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An Ecological Study of the Determinants of Differences in 2009 Pandemic Influenza Mortality Rates between Countries in Europe
dc.creator | Nikolopoulos, G. | en |
dc.creator | Bagos, P. | en |
dc.creator | Lytras, T. | en |
dc.creator | Bonovas, S. | en |
dc.date.accessioned | 2015-11-23T10:41:12Z | |
dc.date.available | 2015-11-23T10:41:12Z | |
dc.date.issued | 2011 | |
dc.identifier | 10.1371/journal.pone.0019432 | |
dc.identifier.issn | 1932-6203 | |
dc.identifier.uri | http://hdl.handle.net/11615/31394 | |
dc.description.abstract | Background: 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. Methodology: 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. Principal Findings: 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). Conclusions: 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. | en |
dc.source.uri | <Go to ISI>://WOS:000290483600010 | |
dc.subject | AIR-POLLUTION | en |
dc.subject | INCOME INEQUALITY | en |
dc.subject | POPULATION HEALTH | en |
dc.subject | A H1N1 | en |
dc.subject | OUTCOMES | en |
dc.subject | DEATH | en |
dc.subject | UNEMPLOYMENT | en |
dc.subject | INFECTION | en |
dc.subject | PROGRAMS | en |
dc.subject | CRISES | en |
dc.subject | Multidisciplinary Sciences | en |
dc.title | An Ecological Study of the Determinants of Differences in 2009 Pandemic Influenza Mortality Rates between Countries in Europe | en |
dc.type | journalArticle | en |
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