Changes in emergency and primary care use after adding virtual physicians to HealthLink BC’s 8-1-1 program
Bibliographic record
Abstract
Health human resource constraints in Canada have left millions of patients without timely access to primary care (PC), leading many to attend emergency departments (ED) to see a doctor. We evaluated changes in service use and costs resulting from the addition of virtual physicians to HealthLink BC's 8-1-1 program. Visits to ED and PC within 30 days and healthcare costs were measured with time series data from 445,630 telehealth users. The virtual physician intervention was associated with 16.14 (p = 0.001, 95% CI = 25.95-6.33) fewer ED visits and 106.14 (p < 0.001, 95% CI = 74.78-137.49) more PC visits in 30 days per 1000 patients. Patients above age 15, without a known chronic illness or existing relationship with a PC provider, had higher PC follow-up and patient-paid medical travel costs; healthcare system costs were neutral over a year. Long-term health outcomes from increased PC follow-up and variability in the amount of medical travel costs paid by patients will be important economic parameters to consider in Canadian health policy evaluations.
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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 | 0.002 | 0.013 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 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".