Patients Living with Social Vulnerabilities Experience Reduced Access at Team-Based Primary Healthcare Clinics
Bibliographic record
Abstract
Objective: This study aims to explore differences in access to care as experienced by patients registered in team-based primary healthcare clinics according to their social vulnerability profile.Method: A total of 1,562 patients from four team-based primary healthcare clinics completed an e-survey conducted between June and November 2021.The social vulnerability index was used to compare the experiences.Results: Patients with low vulnerability consulted at emergency rooms three times more often because their family physician was not available (p = 0.006) than patients with no vulnerability.Lack of continuity was reported two times more often by patients with low vulnerability related to team members not knowing their recent medical history (p = 0.006) and by patients with high vulnerability related to no one being in charge of their file (p = 0.023).Both vulnerable groups reported receiving contradictory information more often than patients with no vulnerability.Conclusion: Patients with high vulnerability experienced more access difficulties related to continuity, interprofessional collaboration and communication with providers. RésuméObjectif : Cette étude a pour objectif d' explorer les différences d' accès aux soins vécues par les patients inscrits dans une équipe clinique de première ligne, selon leur profil de vulnérabilité sociale.Méthode : Au total, 1 562 patients de quatre équipes cliniques de première ligne ont répondu à un sondage en ligne entre juin et novembre 2021.L'indice de vulnérabilité sociale a été utilisé pour comparer les expériences.Résultats : Les patients à faible vulnérabilité ont consulté trois fois plus souvent aux urgences, parce que leur médecin de famille n'était pas disponible (p = 0,006), que les patients sans vulnérabilité.Le manque de continuité a été rapporté deux fois plus souvent par les patients à faible vulnérabilité parce que les membres de l'équipe ne connaissaient pas leurs antécédents médicaux récents (p = 0,006) et par les patients à forte vulnérabilité en raison de l' absence de prise en charge de leur dossier (p = 0,023).Les patients des deux groupes de vulnérabilité ont déclaré avoir reçu des informations contradictoires plus souvent que les patients sans vulnérabilité.Conclusion : Les patients à forte vulnérabilité ont plus de difficultés d' accès liées à la continuité, à la collaboration interprofessionnelle et à la communication avec les prestataires de services.
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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 | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 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".