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Informal payments in public hospitals in Greece

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  • Liaropoulos, Lycourgos
  • Siskou, Olga
  • Kaitelidou, Daphne
  • Theodorou, Mamas
  • Katostaras, Theofanis

Abstract

Informal payments are an ingrained social institution in Greece. In some cases, they are also part of corruption in the health area, which includes a variety of other forms.Objective The objective of this paper is to measure and analyze the size and nature of informal payments in the Greek public hospitals, concentrating on payments made to health personnel to facilitate access to services and preferred providers.Methods We used a randomized countrywide sample of 1616 households, amounting to 4738 individuals. The survey methodology was telephone interviews with a questionnaire supported by the software of Computer Assisted Telephone Interviewing.Results Out of the total number of those reporting treatment in public hospitals (NÂ =Â 336), 36% reported at least one informal payment to a doctor. Of these, 42% reported it was given because of the fear of receiving sub-standard care (if they did not pay) and another 20% claimed that the doctor demanded such a payment. None of the socio-economic characteristics of the family were related to the size of extra (informal) payments. The probability of extra payments is 72% higher for patients aiming to "jump the queue", compared to those admitted through normal procedures. Also, surgical cases had a 137% higher probability for extra payments compared to non-surgical patients.Conclusions A very high percentage of informal payments are made in order to gain access to public hospitals and to receive a higher quality of services. Despite near universal coverage of the population by public health insurance, informal payments are widespread and a major source of inequity and inefficiency in the Greek health care system.

Suggested Citation

  • Liaropoulos, Lycourgos & Siskou, Olga & Kaitelidou, Daphne & Theodorou, Mamas & Katostaras, Theofanis, 2008. "Informal payments in public hospitals in Greece," Health Policy, Elsevier, vol. 87(1), pages 72-81, July.
  • Handle: RePEc:eee:hepoli:v:87:y:2008:i:1:p:72-81
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    1. Siskou, Olga & Kaitelidou, Daphne & Papakonstantinou, Vasiliki & Liaropoulos, Lycourgos, 2008. "Private health expenditure in the Greek health care system: Where truth ends and the myth begins," Health Policy, Elsevier, vol. 88(2-3), pages 282-293, December.
    2. Ifanti, Amalia A. & Argyriou, Andreas A. & Kalofonou, Foteini H. & Kalofonos, Haralabos P., 2013. "Financial crisis and austerity measures in Greece: Their impact on health promotion policies and public health care," Health Policy, Elsevier, vol. 113(1), pages 8-12.
    3. 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.
    4. Erik Schokkaert & Jonas Steel & Carine Van de Voorde, 2017. "Out-of-Pocket Payments and Subjective Unmet Need of Healthcare," Applied Health Economics and Health Policy, Springer, vol. 15(5), pages 545-555, October.
    5. Cavalieri, Marina & Guccio, Calogero & Rizzo, Ilde, 2017. "On the role of environmental corruption in healthcare infrastructures: An empirical assessment for Italy using DEA with truncated regression approach," Health Policy, Elsevier, vol. 121(5), pages 515-524.
    6. Idrissa Beogo & Chieh-Yu Liu & Yiing-Jenq Chou & Chuan-Yu Chen & Nicole Huang, 2014. "Health-Care-Seeking Patterns in the Emerging Private Sector in Burkina Faso: A Population-Based Study of Urban Adult Residents in Ouagadougou," PLOS ONE, Public Library of Science, vol. 9(5), pages 1-11, May.
    7. Vandoros, Sotiris & Stargardt, Tom, 2013. "Reforms in the Greek pharmaceutical market during the financial crisis," Health Policy, Elsevier, vol. 109(1), pages 1-6.
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    10. Kyriakos Souliotis & Christina Golna & Yannis Tountas & Olga Siskou & Daphne Kaitelidou & Lycourgos Liaropoulos, 2016. "Informal payments in the Greek health sector amid the financial crisis: old habits die last..," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 17(2), pages 159-170, March.
    11. 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.
    12. Olga Siskou & Daphne Kaitelidou & Charalampos Economou & Peter Kostagiolas & Lycourgos Liaropoulos, 2009. "Private expenditure and the role of private health insurance in Greece: status quo and future trends," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 10(4), pages 467-474, October.
    13. Szilvia Altwicker-Hámori & János Köllő, 2013. "Hungary: Public sector labour market from crisis to crisis," Chapters, in: Daniel Vaughan-Whitehead (ed.),Public Sector Shock, chapter 8, pages 300-336, Edward Elgar Publishing.
    14. Giannouchos, Theodoros V. & Vozikis, Athanassios & Koufopoulou, Paraskevi & Fawkes, Leanne & Souliotis, Kyriakos, 2020. "Informal out-of-pocket payments for healthcare services in Greece," Health Policy, Elsevier, vol. 124(7), pages 758-764.
    15. 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.
    16. Grigorakis, Nikolaos & Floros, Christos & Tsangari, Haritini & Tsoukatos, Evangelos, 2016. "Out of pocket payments and social health insurance for private hospital care: Evidence from Greece," Health Policy, Elsevier, vol. 120(8), pages 948-959.
    17. 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.
    18. Kyriakos Souliotis & Christina Golna & Yannis Tountas & Olga Siskou & Daphne Kaitelidou & Lycourgos Liaropoulos, 2016. "Informal payments in the Greek health sector amid the financial crisis: old habits die last..," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 17(2), pages 159-170, March.
    19. Enkelejda Avdi, 2013. "Autonomy and Financial Sources, Key Factors in the Performance of Health Insurance Scheme: Case of Albania," Romanian Economic Journal, Department of International Business and Economics from the Academy of Economic Studies Bucharest, vol. 16(50), pages 133-156, December.
    20. Antonia Kountoura & Stavros Emmanouil & Efthymios Ziagkas, 2020. "Financial, Economic Crisis and Quality in Health Services Provision, New Challenges to Improve Quality Policy in the Healthcare System of Greece," Technium Social Sciences Journal, Technium Science, vol. 10(1), pages 267-273, August.
    21. Colin C. Williams & Abbi Kedir & Meryem Fethi & Sara Nadin, 2012. "Evaluating 'Varieties of Capitalism' by the Extent and Nature of the Informal Economy: The Case of South-Eastern Europe," South-Eastern Europe Journal of Economics, Association of Economic Universities of South and Eastern Europe and the Black Sea Region, vol. 10(2), pages 113-130.
    22. 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.
    23. Tim Ensor & Robin Thompson, 2012. "Unofficial Payments in Low- and Middle-income Countries," Chapters, in: Andrew M. Jones (ed.),The Elgar Companion to Health Economics, Second Edition, chapter 15, Edward Elgar Publishing.
    24. Karkanias, C. & Boemi, S.N. & Papadopoulos, A.M. & Tsoutsos, T.D. & Karagiannidis, A., 2010. "Energy efficiency in the Hellenic building sector: An assessment of the restrictions and perspectives of the market," Energy Policy, Elsevier, vol. 38(6), pages 2776-2784, June.

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