Table 4.
Estimated annual change in completeness of four influenza outcome variables and three economic and health expenditure indicators in 29 Pan American countries over the 782-week time series starting from Week 1 (03 January) 2005 to Week 52 (29 December) 2019.
| Outcome | Unadjusted estimates | Adjusted estimatesa | ||||||
|---|---|---|---|---|---|---|---|---|
| Effect size | LCI | UCI | p value | Effect size | LCI | UCI | p value | |
| Estimated annual change in completeness | ||||||||
| Overall | 3.948 | 3.493 | 4.403 | < 0.001 | 4.251 | 3.811 | 4.690 | < 0.001 |
| Tests | 5.040 | 4.517 | 5.563 | < 0.001 | 5.346 | 4.833 | 5.858 | < 0.001 |
| Positives | 4.930 | 4.408 | 5.452 | < 0.001 | 5.229 | 4.717 | 5.741 | < 0.001 |
| A(H1N1)pdm09 | 5.935 | 5.174 | 6.696 | < 0.001 | 6.307 | 5.541 | 7.073 | < 0.001 |
| Estimated effect associated with doubling in gross national income per capita | ||||||||
| Overall | 3.667 | − 0.763 | 8.097 | 0.105 | 0.494 | − 3.088 | 4.077 | 0.787 |
| Tests | 1.321 | − 3.741 | 6.383 | 0.609 | − 1.026 | − 5.251 | 3.199 | 0.634 |
| Positives | 1.502 | − 3.553 | 6.557 | 0.560 | − 0.809 | − 5.047 | 3.428 | 0.708 |
| A(H1N1)pdm09 | 15.858 | 8.568 | 23.149 | < 0.001 | 9.033 | 2.400 | 15.666 | 0.008 |
| Estimated effect associated with doubling in domestic health expenditure per capita | ||||||||
| Overall | 12.489 | 8.050 | 16.928 | < 0.001 | 6.955 | 2.978 | 10.932 | 0.001 |
| Tests | 14.154 | 9.070 | 19.239 | < 0.001 | 8.713 | 3.954 | 13.472 | < 0.001 |
| Positives | 14.670 | 9.575 | 19.765 | < 0.001 | 9.370 | 4.567 | 14.172 | < 0.001 |
| A(H1N1)pdm09 | 12.921 | 6.742 | 19.099 | < 0.001 | 7.261 | 1.258 | 13.263 | 0.018 |
| Estimated effect associated with 10% change in out-of-pocket health expenditure | ||||||||
| Overall | − 1.439 | − 4.945 | 2.068 | 0.421 | − 0.061 | − 3.217 | 3.095 | 0.970 |
| Tests | − 1.880 | − 5.919 | 2.159 | 0.362 | − 0.264 | − 4.012 | 3.484 | 0.890 |
| Positives | − 0.908 | − 4.939 | 3.123 | 0.659 | 0.491 | − 3.249 | 4.231 | 0.797 |
| A(H1N1)pdm09 | − 2.310 | − 7.939 | 3.320 | 0.421 | − 0.522 | − 5.798 | 4.755 | 0.846 |
The effect size estimation was calculated for a doubling in per capita indicator estimates and a 10% increase in out-of-pocket health expenditure. LCI and UCI refer to the lower and upper bounds of the 95% confidence interval.
aModels were adjusted for case definition type, adherence to WHO definition, surveillance strategy, reporting quota, reporting timeframe, number of NICs and reporting facilities.