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Record W2961369453 · doi:10.1136/bmjgh-2019-001601

The Primary Care Spend Model: a systems approach to measuring investment in primary care

2019· review· en· W2961369453 on OpenAlexaff
Robert Baillieu, Michael Kidd, Robert L. Phillips, Martín Roland, Michael Mueller, David Morgan, Bruce E. Landon, Jennifer E. DeVoe, Viviana Martínez-Bianchi, Hong Wang, Rebecca Etz, Chris Koller, Neha Sachdev, Hannah Jackson, Yalda Jabbarpour, Andrew Bazemore

Bibliographic record

VenueBMJ Global Health · 2019
Typereview
Languageen
FieldHealth Professions
TopicPrimary Care and Health Outcomes
Canadian institutionsUniversity of Toronto
FundersAmerican Board of Family Medicine Foundation
KeywordsComparabilityHealth careContext (archaeology)Population healthBusinessPublic economicsInvestment (military)Primary carePopulationActuarial scienceMedicineEconomicsEconomic growthPolitical scienceFamily medicineEnvironmental healthGeography

Abstract

fetched live from OpenAlex

Increased investment in primary care is associated with lower healthcare costs and improved population health. The allocation of scarce resources should be driven by robust models that adequately describe primary care activities and spending within a health system, and allow comparisons within and across health systems. However, disparate definitions result in wide variations in estimates of spending on primary care. We propose a new model that allows for a dynamic assessment of primary care spending (PC Spend) within the context of a system's total healthcare budget. The model articulates varied definitions of primary care through a tiered structure which includes overall spending on primary care services, spending on services delivered by primary care professionals and spending delivered by providers that can be characterised by the '4Cs' (first contact, continuous, comprehensive and coordinated care). This unifying framework allows a more refined description of services to be included in any estimate of primary care spend and also supports measurement of primary care spending across nations of varying economic development, accommodating data limitations and international health system differences. It provides a goal for best accounting while also offering guidance, comparability and assessments of how primary care expenditures are associated with outcomes. Such a framework facilitates comparison through the creation of standard definitions and terms, and it also has the potential to foster new areas of research that facilitate robust policy analysis at the national and international levels.

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 distilled prediction

Teacher imitation

Not 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.

metaresearch head score (Codex)0.003
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMeta-epidemiology (narrow), Science and technology studies, Research integrity
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: none
GenreCandidate signal: Review · Consensus signal: Review
Teacher disagreement score0.925
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0030.000
Meta-epidemiology (narrow)0.0010.001
Meta-epidemiology (broad)0.0050.001
Bibliometrics0.0000.001
Science and technology studies0.0020.000
Scholarly communication0.0000.000
Open science0.0020.001
Research integrity0.0010.003
Insufficient payload (model declined to judge)0.0000.001

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.

Opus teacher head0.271
GPT teacher head0.506
Teacher spread0.235 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

Study designNot applicable
Domainnot available
GenreReview

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".

Quick stats

Citations21
Published2019
Admission routes1
Has abstractyes

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