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Bribery in Health Care in Peru and Uganda

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  • Jennifer Hunt

Abstract

In this paper, I examine the role of household income in determining who bribes and how much they bribe in health care in Peru and Uganda. I find that rich patients are more likely than other patients to bribe in public health care: doubling household consumption increases the bribery probability by 0.2-0.4 percentage points in Peru, compared to a bribery rate of 0.8%; doubling household expenditure in Uganda increases the bribery probability by 1.2 percentage points compared to a bribery rate of 17%. The income elasticity of the bribe amount cannot be precisely estimated in Peru, but is about 0.37 in Uganda. Bribes in the Ugandan public sector appear to be fees-for-service extorted from the richer patients amongst those exempted by government policy from paying the official fees. Bribes in the private sector appear to be flat-rate fees paid by patients who do not pay official fees. I do not find evidence that the public health care sector in either Peru or Uganda is able to price-discriminate less effectively than public institutions with less competition from the private sector.

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Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 13034.

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Date of creation: Apr 2007
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Handle: RePEc:nbr:nberwo:13034

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  1. Daniel Kaufmann & Shang-Jin Wei, 1999. "Does "Grease Money" Speed Up the Wheels of Commerce?," NBER Working Papers 7093, National Bureau of Economic Research, Inc.
  2. Svensson, Jakob, 2002. "Who Must Pay Bribes and How Much? Evidence from a cross-section of firms," Seminar Papers, Stockholm University, Institute for International Economic Studies 713, Stockholm University, Institute for International Economic Studies.
  3. McPake, Barbara & Asiimwe, Delius & Mwesigye, Francis & Ofumbi, Mathias & Ortenblad, Lisbeth & Streefland, Pieter & Turinde, Asaph, 1999. "Informal economic activities of public health workers in Uganda: implications for quality and accessibility of care," Social Science & Medicine, Elsevier, Elsevier, vol. 49(7), pages 849-865, October.
  4. Xavier, Ana & Robin Thompson, 2003. "Unofficial payments for acute state hospital care in Kazakhstan. A model of physician behaviour with price discrimination and vertical service differentiation," Royal Economic Society Annual Conference 2003, Royal Economic Society 224, Royal Economic Society.
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  8. Jitta, Jessica & Whyte, Susan Reynolds & Nshakira, Nathan, 2003. "The availability of drugs: what does it mean in Ugandan primary care," Health Policy, Elsevier, Elsevier, vol. 65(2), pages 167-179, August.
  9. Shang-Jin Wei, 1997. "How Taxing is Corruption on International Investors?," NBER Working Papers 6030, National Bureau of Economic Research, Inc.
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  15. Deininger, Klaus & Mpuga, Paul, 2005. "Does Greater Accountability Improve the Quality of Public Service Delivery? Evidence from Uganda," World Development, Elsevier, Elsevier, vol. 33(1), pages 171-191, January.
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Cited by:
  1. Deepa Narayan & Lant Pritchett & Soumya Kapoor, 2009. "Moving Out of Poverty : Volume 2. Success from the Bottom Up," World Bank Publications, The World Bank, number 11838, August.
  2. Cherecheş, Răzvan M. & Ungureanu, Marius I. & Sandu, Petru & Rus, Ioana A., 2013. "Defining informal payments in healthcare: A systematic review," Health Policy, Elsevier, Elsevier, vol. 110(2), pages 105-114.
  3. Lewis, Maureen & Pettersson, Gunilla, 2009. "Governance in health care delivery : raising performance," Policy Research Working Paper Series 5074, The World Bank.

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