Bibliographic record
Abstract
Health care reform has become the ‘buzzword’ of the 1990s and recommendations for change are being proposed by consumers, providers and policymakers alike. Health care reform is a complex concept, involving both structural and operational revisions to the system, and in its ideal form represents a change in the fundamental relationships among the stakeholders within the system. Although cost effectiveness is one, and only one, piece of reform, it has been the driver of most if not all of the changes proposed or implemented in jurisdictions in much of the industrialized world. Debt and deficit preoccupation has undoubtedly caused this determination to control health care costs which in Ontario, for example, represent roughly one-third of the provincial budget. The bulk of the activity in Canada and in North America has been focused on controlling costs through managing the supply side of the picture and in that way decreasing utilization. Thus, there is considerable attention directed at numbers and mix of providers, decreasing the numbers of hospitals and measuring the outcomes of various clinical interventions. As yet, the evidence is inconclusive as to the size of the effect that can be expected from this approach to controlling costs. What is clear, however, is that the public values Medicare in Canada and is wary and often angry at the prospect of its close-to-home services being reduced and even eliminated. The inability of policy-makers to balance public anger with reduction in costs has led them to consider demand management strategies directed to controlling and reducing the demand for services.
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 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 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.008 | 0.017 |
| Scholarly communication | 0.009 | 0.010 |
| Open science | 0.001 | 0.004 |
| Research integrity | 0.003 | 0.008 |
| Insufficient payload (model declined to judge) | 0.042 | 0.010 |
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.
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".