Impact of Type of Medical Specialist Involvement in Chronic Illness Care on Emergency Department Use
Bibliographic record
Abstract
OBJECTIVES: Medical specialist physicians may act as either consultants or co-managers for patients managed in primary care settings. We assessed whether the type of specialist involvement affected emergency department (ED) use for patients with chronic diseases. METHODS: In total, 709 primary care patients with arthritis, chronic obstructive pulmonary disease, diabetes or congestive heart failure were followed for one year using survey and administrative data. Multivariate logistic regressions were used to compare all-cause ED use according to specialist involvement (none, co-manager or consultant). RESULTS: In total, 240 (34%) patients visited the ED. ED use did not differ between those with specialist involvement and those without it, either as co-managers (adjusted OR = 1.06, 95% CI = [0.61, 1.85]) or consultants (adjusted OR = 0.97, 95% CI = [0.63, 1.50]). DISCUSSION: The type of specialist involvement is not associated with all-cause ED use in primary care patients with chronic diseases. Indications for co-management should be further investigated.
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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 | 0.002 | 0.017 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 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".