| 1. |
- Dieleman, J., et al.
(författare)
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Evolution and patterns of global health financing 1995-2014 : Development assistance for health, and government, prepaid private, and out-of-pocket health spending in 184 countries
- 2017
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Ingår i: The Lancet. - : Lancet Publishing Group. - 0140-6736 .- 1474-547X. ; 389:10083, s. 1981-2004
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Tidskriftsartikel (refereegranskat)abstract
- Background: An adequate amount of prepaid resources for health is important to ensure access to health services and for the pursuit of universal health coverage. Previous studies on global health financing have described the relationship between economic development and health financing. In this study, we further explore global health financing trends and examine how the sources of funds used, types of services purchased, and development assistance for health disbursed change with economic development. We also identify countries that deviate from the trends. Methods: We estimated national health spending by type of care and by source, including development assistance for health, based on a diverse set of data including programme reports, budget data, national estimates, and 964 National Health Accounts. These data represent health spending for 184 countries from 1995 through 2014. We converted these data into a common inflation-adjusted and purchasing power-adjusted currency, and used non-linear regression methods to model the relationship between health financing, time, and economic development. Findings: Between 1995 and 2014, economic development was positively associated with total health spending and a shift away from a reliance on development assistance and out-of-pocket (OOP) towards government spending. The largest absolute increase in spending was in high-income countries, which increased to purchasing power-adjusted $5221 per capita based on an annual growth rate of 3.0%. The largest health spending growth rates were in upper-middle-income (5.9) and lower-middle-income groups (5.0), which both increased spending at more than 5% per year, and spent $914 and $267 per capita in 2014, respectively. Spending in low-income countries grew nearly as fast, at 4.6%, and health spending increased from $51 to $120 per capita. In 2014, 59.2% of all health spending was financed by the government, although in low-income and lower-middle-income countries, 29.1% and 58.0% of spending was OOP spending and 35.7% and 3.0% of spending was development assistance. Recent growth in development assistance for health has been tepid; between 2010 and 2016, it grew annually at 1.8%, and reached US$37.6 billion in 2016. Nonetheless, there is a great deal of variation revolving around these averages. 29 countries spend at least 50% more than expected per capita, based on their level of economic development alone, whereas 11 countries spend less than 50% their expected amount. Interpretation: Health spending remains disparate, with low-income and lower-middle-income countries increasing spending in absolute terms the least, and relying heavily on OOP spending and development assistance. Moreover, tremendous variation shows that neither time nor economic development guarantee adequate prepaid health resources, which are vital for the pursuit of universal health coverage. © The Author(s). Published by Elsevier Ltd.
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| 2. |
- Dieleman, J. L., et al.
(författare)
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Future and potential spending on health 2015-40 : Development assistance for health, and government, prepaid private, and out-of-pocket health spending in 184 countries
- 2017
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Ingår i: The Lancet. - : Lancet Publishing Group. - 0140-6736 .- 1474-547X. ; 389:10083, s. 2005-2030
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Tidskriftsartikel (refereegranskat)abstract
- Background: The amount of resources, particularly prepaid resources, available for health can affect access to health care and health outcomes. Although health spending tends to increase with economic development, tremendous variation exists among health financing systems. Estimates of future spending can be beneficial for policy makers and planners, and can identify financing gaps. In this study, we estimate future gross domestic product (GDP), all-sector government spending, and health spending disaggregated by source, and we compare expected future spending to potential future spending. Methods: We extracted GDP, government spending in 184 countries from 1980-2015, and health spend data from 1995-2014. We used a series of ensemble models to estimate future GDP, all-sector government spending, development assistance for health, and government, out-of-pocket, and prepaid private health spending through 2040. We used frontier analyses to identify patterns exhibited by the countries that dedicate the most funding to health, and used these frontiers to estimate potential health spending for each low-income or middle-income country. All estimates are inflation and purchasing power adjusted. Findings: We estimated that global spending on health will increase from US$9.21 trillion in 2014 to $24.24 trillion (uncertainty interval [UI] 20.47-29.72) in 2040. We expect per capita health spending to increase fastest in upper-middle-income countries, at 5.3% (UI 4.1-6.8) per year. This growth is driven by continued growth in GDP, government spending, and government health spending. Lower-middle income countries are expected to grow at 4.2% (3.8-4.9). High-income countries are expected to grow at 2.1% (UI 1.8-2.4) and low-income countries are expected to grow at 1.8% (1.0-2.8). Despite this growth, health spending per capita in low-income countries is expected to remain low, at $154 (UI 133-181) per capita in 2030 and $195 (157-258) per capita in 2040. Increases in national health spending to reach the level of the countries who spend the most on health, relative to their level of economic development, would mean $321 (157-258) per capita was available for health in 2040 in low-income countries. Interpretation: Health spending is associated with economic development but past trends and relationships suggest that spending will remain variable, and low in some low-resource settings. Policy change could lead to increased health spending, although for the poorest countries external support might remain essential. © The Author(s).
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| 3. |
- Campbell, M, et al.
(författare)
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Detection of single electrons by means of a Micromegas-covered Medipix2 pixel CMOS readout circuit
- 2005
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Ingår i: Nuclear Instruments and Methods in Physics Research Section A. - : Elsevier BV. - 0168-9002 .- 1872-9576. ; 540:2-3, s. 295-304
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Tidskriftsartikel (refereegranskat)abstract
- A small drift chamber was read out by means of a MediPix2 readout chip as a direct anode. A Micromegas foil was placed above the chip, and electron multiplication occurred in the gap. With a He/isobutane 80/20 mixture, gas multiplication factors up to tens of thousands were achieved, resulting in an efficiency for detecting single electrons of better than 90%. We recorded many frames containing 2D images with tracks from cosmic muons. Along these tracks, electron clusters were observed, as well as δ-rays.
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| 4. |
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| 5. |
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| 6. |
- Ballabriga, Rafael, et al.
(författare)
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The Medipix3RX: a high resolution, zero dead-time pixel detector readout chip allowing spectroscopic imaging
- 2013
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Ingår i: Journal of Instrumentation. - 1748-0221. ; 8:2, s. C02016-
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Tidskriftsartikel (refereegranskat)abstract
- The Medipix3 chips have been designed to permit spectroscopic imaging in highly segmented hybrid pixel detectors. Spectral degradation due to charge sharing in the sensor has been addressed by means of an architecture in which adjacent pixels communicate in the analog and digital domains on an event-by-event basis to reconstruct the deposited charge in a neighbourhood prior to the assignation of the hit to a single pixel. The Medipix3RX chip architecture is presented. The first results for the characterization of the chip with 300 μm thick Si sensors are given. ~ 72e− r.m.s. noise and ~ 40e− r.m.s. of threshold dispersion after chip equalization have been measured in Single Pixel Mode of operation. The homogeneity of the image in Charge Summing mode is comparable to the Single Pixel Mode image. This demonstrates both modes are suitable for X-ray imaging applications.
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| 7. |
- Tlustos, L, et al.
(författare)
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Imaging properties of the Medipix2 system exploiting single and dual enery thresholds
- 2006
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Ingår i: IEEE Transactions on Nuclear Science. - 0018-9499 .- 1558-1578. ; 53, s. 1323-1328
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Tidskriftsartikel (refereegranskat)abstract
- Low noise, high resolution and high dose efficiency are the common requirements for most X-ray imaging applications. Especially in medical applications the dose efficiency is a necessity for detector systems. We present the imaging performance of the Medipix2 readout chip bump bonded to a 300 mu m thick Si detector as a function of the detection threshold, a free parameter not available in conventional integrating imaging systems. Spatial resolution has been measured using the modulation transfer function (MTF) and it varies between 8.2 Ip/mm and 11.0 Ip/mm at 70%. An associated measurement of noise power spectrum (NPS) permits us to derive the detective quantum efficiency (DQE) which can be as a high as 25.5 % for a broadband incoming spectrum. The influence of charge diffusion in the sensor together with threshold variation in the readout chip is discussed. Although the Medipix2 system is used in photon counting mode with a single threshold in energy, the system is also capable of counting within a given energy window of down to ~1.4 keV. First measurements and images using this feature reveal capabilities that allow to identify fluorescence and other sources of disturbance.
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| 8. |
- Tlustos, L, et al.
(författare)
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Signal variations in high granularity Si pixel detectors
- 2004
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Ingår i: IEEE Transactions on Nuclear Science. - 0018-9499 .- 1558-1578. ; 51, s. 3006-3012
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Tidskriftsartikel (refereegranskat)abstract
- Fixed pattern noise is one of the limiting factors of image quality and degrades the achievable spatial resolution. In the case of silicon sensors non-uniformities due to doping inhomogeneities can be limited by operating the sensor in strong overdepletion. For high granularity photon counting pixel detectors an additional high frequency interpixel signal variation is an important factor for the achievable signal to noise ratio (SNR). It is common practice to apply flatfield corrections to increase the SNR of the detector system. For the case of direct conversion detectors it can be shown that the Poisson limit can be reached for floodfield irradiation. However when used for imaging with spectral X-ray sources flatfield corrections are less effective. This is partly a consequence of charge sharing between adjacent pixels, which gives rise to an effective energy spectrum seen by the readout, which is different from the spectral content of the incident beam. In this paper we present simulations and measurements of the limited applicability of flatfield corrections for spectral source imaging and investigate the origins of the high frequency interpixel noise component The model, calculations and measurements performed suggest that flatfield correction maps for photon counting detectors with a direct conversion Si sensor can be obtained from electrical characterization of the readout chip alone.
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