Assessing the economic costs of obstetric evacuation in rural and remote First Nation and Inuit communities in Canada
Bibliographic record
Abstract
First Nations and Inuit Health Branch guidelines require First Nations and Inuit birthing persons residing on reserve or in rural and remote areas in Canada to travel to urban centres at 36–38 weeks gestational age, to await labour and birth. We sought to determine the costs of obstetric evacuation.\nOur first study was a systematic review identifying obstetric evacuation costs in Canada. Medical evacuation costs, direct and indirect, ranged from $7,714 to $31,794 Canadian dollars. Our second study was a model-based analysis of the cost for fly-in First Nation communities in Ontario. The estimated average cost of obstetric evacuation was $38,551.72 Canadian dollars, comprised of $14,237.44, $8,540.28, $6,564.11, $5,973.01, $2,195.20, $647.92, and $393.76 representing lost productivity, escort, travel, hospitalization, accommodation, meals, and dependents, respectively.\nFuture research could expand our model-based framework to estimate population-level obstetric evacuation costs and conduct economic evaluations of culturally appropriate obstetric services, such as Indigenous midwifery.
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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 | 0.019 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.004 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.001 | 0.001 |
| 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".