Factors influencing the match between patient needs and primary care services: Patient and healthcare provider perspectives from two Canadian provinces
Bibliographic record
Abstract
ObjectivesThis study aims to combine the perspectives of patients and healthcare providers on the factors that influence the match between patients' needs for and providers' capacity to deliver services.MethodsA qualitative descriptive study design was used to examine perspectives and experiences of patients, family physicians and nurse practitioners in two jurisdictions in Canada: Nova Scotia and Ontario. Data from interviews were analyzed using the concept of comprehensiveness, the extent to which the approach to care and services delivered by providers meets patients' needs, to examine how decisions were made in each province for patients to become members of a providers' panel (the process known as 'empanelment').ResultsInterviews with 33 providers and 25 patients were conducted in Nova Scotia and Ontario. Three areas of tension were identified in patients' decision-making about choosing a regular primary care provider and providers' decision-making about accepting regular patients. Patients and providers discussed the success of such a match as being influenced by personal characteristics, including attitudes, gender and cultural background, scope of practice and panel composition.ConclusionsFindings support the value of team-based care that considers the needs for empanelment of both patients and providers. This study provides healthcare providers with information to improve matching processes by incorporating these considerations (e.g., patient and provider sex, gender and chronic care needs) into decisions about empanelment. Mechanisms that reflect the characteristics and range of skills of the whole team rather than the family physician and nurse practitioner alone are an avenue for optimizing the success of empanelment.
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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 | 0.003 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.016 | 0.002 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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".