Hospitals in a globalized world: a view from Canada.
Bibliographic record
Abstract
Globalization is a complex, multidimensional phenomenon that has already influenced the way hospitals operate and will increasingly impact the healthcare landscape and patients' experience worldwide. This paper briefly analyzes the direct and indirect effects of globalization on healthcare systems and services, mainly focusing on the experience of academic health sciences centres. Building their analysis on the belief that globalization is neither negative nor positive in itself, the authors compare alternative definitions of globalization, suggest possible ways in which it could impact health systems, examine how the role of large teaching and research institutions could evolve over the next decade or so, and put forward some fundamental questions faced by healthcare institutions. In the first part of the paper, the complex and multidimensional nature of globalization is analyzed and the highly polarized debate on the nature of this phenomenon briefly summarized. The second part focuses on the effects of globalization on health and healthcare. A pre-existing conceptual framework is used to analyze the complex linkages between globalization and health, and alternative scenarios are presented to illustrate the current and potential effects of international trade policies and regulations on health systems. In the third part, changes in hospitals' structure, organization and functions triggered by globalization and the introduction of new information and communication technologies are examined. The analysis is built around five main elements: patients, human resources, capital, information and funding. Finally, the paper highlights some of the most fundamental challenges, both practical and ethical, that healthcare institutions have to face in the transition to a new era of globalized health services.
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 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 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.003 | 0.010 |
| Science and technology studies | 0.019 | 0.010 |
| Scholarly communication | 0.012 | 0.005 |
| Open science | 0.001 | 0.005 |
| Research integrity | 0.004 | 0.006 |
| Insufficient payload (model declined to judge) | 0.006 | 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".