“A Band-Aid Solution”: Policy Maker and Primary Care Provider Perspectives on the Value of Attachment Incentives
Bibliographic record
Abstract
Approximately 15% of Canadians are without a primary care provider ("unattached").To address "unattachment," several provinces introduced a financial incentive for family physicians who attach new patients.A descriptive qualitative approach was used to explore perspectives of patient access and attachment to primary care.Semi-structured qualitative interviews were conducted with family physicians, nurse practitioners and policy makers HEALTHCARE POLICY Vol.18 No.4, 2023 [107] in Nova Scotia.Thematic analysis was performed to identify participant perspectives on the value and efficacy of financial incentives to promote patient attachment.Three themes were identified: (1) positive impacts of the incentive, (2) shortcomings of the incentive and (3) alternative strategies to strengthen primary healthcare.Participants felt that attachment incentives may offer short-term solutions to patient unattachment; however, financial incentives cannot overcome systemic challenges.Participants recommended alternative policy levers to strengthen primary healthcare, including addressing the shortage of primary care providers and developing remuneration and practice models that support sustainable patient attachment. RésuméEnviron 15 % des Canadiens n' ont pas de fournisseur de soins de santé primaires (« sans adhésion »).Pour lutter contre le « manque d' adhésion », plusieurs provinces ont mis en place un incitatif financier pour les médecins de famille qui accueillent de nouveaux patients.Une approche qualitative descriptive a été utilisée pour explorer les perspectives d' accès et d' adhésion des patients aux soins primaires.Des entrevues qualitatives semi-structurées ont été menées auprès de médecins de famille, d'infirmières praticiennes et de décideurs en Nouvelle-Écosse.Une analyse thématique a été effectuée pour identifier les points de vue des participants sur la valeur et l' efficacité des incitations financières pour promouvoir l' adhésion du patient.Trois thèmes ont été identifiés : (1) les impacts positifs de l'incitatif, (2) les lacunes de l'incitatif et (3) les stratégies pour renforcer les soins de santé primaires.Les participants ont estimé que les incitations à l' adhésion peuvent offrir des solutions à court terme au manque d' adhésion des patients.Cependant, les incitations financières ne peuvent pas surmonter les défis d' ordre systémique.Les participants recommandent des leviers politiques pour renforcer les soins de santé primaires, notamment en s' attaquant à la pénurie de prestataires de soins primaires et en développant des modèles de rémunération et de pratique qui favorisent une adhésion durable de la part des patients.
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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 | 0.026 | 0.026 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.021 | 0.017 |
| Scholarly communication | 0.011 | 0.004 |
| Open science | 0.002 | 0.006 |
| Research integrity | 0.005 | 0.006 |
| 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".