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Informal payments for health care in transition economies

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  • Ensor, Tim
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    Abstract

    There is considerable evidence that unofficial payments are deeply embedded in the markets for health care in transition countries. Numerous surveys indicate that these payments provide a significant but possibly distorting contribution to health care financing. Unofficial payments can be characterised into three groups: cost contributions, including supplies and salaries, misuse of market position and payments for additional services. There is evidence from across the region on the presence of payment in each category although it is often difficult to distinguish between payment types. Regulatory policy must address a number of issues. Imposing penalties may help to reduce some payments but if the system is simply unable to provide services, such sanctions will drive workers into the private sector. There appears to be some support for formalising payments in order to reduce unofficial charges although the impact must be monitored and the danger is that formal fees add to the burden of payment. Regulation might also attempt to increase the amount of competition, provide information on good performing facilities and develop the legal basis of patient rights. Ultimately, unless governments address the endemic nature of payments across all sectors, policy interventions are unlikely to be fully effective.

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    Bibliographic Info

    Article provided by Elsevier in its journal Social Science & Medicine.

    Volume (Year): 58 (2004)
    Issue (Month): 2 (January)
    Pages: 237-246

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    Handle: RePEc:eee:socmed:v:58:y:2004:i:2:p:237-246

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    Keywords: Informal payments Corruption Unofficial Health Care Markets Rent Seeking;

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    Cited by:
    1. Onwujekwe, Obinna & Dike, Nkem & Uzochukwu, Benjamin & Ezeoke, Ogochukwu, 2010. "Informal payments for healthcare: Differences in expenditures from consumers and providers perspectives for treatment of malaria in Nigeria," Health Policy, Elsevier, vol. 96(1), pages 72-79, June.
    2. World Bank, 2008. "Serbia : Decentralization and Local Service Delivery," World Bank Other Operational Studies 8099, The World Bank.
    3. Magnus Lindelow & Pieter Serneels & Teigist Lemma, 2005. "The Performance of Health Workers in Ethiopia Results from Qualitative Research," CSAE Working Paper Series 2005-06, Centre for the Study of African Economies, University of Oxford.
    4. Nguyen, Kim Thuy & Hai Khuat, Oanh Thi & Ma, Shuangge & Pham, Duc Cuong & Hong Khuat, Giang Thi & Ruger, Jennifer Prah, 2012. "Coping with health care expenses among poor households: Evidence from a rural commune in Vietnam," Social Science & Medicine, Elsevier, vol. 74(5), pages 724-733.
    5. Mihajlo Jakovljevic, 2013. "Resource allocation strategies in Southeastern European health policy," The European Journal of Health Economics, Springer, vol. 14(2), pages 153-159, April.
    6. Baji, Petra & Pavlova, Milena & Gulácsi, LászlÓ & Groot, Wim, 2011. "User fees for public health care services in Hungary: Expectations, experience, and acceptability from the perspectives of different stakeholders," Health Policy, Elsevier, vol. 102(2), pages 255-262.
    7. Tambor, Marzena & Pavlova, Milena & Golinowska, Stanisława & Sowada, Christoph & Groot, Wim, 2013. "The formal–informal patient payment mix in European countries. Governance, economics, culture or all of these?," Health Policy, Elsevier, vol. 113(3), pages 284-295.
    8. Kaitelidou, Daphne Ch. & Tsirona, Christina S. & Galanis, Petros A. & Siskou, Olga Ch. & Mladovsky, Philipa & Kouli, Eugenia G. & Prezerakos, Panagiotis E. & Theodorou, Mamas & Sourtzi, Panagiota A. &, 2013. "Informal payments for maternity health services in public hospitals in Greece," Health Policy, Elsevier, vol. 109(1), pages 23-30.
    9. Huffman, Samantha A. & Veen, Jaap & Hennink, Monique M. & McFarland, Deborah A., 2012. "Exploitation, vulnerability to tuberculosis and access to treatment among Uzbek labor migrants in Kazakhstan," Social Science & Medicine, Elsevier, vol. 74(6), pages 864-872.
    10. Sonila Tomini & Wim Groot & Milena Pavlova, 2012. "Paying informally in the Albanian health care sector: a two-tiered stochastic frontier model," The European Journal of Health Economics, Springer, vol. 13(6), pages 777-788, December.
    11. Cherecheş, Răzvan M. & Ungureanu, Marius I. & Sandu, Petru & Rus, Ioana A., 2013. "Defining informal payments in healthcare: A systematic review," Health Policy, Elsevier, vol. 110(2), pages 105-114.
    12. Mokhtari, Manouchehr & Ashtari, Mamak, 2012. "Reducing informal payments in the health care system: Evidence from a large patient satisfaction survey," Journal of Asian Economics, Elsevier, vol. 23(2), pages 189-200.

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