriate in evenings, in teaching hospitals and by less-experienced doctors (mainly working in teaching hospitals). Common motives for visiting the walk-in clinics included worries about symptoms getting worse, persistence of symptoms and not being able to get regular appointments. CONCLUSION: In our study, doctors rated most visits to walk-in clinics as appropriate, whereas most patients rated the same visits' urgency as medium or low. Doctors in Québec appear to judge patient factors like worries and logistics as legitimate reasons for attending these facilities.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".