MétaCan
Menu
Back to cohort
Record W2131118532 · doi:10.1093/ije/dyp239

Commentary: How does 'insurance' improve equity in health?

2009· letter· en· W2131118532 on OpenAlexaboutno aff
Bárbara Starfield

Bibliographic record

VenueInternational Journal of Epidemiology · 2009
Typeletter
Languageen
FieldMedicine
TopicGlobal Cancer Incidence and Screening
Canadian institutionsnot available
Fundersnot available
KeywordsEquity (law)Actuarial scienceHealth insuranceBusinessHealth equityMedicineEnvironmental healthEconomicsPublic healthHealth carePolitical scienceEconomic growthNursing

Abstract

fetched live from OpenAlex

In a meta-analysis of eight studies on overall mortality in women with breast cancer, Kevin Gorey1 makes a powerful case that better equity in survival in Canada than in the USA is a direct result of universal financial coverage for health services in the former country. The combined studies made it possible to examine age-adjusted survival rates in different age groups (under and over the age of 65 years), with different geographic units of analysis, in different types of place of residence, and with different specifications for socio-economic characteristics. All in all, 78 different comparisons were made in seven domains [two socio-economic status (SES) group comparisons in each of the two countries and one comparison in each of three socio-economic strata of the two countries]. The main findings were as follows. Gorey's analysis is not the first to examine US–Canadian differences in health outcomes. After reviewing studies concerning the outcomes for a wide variety of types of health problems, Guyatt et al.2 concluded that there were inconsistent differences between Canada and the USA, but the review did not address socio-economic differences and did not distinguish differences in incidence from those in case fatality associated with health system characteristics such as insurance, access to care, or use of preventive or therapeutic interventions. Other studies have explored the relationship between insurance and health outcomes within the USA. Provision of financing for medical care in the mid-1960s in the USA (primarily through the US Medicaid Program), improved health for 16 health problems in childhood, through reductions in frequency of occurrence, detection and management in the premorbid stage, and through prevention of complications or sequelae.3 Much more recently, McWilliams and colleagues4 showed that recent progress in the control of blood pressure, blood glucose and cholesterol levels has not reduced racial, ethnic or socio-economic differences in the US population EXCEPT in individuals aged >65 years, whose costs have been partly covered by the Medicare program since 1965.

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 imitation

Not 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.

metaresearch head score (Codex)0.008
metaresearch head score (Gemma)0.064
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: Not applicable
GenreCandidate signal: Commentary · Consensus signal: Commentary
Teacher disagreement score0.052
Threshold uncertainty score0.043

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0080.064
Meta-epidemiology (narrow)0.0010.001
Meta-epidemiology (broad)0.0020.002
Bibliometrics0.0010.001
Science and technology studies0.0030.003
Scholarly communication0.0030.004
Open science0.0040.001
Research integrity0.0520.038
Insufficient payload (model declined to judge)0.0080.008

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.

Opus teacher head0.184
GPT teacher head0.475
Teacher spread0.291 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designNot applicable
Domainnot available
GenreCommentary

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".

Quick stats

Citations11
Published2009
Admission routes1
Has abstractyes

Explore more

Same venueInternational Journal of EpidemiologySame topicGlobal Cancer Incidence and ScreeningFrench-language works237,207