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Record W2156855625

The declining comprehensiveness of primary care.

2002· article· en· W2156855625 on OpenAlex
Benjamin T.B. Chan

Why this work is in the frame

A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.

affAt least one author lists a Canadian institution in the pinned OpenAlex snapshot.
aboutThe title or abstract carries a Canadian signal from the geographic lexicon.

Bibliographic record

VenuePubMed · 2002
Typearticle
Languageen
FieldHealth Professions
TopicPrimary Care and Health Outcomes
Canadian institutionsInstitute for Clinical Evaluative Sciences
Fundersnot available
KeywordsMedicineFamily medicineOdds ratioConfidence intervalPrimary careOddsDemographyLogistic regression
DOInot available

Abstract

fetched live from OpenAlex

BACKGROUND: Recent studies suggest that comprehensiveness of primary care has declined steadily over the past decade. This study tracks the participation rates of general practitioners and family physicians in 6 nonoffice settings across Ontario and examines among which types of physicians this decline in comprehensiveness has occurred. METHODS: Billing (claims) records were used to determine the proportions of fee-for-service general practitioners and family physicians who provided emergency, inpatient, nursing home, house call, anesthesia or obstetrical services from 1989/90 to 1999/2000. "Office-only" physicians were those who worked in none of these nonoffice settings. The relation of various physician characteristics to comprehensiveness of care was tested with multivariate analysis for 1999/2000. RESULTS: The proportion of "office-only" general practitioners and family physicians rose from 14% in 1989/90 to 24% in 1999/2000 (p < 0.001). Significant increases in this proportion were noted among general practitioners and family physicians of all ages, both sexes and all practice locations. In 1999/2000, recent graduates (who had completed medical school within the past 7 years) had higher participation rates for emergency medicine (40% v. 5% for physicians aged 65 years and older); female physicians had higher participation rates for obstetrics (16% v. 11% for males); and older physicians had higher participation rates for nursing home visits and house calls (20% and 57% respectively v. 11% and 37% for recent graduates). However, "office-only" physicians were more likely to be female (odds ratio [OR] 2.65, 95% confidence interval [CI] 2.37-2.96), recent graduates (OR 1.35, 95% CI 1.15-1.60), aged 65 years and older (OR 1.45, 95% CI 1.20-1.75) or practising in a city with a medical school (OR 2.30, 95% CI 2.06-2.56) and were less likely to be rural physicians (OR 0.31, 95% CI 0.24-0.41) or certified in family medicine (OR 0.58, 95% CI 0.52-0.66). INTERPRETATION: There has been a decline in the provision of comprehensive care by general practitioners and family physicians in Ontario. The decline is evident across all age groups and for both male and female physicians. It is also evident in rural areas and in cities with and without medical schools.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

Full frame distilled prediction

Teacher imitation

Not 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.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Other design · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: none
Teacher disagreement score0.738
Threshold uncertainty score0.636

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0010.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0010.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

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.

Opus teacher head0.133
GPT teacher head0.366
Teacher spread0.233 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it