Private Surgical Centres : An Outlet for Hospitals Bursting at the Seams?
Bibliographic record
Abstract
Wait times for many types of planned surgeries have increased beyond clinical recommendations in Canadian provinces in recent years. The causes of lengthening wait times are complex and there are no easy fixes, but provinces have increasingly turned to contracts with private surgical facilities. This commentary reviews key policy issues associated with provincial governments contracting for-profit surgical centres through the lens of the Quadruple Aim quality improvement framework, focused on population health outcomes (volume-quality relationship, corner-cutting); cost and value (marginal cost of increasing surgeries in public hospitals, risk selection or ‘cherry-picking’, ‘upselling’ of services); provider satisfaction (competition for skilled staff); and patient experience; and offers recommendations for policy makers.
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 | 0.005 | 0.024 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.010 | 0.013 |
| Scholarly communication | 0.011 | 0.010 |
| Open science | 0.004 | 0.003 |
| Research integrity | 0.017 | 0.013 |
| Insufficient payload (model declined to judge) | 0.013 | 0.002 |
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".