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Record W2296791571

Chronic failure in primary care

2016· article· en· W2296791571 on OpenAlexaboutno aff
Hal Swerissen, Stephen Duckett

Bibliographic record

Venuenot available
Typearticle
Languageen
FieldHealth Professions
TopicPrimary Care and Health Outcomes
Canadian institutionsnot available
Fundersnot available
KeywordsMedicineGovernment (linguistics)Health careChronic carePaymentDisease managementQuarter (Canadian coin)Chronic conditionPrimary careDiseaseFamily medicineMedical emergencyBusinessNursingEconomic growthFinanceGeography
DOInot available

Abstract

fetched live from OpenAlex

Overview Ineffective management of heart disease, asthma, diabetes and other chronic diseases costs the Australian health system more than $320 million each year in avoidable hospital admissions. At best, our primary care system provides only half the recommended care for many chronic conditions. Only a quarter of the nearly one million Australians diagnosed with type 2 diabetes get the monitoring and treatment recommended for their condition. Each year there are more than a quarter of a million admissions to hospital for health problems that potentially could have been prevented. Yet each year the government spends at least $1 billion on planning, coordinating and reviewing chronic disease management and encouraging good practice in primary care. Three quarters of Australians over the age of 65 have at least one chronic condition that puts them at risk of serious complications and premature death. Social, economic and environmental changes are the best way to prevent these diseases. But there are much better outcomes where good quality primary care services are in place. Our primary care system is not working anywhere near as well as it should because the way we pay for and organise services goes against what we know works. The role of GPs is vital, but the focus must move away from fee-for-service payments for one-off visits. A broader payment for integrated treatment would help to focus care on patients and long-term outcomes. Primary Health Networks should be given more responsibility for local primary care services. The evidence shows that a consistent, coordinated approach to specific diseases helps primary care more effectively prevent and manage chronic conditions. In regional areas, clear targets and well-designed incentives for disease prevention are vital. Simple reforms can reduce the burden on Australian hospitals, and make patients healthier for longer.

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.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not 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.

metaresearch head score (Codex)0.002
metaresearch head score (Gemma)0.004
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: Not applicable
GenreCandidate signal: Empirical · Consensus signal: none
Teacher disagreement score0.037
Threshold uncertainty score0.125

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0020.004
Meta-epidemiology (narrow)0.0010.000
Meta-epidemiology (broad)0.0010.001
Bibliometrics0.0030.003
Science and technology studies0.0010.001
Scholarly communication0.0030.002
Open science0.0010.002
Research integrity0.0030.004
Insufficient payload (model declined to judge)0.0370.005

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 head0.031
GPT teacher head0.389
Teacher spread0.358 · 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

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designNot applicable
Domainnot available
GenreEmpirical

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".

Quick stats

Citations25
Published2016
Admission routes1
Has abstractyes

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