“You Can’t Get There from Here”: Is There a Future for Value-Based Healthcare in Canada?
Bibliographic record
Abstract
Moving toward greater value in healthcare in Canada requires more than novel tools and policy levers. First, we need clear objectives, namely, value as defined across stakeholders with primacy given to patients and the public. Next, an unwavering commitment by payers, providers and system managers to pursue those definitions of value. At the most basic level, we need to remember whom the healthcare system is working for. Although numerous pilot projects and promising examples exist, pursuing value in healthcare in Canada will likely require a reassessment of some fundamental aspects of our healthcare systems. A pragmatic approach of learning from the successes and failures of current efforts combined with a major rethinking of the foundational and operating principles of our current systems may be required to get there from here.
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 | 0.006 | 0.019 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.024 | 0.018 |
| Scholarly communication | 0.017 | 0.008 |
| Open science | 0.002 | 0.005 |
| Research integrity | 0.005 | 0.012 |
| Insufficient payload (model declined to judge) | 0.009 | 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 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".