Changes in the Perception of Health Care Policy and Delivery Among Manitoba Elders During the Downsizing of the Hospital Sector
Bibliographic record
Abstract
Résumé Dans un monde où l'assurance des soins de santé est universelle, la fermeture de lits d'hôpitaux se transforme inévitablement en un dossier politique chaud et les médias deviennent le véhicule du débat et des pressions exercées par certains groupes d'intérêt. Cette étude repose sur les données d'une interview d'aîné(e)s du Manitoba avant, puis un an après, la diminution substantielle du secteur hospitalier à Winnipeg. Nous comparons les réponses des résidents de Winnipeg à celles de résidents de l'extérieur de Winnipeg à des questions sur leurs opinions concernant la qualité générale des soins de santé et l'aecès aux soins hospitaliers. Nous comparons également les réponses aux mêmes questions données par des aîné(e)s qui ont été hospitalisés avant la première interview, par d'autres qui ont été hospitalisés avant la seconde interview et enfin par des aîné(e)s qui n'ont pas été hospitalisés. Bien qu'il n'y ait pas eu de fermeture de lits d'hôpitaux à l'extérieur de Winnipeg, l'opinion sur la qualité des soins chez les citoyens de Winnipeg et ceux de l'extérieur était moins positive après la réduction de Winnipeg et la publicité négative dont l'événement a été entouré. Cependant, les opinions sur la qualité et l'accès de ceux qui avaient été hospitalisés alors que les lits se fermaient étaient sensiblement plus positives que celles des ainé(e)s qui avaient été hospitalisés avant la fermeture ou qui n'avaient pas été hospitalisés. Abstract In a universally-insured health care system, closing hospital beds inevitably becomes a hot political issue and the media often become the vehicle for debate and pressure from special interest groups. This study uses data from a representative sample of Manitoba older persons, interviewed before and again one year after the substantial downsizing of the hospital sector in Winnipeg. We compare the responses of Winnipeg residents with those of non-Winnipeg residents to questions about their opinion regarding the overall quality of health care and access to hospital care. Also compared were the responses to the same questions by older persons who were hospitalized before the first interview, those hospitalized before the second interview and those who were not hospitalized. Despite experiencing no bed closures outside Winnipeg, the opinions about the overall quality of care among both non-Winnipeggers and Winnipeggers were less favourable after the Winnipeg downsizing and the accompanying negative publicity. However, the opinions about quality and access among those who were actually hospitalized when most of the beds were being closed were significantly more favourable than among those hospitalized before the bed closures or not hospitalized at all.
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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 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.003 | 0.002 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.002 |
| 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".