Connecting Health and Social Services for Patients with Complex Care Needs: A Pan-Canadian Comparative Policy Research Program
Bibliographic record
Abstract
Comprehensive primary healthcare for patients with complex care needs requires connections to other health services, social services and community supports.This descriptive comparative policy research program used publicly available documents and informant interviews to examine progress toward integrated comprehensive care through the lens of services needed by children and youth (0-25 years) and community-dwelling older adults (≥ 65 years) with high functional health needs.This article describes five projects.The following three findings emerged across all the projects: Canada indeed has multiple health systems; numerous integrated service delivery solutions are being trialled and most focus on medical services; and it is an ongoing challenge for ministries of health to engage physicians and physician associations in integration. RésuméPour offrir des soins de santé primaire globale, aux patients ayant des besoins complexes, il faut établir des liens avec les autres services de santé, les services sociaux ainsi que le soutien communautaire.Ce programme descriptif de recherche comparative sur les politiques a recours aux documents publiquement accessibles et à des entrevues avec des clés informateurs pour examiner les progrès réalisés dans l' atteinte des soins intégrés globaux selon les services dont ont besoin les enfants et les jeunes (de 0 à 25 ans) ainsi que les aînés (≥ 65 ans) qui vivent dans la communauté et ont de forts besoins en matière de santé fonctionnelle.Cet article décrit cinq projets.Les trois constatations suivantes sont ressorties de chacun des projets : le Canada a effectivement plusieurs systèmes de santé; de nombreuses solutions intégrées de prestation de services sont mises à l' essai et la plupart sont axées sur les services médicaux; et il est toujours difficile pour les ministères de la Santé de faire participer les médecins et les associations de médecins aux initiatives d'intégration.
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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 | 0.027 | 0.023 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.006 | 0.016 |
| Science and technology studies | 0.022 | 0.004 |
| Scholarly communication | 0.004 | 0.003 |
| Open science | 0.003 | 0.005 |
| Research integrity | 0.001 | 0.002 |
| 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".