Inconsistent Governance Structures for Health and Social Services Limit Service Integration for Patients with Complex Care Needs
Bibliographic record
Abstract
This paper describes how health and social services are governed and organized across Canada for two patient groups.Governance configurations and governance proximity between primary care and priority health and social services varied markedly between provinces.While the need for integrated service delivery has been made a clear priority during the COVID-19 pandemic, the potential of Canada' s healthcare systems has not yet translated into coordinated and integrated care for health services, much less for health and social services.It is time to act on the policy recommendations from commissioned reports over the past two decades that focus on comprehensive, community-based care. RésuméCet article décrit comment les services de santé et les services sociaux sont régis et organisés au Canada pour deux groupes de patients.Les configurations de gouvernance ainsi que la proximité de la gouvernance entre, d' une part, les soins primaires et, d' autre part, les services de santé et sociaux prioritaires varient considérablement d' une province à l' autre.Bien que la nécessité d' une prestation de services intégrés ait été clairement établie comme une priorité pendant la pandémie de COVID-19, le potentiel des systèmes de santé du Canada ne s' est pas encore traduit par des soins coordonnés et intégrés pour les soins de santé, et encore moins pour les services de santé et sociaux.Il est temps de donner suite aux recommandations stratégiques des rapports commandés au cours des deux dernières décennies, lesquels mettent l' accent sur les soins communautaires complets.
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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 | 0.013 | 0.039 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.012 | 0.018 |
| Scholarly communication | 0.013 | 0.005 |
| Open science | 0.002 | 0.015 |
| Research integrity | 0.002 | 0.005 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
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".