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Record W4415240354 · doi:10.12927/hcpap.2025.27696

How to Achieve Meaningful Change

2025· article· en· W4415240354 on OpenAlexaffvenue
Gregory P. Marchildon

Bibliographic record

VenueA Nudge Too Far? A Nudge at All? On Paying People to Be Healthy · 2025
Typearticle
Languageen
FieldDecision Sciences
TopicEvaluation and Performance Assessment
Canadian institutionsPublic Health Ontario
Fundersnot available
KeywordsRemunerationAccountabilityPaymentHealth policyHealth careHealth management systemPublic health

Abstract

fetched live from OpenAlex

Over the past four decades, the most significant organizational change has been the establishment of health authorities that have been delegated by provincial governments to manage health systems. The continual changes made to the structure of health authorities, including the recent trend to more centralized administration, have caused considerable upheaval. Although a major change in the immediate future would only amplify this upheaval, it is still worth delegating to health authorities the additional responsibility for the payment and management of health human resources, including physician remuneration and bargaining. This is one more incremental change that holds the greatest promise in terms of improving accountability and health system performance.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not 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.

metaresearch head score (Codex)0.118
metaresearch head score (Gemma)0.185
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Theoretical or conceptual · Consensus signal: Theoretical or conceptual
GenreCandidate signal: Empirical · Consensus signal: none
Teacher disagreement score0.118
Threshold uncertainty score0.622

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.1180.185
Meta-epidemiology (narrow)0.0030.001
Meta-epidemiology (broad)0.0030.003
Bibliometrics0.0040.003
Science and technology studies0.0110.031
Scholarly communication0.0280.024
Open science0.0050.023
Research integrity0.0180.022
Insufficient payload (model declined to judge)0.0190.010

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.

Opus teacher head0.313
GPT teacher head0.494
Teacher spread0.181 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designTheoretical or conceptual
Domainnot available
GenreEmpirical

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".

Quick stats

Citations0
Published2025
Admission routes2
Has abstractyes

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