Decisions regarding Quebec’s publicly funded health and social services: Promoting the citizen voice
Bibliographic record
Abstract
Background In the province of Quebec (Canada), 71% of health and social services are publicly funded. Decisions about which services to include in the public services basket are complex (e.g. obsolete interventions, new and costly technologies, preventive activities). Different criteria (individual/population needs, effectiveness, safety and efficiency of services) are taken into account in decision-making, as well as ethical, economic, and political issues. Furthermore, there is a global consensus supporting that citizens’ values and preferences must guide decision-making. To elicit citizens’ values and preferences regarding publicly funded health and social services, the Quebec Health and Welfare Commissioner has conducted a vast public consultation on the population viewpoints. Methods Various consultation methods were used in complementary steps. One step involved holding six focus groups in different regions with randomly selected participants (n = 62) from a previous representative population survey (n = 1850). A four-step content analysis was performed on those focus groups (double-listening, open coding, semantic data processing, interpretation of coded and processed data). Results Citizens' concerns about publicly funded services were grouped in eight dimensions, namely the: 1) health in first, 2) strength of prevention and psychosocial care, 3) importance of patient and relatives, 4) economic issue, 5) disillusionment toward the system and decision-makers, 6) science, reason, and measurement, 7) fear of drifts in allocating limited resources, and 8) duration vs. quality of life. Conclusions To promote social participation and accountability, the Commissioner conducted a vast public consultation. Preventive and psychosocial interventions ranked high in citizens’ priorities. Decision-makers must take into account citizen voice to be sure that the basket of insured services is representative of social values and preferences. Key messages: The citizen voice must also guide decision-making to provide publicly funded services or not Preventive and psychosocial interventions are ranked high in citizens’ priorities
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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 | 0.014 | 0.017 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.021 | 0.006 |
| Scholarly communication | 0.008 | 0.003 |
| Open science | 0.002 | 0.004 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.007 | 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".