Comparison of sampling designs from the two editions of the Brazilian National Health Survey, 2013 and 2019

Abstract

Our objective is to describe the differences in the sampling plans of the two editions of the Brazilian National Health Survey (PNS 2013 and 2019) and to evaluate how the changes affected the coefficient of variation (CV) and the design effect (Deff) of some estimated indicators. Variables from different parts of the questionnaire were analyzed to cover proportions with different magnitudes. The prevalence of obesity was included in the analysis since anthropometry measurement in the 2019 survey was performed in a subsample. The value of the point estimate, CV, and the Deff were calculated for each indicator, considering the stratification of the primary sampling units, the weighting of the sampling units, and the clustering effect. The CV and the Deff were lower in the 2019 estimates for most indicators. Concerning the questionnaire indicators of all household members, the Deffs were high and reached values greater than 18 for having a health insurance plan. Regarding the indicators of the individual questionnaire, for the prevalence of obesity, the Deff ranged from 2.7 to 4.2, in 2013, and from 2.7 to 10.2, in 2019. The prevalence of hypertension and diabetes per Federative Unit had a higher CV and lower Deff. Expanding the sample size to meet the diverse health objectives and the high Deff are significant challenges for developing probabilistic household-based national survey. New probabilistic sampling strategies should be considered to reduce costs and clustering effects.

Geographical Inequalities in Access to Bellwether Procedures in Brazil

“…The major limitation of this work, as an epidemiological study, is that it is necessary to consider reporting bias and the consequent distortion of data due to underreporting or reporting error, which is more common to occur in the North and Northeast of Brazil than in other regions [21]. Another limitation of our study is the emphasis placed on the public healthcare system, even though private insurance covers 28.5% of the population [10]. Regardless, our findings referred to a system that any Brazilian can access at any time and for free across the five Brazilian geographical regions.…”

“…This result could be explained by not evaluating the private practice since DATASUS represents hospital information regarding the public sector. 37.5% of the health insurance coverage in 2019 was concentrated in the Southeast region, and these unexpected findings may be due to a greater effect of the private sector in this region [10].…”

“…SIH collects information on 60–70% of hospital admissions in the country within the Unified Health System [3]. These data do not include private healthcare information, for which approximately 28.5% of the population is covered [10].…”

Access to diabetes diagnosis in Brazil based on recent testing and consultation: The Brazilian national health survey, 2013 and 2019

“…To compare the results of the 2013 and 2019 PNS surveys, the IBGE recalibrated the PNS 2013 sample weights, based on the revised Brazilian population projection by gender and age used for the 2019 survey ( 17 ). The data of the two PNS editions were combined, using the survey year as a covariate, and making adjustments in the sample weights as suggested by Korn and Graubard (1999) ( 18 ), similar to those adopted in other studies ( 19 , 20 ).…”

Sexual Behavior, Self-declaration of Sexual Orientation, and Violence Experience: National Health Survey, Brazil, 2019

“…The second edition of the PNS was carried out in 2019 and gave continuity to most of the modules covered in the rst edition, involving an even larger sample of households (13). New modules required by technical areas of the Ministry of Health (MoH) were included in the PNS-2019.…”