Accountability in Canadian Health Care Systems: Fitting the Pieces of the Puzzle Together
Bibliographic record
Abstract
This chapter analyses the information gained from three case studies and shows what models of accountability are dominant in the Canadian health care systems, what their interrelationship is and what management practices they drive. The case studies are: Quebec, Alberta and Ontario. The chapter discusses recommendations to reframe accountability in health care organisations. It argues that fitting the pieces of puzzle metaphor together requires that attention be paid to the size of each piece, intersection points, divergence points and complementarities. The chapter highlights four main models of accountability in the context of the health sector: the political model, the professional model, the bureaucratic model and the managerial model. Data collected from interviews in Quebec show evidence of a codominance of professional and bureaucratic forms of accountability with explicit attempts to introduce components of managerial and political accountability. The political model combines principles of participatory and representative democracy and fosters the input of the population in decision-making.
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 | 0.007 | 0.012 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.005 | 0.012 |
| Science and technology studies | 0.029 | 0.018 |
| Scholarly communication | 0.015 | 0.005 |
| Open science | 0.002 | 0.004 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.005 | 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".