A scramble for value:On the interpretation and application of value-based health care in the Netherlands
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
In many health care systems across the globe, value-based health care has quickly become a remarkably popular concept. Yet, despite its global popularity, the meaning of the concept remains shrouded in ambiguity, and efforts to put value-based health care into practice are characterized by a high degree of local variability. This makes it rather challenging to grasp the essence of this seemingly influential concept, let alone evaluate its effects within health care systems. A Scramble for Value addresses that challenge.<br/><br/>The thesis traces the journey of value-based health care from its original conception by Harvard business scholar Michael Porter to its global popularity, and zooms in on its interpretation and application in the Netherlands. As the original set of ideas runs into the historically rooted institutions of the Dutch health care system, the meaning of value-based health care gets moderated, and its application conforms to the very structures it once so boldly set out to reform. <br/><br/>It is by overlaying rather than overthrowing those traditional structures that value-based health care has ignited a renewed focus on outcomes that matter to patients, and amplified multidisciplinary efforts to improve those outcomes. All in all, this can be seen as quite an accomplishment..<br/>
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.010 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.003 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.002 |
| Insufficient payload (model declined to judge) | 0.000 | 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 it