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Paying informally for public health care in Albania: scarce resources or governance failure?

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  • Tomini, Sonila

    ()
    (UNU-MERIT/MGSoG)

  • Groot, Wim

    (CAPHRI and TIER, Maastricht University)

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    Abstract

    Informal payments for health care are common in most former communist countries. This paper explores the demand side of these payments in Albania. Using tobit and Heckman selection models we control for individual determinants of informal payments in outpatient and inpatient health care. Propensity score matching techniques are used to investigate the changes in the characteristics of people paying informally over the different years. Our findings suggest that vulnerable groups in society remain less protected against such payments and policy measures have not reached the most deprived regions of the country.

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    File URL: http://www.merit.unu.edu/publications/wppdf/2012/wp2012-070.pdf
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    Bibliographic Info

    Paper provided by United Nations University - Maastricht Economic and Social Research Institute on Innovation and Technology (MERIT) in its series MERIT Working Papers with number 070.

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    Date of creation: 2012
    Date of revision:
    Handle: RePEc:unm:unumer:2012070

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    Related research

    Keywords: informal payment; health policy; Heckman selection model; propensity score matching;

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    1. Heckman, James J & Ichimura, Hidehiko & Todd, Petra E, 1997. "Matching as an Econometric Evaluation Estimator: Evidence from Evaluating a Job Training Programme," Review of Economic Studies, Wiley Blackwell, vol. 64(4), pages 605-54, October.
    2. Mukesh Chawla & Peter Berman & Dorota Kawiorska, 1998. "Financing health services in Poland: new evidence on private expenditures," Health Economics, John Wiley & Sons, Ltd., vol. 7(4), pages 337-346.
    3. Ensor, Tim & Witter, Sophie, 2001. "Health economics in low income countries: adapting to the reality of the unofficial economy," Health Policy, Elsevier, vol. 57(1), pages 1-13, July.
    4. Balabanova, Dina & McKee, Martin, 2002. "Understanding informal payments for health care: the example of Bulgaria," Health Policy, Elsevier, vol. 62(3), pages 243-273, December.
    5. 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, vol. 49(7), pages 849-865, October.
    6. Liaropoulos, Lycurgus & Tragakes, Ellie, 1998. "Public/private financing in the Greek health care system: implications for equity," Health Policy, Elsevier, vol. 43(2), pages 153-169, February.
    7. Lewis, Maureen & Pettersson, Gunilla, 2009. "Governance in health care delivery : raising performance," Policy Research Working Paper Series 5074, The World Bank.
    8. Dabalen, Andrew & Kilic, Talip & Wane, Waly, 2008. "Social Transfers, Labor Supply and Poverty Reduction: The Case of Albania," Policy Research Working Paper Series 4783, The World Bank.
    9. 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.
    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.
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