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Explaining informal payments for health services in Central and Eastern Europe: an institutional asymmetry perspective

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  • Colin C. Williams
  • Adrian V. Horodnic

Abstract

The aim of this paper is to propose and evaluate a new institutional theory explanation for patients making informal payments for health services in Central and Eastern Europe. This views informal payments by patients to healthcare professionals as arising when formal institutional failures lead to an asymmetry between the laws and regulations of formal institutions and the unwritten rules of informal institutions. Reporting a 2013 Eurobarometer survey of the prevalence of informal payments by patients in Central and Eastern European countries, a strong association is revealed between the level of asymmetry between the formal and informal institutions, and the propensity to make informal payments. The association between informal payments and various formal institutional imperfections is then explored to evaluate which structural conditions might reduce this institutional asymmetry, and thus the propensity to make informal payments. The paper concludes by exploring the implications for tackling such informal practices.

Suggested Citation

  • 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.
    • Handle: RePEc:taf:pocoec:v:30:y:2018:i:4:p:440-458
    DOI: 10.1080/14631377.2018.1442051
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    Citations

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    Cited by:

    1. Franić Josip & Kojouharov Anton, 2019. "Informal payments by patients in Croatia: benign custom or detrimental residue from socialism?," Croatian Review of Economic, Business and Social Statistics, Sciendo, vol. 5(2), pages 49-63, December.
    2. Cristian Incaltarau & Adrian V. Horodnic & Colin C. Williams & Liviu Oprea, 2021. "Institutional Determinants of Informal Payments for Health Services: An Exploratory Analysis across 117 Countries," IJERPH, MDPI, vol. 18(23), pages 1-19, November.
    3. repec:aud:audfin:v:21:y:2019:i:50:p:60 is not listed on IDEAS
    4. Gheorghe Epuran & Claudia-Ioana Ciobanu & Adrian V. Horodnic & Gheorghe Epuran & Claudia-Ioana Ciobanu & Adrian V. Horodnic, 2019. "Green Jobs Creation – Main Element in the Implementation of Bioeconomic Mechanisms," The AMFITEATRU ECONOMIC journal, Academy of Economic Studies - Bucharest, Romania, vol. 21(50), pages 1-60, February.
    5. Ioana Alexandra Horodnic & Colin C. Williams & Alexandru Maxim & Iuliana Claudia Stoian & Oana Carmen Țugulea & Adrian V. Horodnic, 2021. "Knowing and Unknowing Purchases of Undeclared Healthcare Goods and Services: The Role of Vertical and Horizontal Trust," IJERPH, MDPI, vol. 18(21), pages 1-14, November.
    6. Adrian V. Horodnic & Colin C. Williams & Răzvan Ionuț Drugă & Cristian Incaltarau, 2021. "Informal Payments by Patients in Central and Eastern Europe during the COVID-19 Pandemic: An Institutional Perspective," IJERPH, MDPI, vol. 18(20), pages 1-17, October.
    7. 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.

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