An Ecological Study of the Determinants of Differences in 2009 Pandemic Influenza Mortality Rates between Countries in Europe
2011

Determinants of Pandemic Influenza Mortality Rates in Europe

Sample size: 30 publication 10 minutes Evidence: high

Author Information

Author(s): Nikolopoulos Georgios, Bagos Pantelis, Lytras Theodoros, Bonovas Stefanos

Primary Institution: Hellenic Centre for Disease Control and Prevention, Athens, Greece

Hypothesis

What are the socioeconomic determinants of pandemic mortality rates across European countries?

Conclusion

Higher public spending on health is associated with lower pandemic influenza mortality rates.

Supporting Evidence

  • A rise of 100 international dollars in health spending is linked to a 2.8% reduction in mortality.
  • The study analyzed data from 30 countries to find associations between health spending and mortality.
  • Statistical models showed a consistent inverse relationship between health expenditure and death rates.

Takeaway

Countries that spend more money on health care have fewer deaths from the flu pandemic.

Methodology

Random-effects Poisson regression models were used to analyze data from 30 European countries.

Potential Biases

Potential underreporting of deaths in countries with lower health spending could bias results.

Limitations

The study may have spurious correlations and ecological fallacies due to aggregate data.

Participant Demographics

Data from 30 European countries with varying health care expenditures.

Statistical Information

P-Value

0.002

Confidence Interval

95% CI: –0.00046, –0.00010

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1371/journal.pone.0019432

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