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VenueThe Lancet Global Health · 2022
Typearticle
Languageen
FieldMedicine
TopicGlobal Maternal and Child Health
Canadian institutionsnot available
FundersResearch Management Centre, International Islamic University MalaysiaNational Research, Development and Innovation OfficeHorizon 2020Instituto de Salud Carlos IIINational Health and Medical Research CouncilMedical Research CouncilDepartment of Global Health and Population, Harvard T.H. Chan School of Public HealthUniversity at BuffaloDirectorate for Biological SciencesNational Institute for Health Research Southampton Biomedical Research CentreUniversity of Health and Allied SciencesGeorge Institute for Global HealthMadda Walabu UniversityMoscow Institute of Physics and TechnologyWestern Sydney UniversityAl-Farabi Kazakh National UniversityINCLIVA Instituto de Investigación SanitariaJahrom University of Medical SciencesJenderal Soedirman UniversityImam Abdulrahman Bin Faisal UniversityLingnan UniversityI.M. Sechenov First Moscow State Medical UniversityNational Institute for Medical Research DevelopmentNemzeti Kutatási Fejlesztési és Innovációs HivatalAlexandria UniversityNovo Nordisk FondenAfrican Population and Health Research CenterUniversidade do MinhoNational Research University Higher School of EconomicsTechnische Universität BerlinCentro de Investigación Biomédica en Red de Salud MentalUnitatea Executiva pentru Finantarea Invatamantului Superior, a Cercetarii, Dezvoltarii si InovariiUniversità degli Studi dell'AquilaBahir Dar UniversityUniversità di BolognaShahid Beheshti University of Medical SciencesAutoritatea Natională pentru Cercetare StiintificăShahrekord University of Medical SciencesUniversità Cattolica del Sacro CuoreUniversity of the PhilippinesUniversidad Nacional Autónoma de MéxicoBabol University of Medical SciencesUniversidade de São PauloBirjand University of Medical SciencesUniversitair Medisch Centrum GroningenMinistry of HealthImperial College LondonKing's College LondonShiraz UniversityPublic Health Foundation of IndiaNaresuan UniversityHaramaya UniversityInyuvesi Yakwazulu-NataliIsfahan University of Medical SciencesUniversiti MalayaUniversità degli Studi di GenovaKerman University of Medical SciencesUniversiti Kebangsaan MalaysiaNational Research FoundationUniversidad ICESIUniversity of CalcuttaUniversità di CataniaTehran University of Medical Sciences and Health ServicesKuwait UniversitySultan Qaboos UniversityUniversidad Autónoma MetropolitanaBrien Holden Vision InstituteKing Abdulaziz UniversityKarolinska InstitutetConselho Nacional de Desenvolvimento Científico e TecnológicoRajshahi UniversityFundación Valle del LiliPirogov Russian National Research Medical UniversitySaveetha Dental CollegeNovo NordiskIslamic Azad UniversityPohang University of Science and TechnologyUniversità degli Studi di Napoli Federico IIMinistry of Health and Medical EducationFundação de Amparo à Pesquisa do Estado de Minas GeraisUniversity of GondarUniversity of WaterlooShiraz University of Medical SciencesAin Shams UniversityBundesministerium für Bildung und ForschungHamad Medical CorporationMurdoch UniversityQueensland University of TechnologyJames Cook UniversityCairo UniversityDepartment of Social Services, Australian GovernmentFlinders UniversityMonash UniversityTabriz University of Medical SciencesUniversity of Technology SydneyCentral University of KeralaAlexander von Humboldt-StiftungMashhad University of Medical SciencesUniversitetet i BergenMinistarstvo Prosvete, Nauke i Tehnološkog RazvojaUniversiteit StellenboschHealth Services Management Research CenterNational Rosacea SocietyPublic Health EnglandUniversity of OttawaNational Authority for Scientific Research and InnovationUniversitat de ValènciaMassachusetts General HospitalUniwersytet Jagielloński Collegium MedicumUniversity College LondonIndian Council of Medical ResearchTrường Đại học Nguyễn Tất ThànhNational University of SingaporeNational Institute for Health and Care ResearchHarvard UniversityDeutsches KrebsforschungszentrumManipal Academy of Higher EducationUniversity of AberdeenCanadian Institutes of Health ResearchUniversity of TabrizEuropean CommissionUniversity of WashingtonRijksuniversiteit GroningenIran University of Medical SciencesUniversity of LeicesterMinisterul Cercetării, Inovării şi DigitalizăriiOttawa Hospital Research InstituteHøgskulen på VestlandetBarts CharitySocial Science Research CouncilUniversity of South CarolinaKasturba Medical College, ManipalDivision of Human Resource DevelopmentUniversity of TorontoMinisterio de Ciencia e InnovaciónGeneralitat de CatalunyaUniversity of Agriculture, FaisalabadCase Western Reserve UniversityUniversidade Federal do Rio Grande do SulJohns Hopkins UniversityBill and Melinda Gates FoundationTufts Medical CenterKrishna Institute Of Medical Sciences Deemed To Be UniversityShahrekord UniversityNational Heart, Lung, and Blood InstituteEdwards LifesciencesBrigham and Women's HospitalUniversity of New South WalesU.S. Department of Veterans AffairsBournemouth University
KeywordsMedicineIndex (typography)DemographyConfidence intervalHealth careIncidence (geometry)GerontologyMetric (unit)Operations managementMathematicsInternal medicine
Abstract
fetched live from OpenAlexBACKGROUND: Health-care needs change throughout the life course. It is thus crucial to assess whether health systems provide access to quality health care for all ages. Drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019), we measured the Healthcare Access and Quality (HAQ) Index overall and for select age groups in 204 locations from 1990 to 2019. METHODS: We distinguished the overall HAQ Index (ages 0-74 years) from scores for select age groups: the young (ages 0-14 years), working (ages 15-64 years), and post-working (ages 65-74 years) groups. For GBD 2019, HAQ Index construction methods were updated to use the arithmetic mean of scaled mortality-to-incidence ratios (MIRs) and risk-standardised death rates (RSDRs) for 32 causes of death that should not occur in the presence of timely, quality health care. Across locations and years, MIRs and RSDRs were scaled from 0 (worst) to 100 (best) separately, putting the HAQ Index on a different relative scale for each age group. We estimated absolute convergence for each group on the basis of whether the HAQ Index grew faster in absolute terms between 1990 and 2019 in countries with lower 1990 HAQ Index scores than countries with higher 1990 HAQ Index scores and by Socio-demographic Index (SDI) quintile. SDI is a summary metric of overall development. FINDINGS: Between 1990 and 2019, the HAQ Index increased overall (by 19·6 points, 95% uncertainty interval 17·9-21·3), as well as among the young (22·5, 19·9-24·7), working (17·2, 15·2-19·1), and post-working (15·1, 13·2-17·0) age groups. Large differences in HAQ Index scores were present across SDI levels in 2019, with the overall index ranging from 30·7 (28·6-33·0) on average in low-SDI countries to 83·4 (82·4-84·3) on average in high-SDI countries. Similarly large ranges between low-SDI and high-SDI countries, respectively, were estimated in the HAQ Index for the young (40·4-89·0), working (33·8-82·8), and post-working (30·4-79·1) groups. Absolute convergence in HAQ Index was estimated in the young group only. In contrast, divergence was estimated among the working and post-working groups, driven by slow progress in low-SDI countries. INTERPRETATION: Although major gaps remain across levels of social and economic development, convergence in the young group is an encouraging sign of reduced disparities in health-care access and quality. However, divergence in the working and post-working groups indicates that health-care access and quality is lagging at lower levels of social and economic development. To meet the needs of ageing populations, health systems need to improve health-care access and quality for working-age adults and older populations while continuing to realise gains among the young. FUNDING: Bill & Melinda Gates Foundation.
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.
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.
metaresearch head score (Codex)0.002
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.108
Threshold uncertainty score0.893
Codex and Gemma teacher scores by category
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.
Teacher spread0.348 · 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
