Case Manager Resource Allocation Decision-Making for Adult Home Care Clients: With Comparisons to a High Needs Pediatric Home Care Clients
Why this work is in the frame
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Bibliographic record
Abstract
Home care programs have become integral parts of the overall health service system in Canada and in many other developed nations. Resource allocation decision-making by home care case managers (CM) is a complex task where CMs are challenged to meet the dual responsibilities for clients, in order that they achieve high quality care, and to the system to contain costs. The purpose of this study was to extend what is known about resource allocation decision-making factors identified in a previous systematic literature review and ethnographic study within a high needs pediatric context conducted by the principal investigator in Western Canada. Spradley’s ethnoscience method was used in this research. The study sample consisted of 17 home care CMs, professional practice leads, and their managers from two separate home care offices. All participating CMs had assigned caseloads and were involved in the assessment and implementation of care planning for clients. Purposive sampling methods were employed. In keeping with Spradley’s ethnoscience approach, data collection occurred in three distinct phases or rounds. The first round of data collection began with a series of one-on-one interviews with card sorts, the second round of data collection was another series of one-on-one interviews with CMs who were not interviewed in the prior round, and the third and final round of data collection was a focus group to accomplish further refinement and verification of our established categories. Participants identified five categories of factors that effected their resource allocation decision-making. The categories were related to one of five main areas: the client, the CM, the home care program, community resources, or the health care system. The findings of this study reinforced the complexity of CM resource allocation decision-making in home care. This study provides new insights into CM resource allocation decision-making based on multidisciplinary, integrated home care teams caring for adults, the majority of whom are 65 years and older. This study also provides the comparison of taxonomy that differs between pediatric and adult home care populations that influence resource allocation decision-making.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.004 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 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 it