Les impacts financiers d’un virage vers le soutien à domicile au Québec
Bibliographic record
Abstract
Following the publication of a first report by our group on the evaluation of future needs and costs related to the support of the autonomy of elderly people in Quebec (Clavet et al., 2021), this report aims to consider possible reform scenarios and to evaluate their impacts. They all have in common that they involve a major shift towards home care and services for people with moderate to major needs, and they all involve an adjustment of the resident's contribution to housing. According to our calculations, substantial savings are generated by the proposed reforms, compared to the status quo scenario. This makes it possible to improve home support through the creation of an autonomy account. With this account, the number of hours of publicly funded services is modulated according to the individual's support needs, thus ensuring horizontal equity in the system. Finally, we discuss the possibility of modulating public funding according to the person's financial resources, both in housing and home support, in order to improve vertical equity. Suite à la publication d’un premier rapport de notre groupe sur l’évaluation des besoins et des coûts futurs liés au soutien à l’autonomie des personnes âgées au Québec (Clavet et al., 2021), ce rapport vise à considérer des scénarios de réformes possibles et d’en évaluer les impacts. Ils ont tous en commun d’impliquer un virage important vers les soins et services à domicile pour les personnes ayant des besoins modérés à importants, et ils impliquent tous un ajustement de la contribution du résident en hébergement. Selon nos calculs, des économies substantielles sont dégagées grâce aux réformes proposées, en comparaison avec le scénario de statu quo. Cela permet de bonifier le soutien à domicile par le biais de la création d’un compte autonomie. Avec ce compte, le nombre d’heures de services financé par le secteur public est modulé selon les besoins de soutien de la personne, ce qui permet d’assurer l’équité horizontale du système. Finalement, nous discutons de la possibilité de moduler le financement public selon les ressources financières de la personne, tant en hébergement qu’en soutien à domicile, afin d’améliorer l’équité verticale.
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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 | 0.007 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.006 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.008 | 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".