Are Family Medicine Clinics Improving Access to Care through Organizational Changes Driven by Healthcare Reform?
Bibliographic record
Abstract
PURPOSE: This observational descriptive study reports organizational changes after the last reform in 18 family medicine units (FMUs) affiliated with the University of Montreal in Québec. METHOD: Two self-administered surveys on access to care were administered to FMU directors between December 2016 and January 2017, and in August 2018. RESULTS: Between surveys, the number of registered patients increased substantially. All clinics recruited new patients, and most offered walk-in services (89%) and moved toward an advanced access scheduling model (83%). For licensed practical nurses, there was a median increase from 0 to 3 and for nurse clinicians, from 2 to 3, that helped the development of collaborative teamwork. CONCLUSION: Despite the added teaching mission, the response of the FMU network has been dynamic, has adapted to the major changes and has continued to actively improve access to care for their communities. Challenges still remain regarding work on key priorities for improving access management.
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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 | 0.003 | 0.019 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| 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".