A survey of the immunization delivery system to preschool children in an urban Canadian community
Bibliographic record
Abstract
A study was carried out of the mixed public—private delivery system for preschool immunizations in the Simon Fraser Health Unit, an urban health unit area in the Lower Mainland of British Columbia. The objectives of the study were to compare the effectiveness of physicians and public health nurses as providers of immunizations by specific measures of performance and to assess some of the determinants of parental preference for providers. General data was gathered from a literature review on these issues of provider effectiveness and parental preferences. Specific data was gathered on these two providers' effectiveness in timing measles immunization and parental willingness to pay user fees using a sample survey of 600 randomly selected three year old children born in 1978 in the health unit area. The literature reviewed and the results of the survey suggested that public health nurses provide equivalent or better services by specific measures of performance. In particular, the survey was able to show that public health nurses more closely adhered to provincial policies for the timing of measles immunizations. The survey also showed a mix of 55% private and 45% public delivery in the area studied. Prominent determinants of parental preference for both providers were found to be convenience (38%), personal preferences other than convenience (34%), and physician's advice (25%). Respondents in the survey were split on their willingness to pay user fees for these preventive care services. Finally based upon the findings of this study, a number of future studies were suggested. In particular, cost-minimization studies were recommended to assess the potential of various supply and demand side controls in making the current mixed delivery system of preschool immunization more efficient.
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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 | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.005 |
| Science and technology studies | 0.004 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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".