The best performing machine learning models predicted normal results with an AUROC of 0.90 or greater for 12 stand-alone laboratory tests (eg, sodium AUROC, 0.92 [95%CI, 0.91-0.93]; sensitivity, 98%; specificity, 35%; PPV, 66%; NPV, 93%; lactate dehydrogenase AUROC, 0.93 [95%CI, 0.93-0.94]; sensitivity, 96%; specificity, 65%; PPV, 71%; NPV, 95%; and troponin I AUROC, 0.92 [95%CI, 0.91- 0.93]; sensitivity, 88%; specificity, 79%; PPV, 67%; NPV, 93%) and 10 common laboratory test components (eg, hemoglobin AUROC, 0.94 [95%CI, 0.92-0.95]; sensitivity, 99%; specificity, 17%; PPV, 90%; NPV, 81%; creatinine AUROC, 0.96 [95%CI, 0.96-0.97]; sensitivity, 93%; specificity, 83%; PPV, 79%; NPV, 94%; and urea nitrogen AUROC, 0.95 [95%CI, 0.94, 0.96]; sensitivity, 87%; specificity, 89%; PPV, 77%; NPV 94%).This approach goes further than this book:
The essential element of access to healthcare overshadows the understanding that better health can only be achieved if accessed services are also of high quality. The Sustainable Development Goals spell this out quite clearly: “Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all” (Goal 3, Target 8). Indeed, ensuring that healthcare services are of good quality is an imperative for policy-makers at all levels and an important contributor to health system performance.
The number of older inactive people who will need to be supported by each worker could rise by around 40% between 2018 and 2050 on average in the OECD area. This would put a brake on rising living standards as well as enormous pressure on younger generations who will be financing social protection systems. Improving employment prospects of older workers will be crucial. At the same time, taking a life-course approach will be necessary to avoid accumulation of individual disadvantages over work careers that discourage or prevent work at an older age; What can countries do to help? How can they give older people better work incentives and opportunities? This report provides a synthesis of the main challenges and policy recommendations together with a set of international best practices to foster employability, labour demand and incentives to work at an older age.And the WHO report message:
Dominant policy approaches such as increasing the statutory retirement age are often overshadowed by a lack of attention to two critical questions: firstly, are older workers in sufficiently good health to work longer? And secondly, does increasing the statutory retirement age have consequences, negative or positive, for the health of older workers?
These analyses find that population ageing is not, and will not become, a major driver of growth in health expenditures. Moreover, they suggest that in countries where age demographics are changing but the size of the older population is not yet large, the costs of improving coverage and access to services for older people is likely to be manageable and now is a good time to begin investing in the health system while the population is relatively young.
However, while population ageing will not become a main driver of health expenditure growth, policy choices related to how health services are delivered, the prices paid (or negotiated) for services, medicines and technologies, and volumes of care will ultimately determine health spending by age trends.
Contrary to some expectations, SHI in Europe has further expanded toward universal coverage, with access to health care considered a right based on either direct or indirect financial contributions. Indeed, Germany is now the only example in Europe where groups of the population can opt out from the main insurance system. And, since 2009, the overall population is required to be covered by either social or private insurance.