Global models of restructuring health care: challenges of integration and coordination
Bibliographic record
Abstract
This chapter provides an overview of developments in different health care systems in order to identify global concepts of modernisation and major areas of change. The US and Britain serve as reference points for market-driven and state-centred systems. The discussion also takes into account examples from continental Europe and Canada. Two key strategies of modernising health care are emerging, namely marketisation and managerialism coupled with consumerism, on the one hand, and the introduction and strengthening of primary care models based on integrated care concepts, on the other. New forms of flexible governance and ‘soft bureaucracy’ flank these global patterns of restructuring health care systems. The common goals of health care systems across countries are integration and coordination of provider services in order to improve both the efficiency and quality of care.
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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 | 0.005 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.002 | 0.021 |
| Scholarly communication | 0.013 | 0.009 |
| Open science | 0.001 | 0.006 |
| Research integrity | 0.003 | 0.005 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
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".