Understanding Patterns of Care for Older Adults: Data to Action
Bibliographic record
Abstract
ObjectiveOlder adult population is growing rapidly, the current system is not adequately designed to meet the needs of individuals to live safely and independently in the place of their choice. To understand the variations in care and identify where to intervene, we examined the transitions in care of community-dwelling older adults (COA) leading up to 24-hour assisted living at special care homes (SCH). ApproachWe conducted a retrospective-cohort study using health administrative data from a Canadian province with a long history of comprehensive, longitudinal data. Using process mining techniques, health service utilization of COA, 65 and older, was mapped as a journey rather than independent care events. We examined the common patterns experienced leading up to SCH admission by sequencing transitions between care settings. Consideration was given to geography that the individual resides in and their health status to understand variations. ResultsOverall health utilization patterns revealed predominant reliance on acute care and SCH admissions. However, geographic variations were identified (regions and urban/rural). More than 2000 transition patterns between emergency department, hospital, community, and SCH were observed. ConclusionThe ability for COA to age in place is dependent on the individual, where they live, and the availability of and access to services to meet their needs. To minimize undesirable and early admissions to SCH, a multifaceted, collaborative approach to align community-based supports for COA is required. The results of these analyses will help inform areas in which to focus interventions and serve as a baseline while evaluating impact.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.003 |
| Open science | 0.002 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".