Continuity of primary care and return visits to the emergency department for seniors in Quebec
Bibliographic record
Abstract
Background. Continuity of care as a principle of health care planning is losing ground in favor of new principles such as accessibility and plurality of provision, but the long-term effects of these changes on the utilization of expensive health services such as hospitalizations and emergency department utilization are still unknown. Objective. To investigate among individuals aged 66 years or older who have had an index visit to an emergency department (ED) whether there is an association between the continuity with a primary care provider and the likelihood of having an ED return visit 14 days after the index ED visit. Conclusions. Among Quebec seniors, relational continuity of care measured by UPC may not be an important protective factor against returning to the ED after an index visit. The main study limitations to be considered in the interpretation of these results relate to the use of administrative data, and include potential misclassification of ED visits and return visits, inability to distinguish planned from unplanned return visits, and residual confounding due to covariates that were either not measured or measured at the ecological level (e.g., socioeconomic status). Research and policy implications. Further research, using different data sources and measures, is needed to investigate the association between continuity of care and ED utilization among seniors in Quebec. (Abstract shortened by UMI.)
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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 | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.007 | 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".