Strengths, challenges, and gaps in linkage to primary care among hospitalized individuals who are homeless in Vancouver, British Columbia
Bibliographic record
Abstract
Individuals who are homeless in the Canadian city of Vancouver, British Columbia have an increasing burden of chronic medical conditions, resulting in rising use of hospital services. Although continued efforts have been made to improve accessibility, barriers to primary care linkage and utilization still exist. Our study explored the strengths, barriers, and gaps in how inpatients who are homeless are connected to primary care through semi-structured qualitative interviews with patients (n = 22) and healthcare providers (n = 7) with experience in caring for patients who are homeless. Patients identified cell phone ownership and use of commitment devices as strengths, while clinics with long wait times, or those proximal to areas of prevalent drug use, were seen as barriers. Providers perceived that low priority was given to primary care linkage within hospitals, and that early and bidirectional communication with hospital staff is vital, particularly around discharge planning. Patients and providers then identified major gaps in service, which included a need for peer health navigation, technology-assisted outreach, and improved service distribution.
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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 | 0.004 | 0.011 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.011 | 0.003 |
| Scholarly communication | 0.004 | 0.001 |
| Open science | 0.002 | 0.005 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 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".