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Civil Servants and Non-Western Migrants’ Perceptions on Pathways to Health Care in Serbia—A Grounded Theory, Multi-Perspective Study

Author

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  • Sofie Buch Mejsner

    (Unit for Health Promotion Research, University of Southern Denmark, Degnevej 14, 6705 Esbjerg, Denmark)

  • Maria Kristiansen

    (Department of Public Health, Center for Healthy Aging, University of Copenhagen, Øster Farimagsgade 5, 1353 Copenhagen, Denmark)

  • Leena Eklund Karlsson

    (Unit for Health Promotion Research, University of Southern Denmark, Degnevej 14, 6705 Esbjerg, Denmark)

Abstract

(1) Background: Informal patient payments continue to persist in the Serbian health care system, exposing vulnerable groups to private spending on health care. Migrants may in particular be subject to such payments, as they often experience barriers in access to health care. Little is known about migrants paying informally to access health care in Serbia. The study aims to explore pathways of accessing health care, including the role of informal patient payments, from the perspectives of civil servants and non-western migrants in Serbia. (2) Methods: Respondents ( n = 8 civil servants and n = 6 migrants) were recruited in Belgrade in 2018, where semi-structured interviews were conducted. The interviews were analysed applying the grounded theory methodological steps. (3) Results: Data reveal different pathways to navigate the Serbian health care system, and ultimately whether paying informally occurs. Migrants appear less prone to paying informally and receive the same or better-quality health care. Locals experience the need to pay informal patient payments, quasi-formal payments and to bring medicine, materials or equipment when in health facilities. (4) Conclusions: Paying informally or using private care in Serbia appear to have become common. Despite a comprehensive health insurance coverage, high levels of out-of-pocket payments show barriers in accessing health care. It is highly important to not confuse the cultural beliefs with forced spending on health care and such private spending should be reduced to not push people into poverty.

Suggested Citation

  • Sofie Buch Mejsner & Maria Kristiansen & Leena Eklund Karlsson, 2021. "Civil Servants and Non-Western Migrants’ Perceptions on Pathways to Health Care in Serbia—A Grounded Theory, Multi-Perspective Study," IJERPH, MDPI, vol. 18(19), pages 1-17, September.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:19:p:10247-:d:646174
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    1. Patricia Gabriel & Janusz Kaczorowski & Nicole Berry, 2017. "Recruitment of Refugees for Health Research: A Qualitative Study to Add Refugees’ Perspectives," IJERPH, MDPI, vol. 14(2), pages 1-10, January.
    2. Siddiqi, Sameen & Masud, Tayyeb I. & Nishtar, Sania & Peters, David H. & Sabri, Belgacem & Bile, Khalif M. & Jama, Mohamed A., 2009. "Framework for assessing governance of the health system in developing countries: Gateway to good governance," Health Policy, Elsevier, vol. 90(1), pages 13-25, April.
    3. Sofie Buch Mejsner & Leena Eklund Karlsson, 2017. "Informal Payments and Health System Governance in Serbia: A Pilot Study," SAGE Open, , vol. 7(3), pages 21582440177, August.
    4. Julia Kadin Funge & Mathilde Christine Boye & Helle Johnsen & Marie Nørredam, 2020. "“No Papers. No Doctor” : A Qualitative Study of Access to Maternity Care Services for Undocumented Immigrant Women in Denmark," IJERPH, MDPI, vol. 17(18), pages 1-14, September.
    5. Raj S Bhopal & Laurence Gruer & Genevieve Cezard & Anne Douglas & Markus F C Steiner & Andrew Millard & Duncan Buchanan & S Vittal Katikireddi & Aziz Sheikh, 2018. "Mortality, ethnicity, and country of birth on a national scale, 2001–2013: A retrospective cohort (Scottish Health and Ethnicity Linkage Study)," PLOS Medicine, Public Library of Science, vol. 15(3), pages 1-18, March.
    6. Arsenijevic, Jelena & Pavlova, Milena & Groot, Wim, 2015. "Out-of-pocket payments for health care in Serbia," Health Policy, Elsevier, vol. 119(10), pages 1366-1374.
    7. Glenn Laverack, 2018. "The Challenge of Promoting the Health of Refugees and Migrants in Europe: A Review of the Literature and Urgent Policy Options," Challenges, MDPI, vol. 9(2), pages 1-12, August.
    8. 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;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 13(6), pages 777-788, December.
    9. Hotchkiss, David Richards & Hutchinson, Paul Lawrence & Malaj, Altin & Berruti, Andres Alejandro, 2005. "Out-of-pocket payments and utilization of health care services in Albania: Evidence from three districts," Health Policy, Elsevier, vol. 75(1), pages 18-39, December.
    10. Vian, Taryn & Grybosk, Kristina & Sinoimeri, Zamira & Hall, Rachel, 2006. "Informal payments in government health facilities in Albania: Results of a qualitative study," Social Science & Medicine, Elsevier, vol. 62(4), pages 877-887, February.
    11. Colin C. Williams & Adrian V. Horodnic, 2018. "Explaining informal payments for health services in Central and Eastern Europe: an institutional asymmetry perspective," Post-Communist Economies, Taylor & Francis Journals, vol. 30(4), pages 440-458, July.
    12. Abdolvahed Khodamoradi & Mohammad Payam Ghaffari & Reza Daryabeygi‐Khotbehsara & Haniye Sadat Sajadi & Reza Majdzadeh, 2018. "A systematic review of empirical studies on methodology and burden of informal patient payments in health systems," International Journal of Health Planning and Management, Wiley Blackwell, vol. 33(1), pages 26-37, January.
    13. Radin, Dagmar, 2013. "Does corruption undermine trust in health care? Results from public opinion polls in Croatia," Social Science & Medicine, Elsevier, vol. 98(C), pages 46-53.
    14. Vladimir Andrić & Milojko Arsić & Aleksandra Nojković, 2016. "Public Debt Sustainability In Serbia Before And During The Global Financial Crisis," Economic Annals, Faculty of Economics and Business, University of Belgrade, vol. 61(210), pages 47-78, July - Se.
    15. Gaal, Peter & McKee, Martin, 2005. "Fee-for-service or donation? Hungarian perspectives on informal payment for health care," Social Science & Medicine, Elsevier, vol. 60(7), pages 1445-1457, April.
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