An ecological study of the determinants of differences in 2009 pandemic influenza mortality rates between countries in Europe.

<h4>Background</h4>Pandemic A (H1N1) 2009 mortality rates varied widely from one country to another. Our aim was to identify potential socioeconomic determinants of pandemic mortality and explain between-country variation.<h4>Methodology</h4>Based on data from a total of 30 E...

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Autores principales:	Georgios Nikolopoulos, Pantelis Bagos, Theodoros Lytras, Stefanos Bonovas
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2011
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/65b6f994410d45ffbbbf18611f017472
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spelling	oai:doaj.org-article:65b6f994410d45ffbbbf18611f0174722021-11-18T06:54:09ZAn ecological study of the determinants of differences in 2009 pandemic influenza mortality rates between countries in Europe.1932-620310.1371/journal.pone.0019432https://doaj.org/article/65b6f994410d45ffbbbf18611f0174722011-05-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/21589928/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Pandemic A (H1N1) 2009 mortality rates varied widely from one country to another. Our aim was to identify potential socioeconomic determinants of pandemic mortality and explain between-country variation.<h4>Methodology</h4>Based on data from a total of 30 European countries, we applied random-effects Poisson regression models to study the relationship between pandemic mortality rates (May 2009 to May 2010) and a set of representative environmental, health care-associated, economic and demographic country-level parameters. The study was completed by June 2010.<h4>Principal findings</h4>Most regression approaches indicated a consistent, statistically significant inverse association between pandemic influenza-related mortality and per capita government expenditure on health. The findings were similar in univariable [coefficient: -0.00028, 95% Confidence Interval (CI): -0.00046, -0.00010, p = 0.002] and multivariable analyses (including all covariates, coefficient: -0.00107, 95% CI: -0.00196, -0.00018, p = 0.018). The estimate was barely insignificant when the multivariable model included only significant covariates from the univariate step (coefficient: -0.00046, 95% CI: -0.00095, 0.00003, p = 0.063).<h4>Conclusions</h4>Our findings imply a significant inverse association between public spending on health and pandemic influenza mortality. In an attempt to interpret the estimated coefficient (-0.00028) for the per capita government expenditure on health, we observed that a rise of 100 international dollars was associated with a reduction in the pandemic influenza mortality rate by approximately 2.8%. However, further work needs to be done to unravel the mechanisms by which reduced government spending on health may have affected the 2009 pandemic influenza mortality.Georgios NikolopoulosPantelis BagosTheodoros LytrasStefanos BonovasPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 6, Iss 5, p e19432 (2011)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Georgios Nikolopoulos Pantelis Bagos Theodoros Lytras Stefanos Bonovas An ecological study of the determinants of differences in 2009 pandemic influenza mortality rates between countries in Europe.
description	<h4>Background</h4>Pandemic A (H1N1) 2009 mortality rates varied widely from one country to another. Our aim was to identify potential socioeconomic determinants of pandemic mortality and explain between-country variation.<h4>Methodology</h4>Based on data from a total of 30 European countries, we applied random-effects Poisson regression models to study the relationship between pandemic mortality rates (May 2009 to May 2010) and a set of representative environmental, health care-associated, economic and demographic country-level parameters. The study was completed by June 2010.<h4>Principal findings</h4>Most regression approaches indicated a consistent, statistically significant inverse association between pandemic influenza-related mortality and per capita government expenditure on health. The findings were similar in univariable [coefficient: -0.00028, 95% Confidence Interval (CI): -0.00046, -0.00010, p = 0.002] and multivariable analyses (including all covariates, coefficient: -0.00107, 95% CI: -0.00196, -0.00018, p = 0.018). The estimate was barely insignificant when the multivariable model included only significant covariates from the univariate step (coefficient: -0.00046, 95% CI: -0.00095, 0.00003, p = 0.063).<h4>Conclusions</h4>Our findings imply a significant inverse association between public spending on health and pandemic influenza mortality. In an attempt to interpret the estimated coefficient (-0.00028) for the per capita government expenditure on health, we observed that a rise of 100 international dollars was associated with a reduction in the pandemic influenza mortality rate by approximately 2.8%. However, further work needs to be done to unravel the mechanisms by which reduced government spending on health may have affected the 2009 pandemic influenza mortality.
format	article
author	Georgios Nikolopoulos Pantelis Bagos Theodoros Lytras Stefanos Bonovas
author_facet	Georgios Nikolopoulos Pantelis Bagos Theodoros Lytras Stefanos Bonovas
author_sort	Georgios Nikolopoulos
title	An ecological study of the determinants of differences in 2009 pandemic influenza mortality rates between countries in Europe.
title_short	An ecological study of the determinants of differences in 2009 pandemic influenza mortality rates between countries in Europe.
title_full	An ecological study of the determinants of differences in 2009 pandemic influenza mortality rates between countries in Europe.
title_fullStr	An ecological study of the determinants of differences in 2009 pandemic influenza mortality rates between countries in Europe.
title_full_unstemmed	An ecological study of the determinants of differences in 2009 pandemic influenza mortality rates between countries in Europe.
title_sort	ecological study of the determinants of differences in 2009 pandemic influenza mortality rates between countries in europe.
publisher	Public Library of Science (PLoS)
publishDate	2011
url	https://doaj.org/article/65b6f994410d45ffbbbf18611f017472
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An ecological study of the determinants of differences in 2009 pandemic influenza mortality rates between countries in Europe.

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