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Financing health services in Poland: new evidence on private expenditures

Author

Listed:
  • Mukesh Chawla

    (Harvard School of Public Health, Boston, USA)

  • Peter Berman

    (Harvard School of Public Health, Boston, USA)

  • Dorota Kawiorska

    (Academy of Economics, Cracow, Poland)

Abstract

This paper estimates total expenditure on health care in Poland in 1994 and provides new evidence on high levels of private spending on health care. The analysis shows that health care expenditures in Poland are higher than has usually been maintained, and are comparable with the prevailing levels in many other European countries. Private expenditure on health is a significant proportion of total expenditure on health, and in particular on financing outpatient care. Available evidence indicates that informal payments made by patients to physicians contribute as much as double of the physician's salary, and thus form an important source of earnings for physicians. This situation of high private expenditures on health care and informal payments to physicians is likely to be true of other transitional economies of Central and Eastern Europe as well. One policy implication that emerges is these transitional economies face a big challenge in managing existing resources, as opposed to finding new resources, in the health sector more effectively to meet the health care needs of their population. The paper highlights the need for better understanding of the current availability and distribution of resources in the health sector and their directions of flow, in both public and private sectors, and suggests using tools such as National Health Accounts to track and monitor changes in the financing of the health care system. © 1998 John Wiley & Sons, Ltd.

Suggested Citation

  • 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.
  • Handle: RePEc:wly:hlthec:v:7:y:1998:i:4:p:337-346 DOI: 10.1002/(SICI)1099-1050(199806)7:4<337::AID-HEC340>3.0.CO;2-Z
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    References listed on IDEAS

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    Cited by:

    1. Robin Thompson & Ana Xavier, 2004. "Are Patients in the Transition World Paying Unofficially to Stay Longer in Hospital? Some Evidence from Kazakhstan," LICOS Discussion Papers 14004, LICOS - Centre for Institutions and Economic Performance, KU Leuven.
    2. 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.
    3. Patricia Willert, 2007. "Assessment of the pharmaceutical market in Poland after accession to the European Union," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 8(4), pages 347-357, December.
    4. Szilvia Altwicker-Hámori & János Köllő, 2013. "Hungary: Public sector labour market from crisis to crisis," Chapters,in: Public Sector Shock, chapter 8, pages 300-336 Edward Elgar Publishing.
    5. 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.
    6. Garcia-Prado, Ariadna, 2005. "Sweetening the carrot : motivating public physicians for better performance," Policy Research Working Paper Series 3772, The World Bank.
    7. Niccolò Persiani & Alberto Romolini & Claudia Galanti & Maria José Caldés Pinilla & Michele De Luca, 2014. "La riforma del sistema di finanziamento del Servizio Sanitario nazionale albanese," MECOSAN. Menagement e economia sanitaria, FrancoAngeli Editore, vol. 2014(89), pages 7-30.
    8. Mæstad, Ottar & Mwisongo, Aziza, 2011. "Informal payments and the quality of health care: Mechanisms revealed by Tanzanian health workers," Health Policy, Elsevier, vol. 99(2), pages 107-115, February.
    9. 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.
    10. Kornai, János & McHale, John, 2001. "Eltérnek-e a nemzetközileg szokásostól a posztszocialista országok egészségügyi kiadásai?
      [Is the health spending of post-communist countries internationally unusual?]
      ," Közgazdasági Szemle (Economic Review - monthly of the Hungarian Academy of Sciences), Közgazdasági Szemle Alapítvány (Economic Review Foundation), vol. 0(7), pages 555-580.
    11. 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.
    12. 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.
    13. Gaal, Peter & Evetovits, Tamas & McKee, Martin, 2006. "Informal payment for health care: Evidence from Hungary," Health Policy, Elsevier, vol. 77(1), pages 86-102, June.
    14. Chiu, Yu-Chan & Smith, Katherine Clegg & Morlock, Laura & Wissow, Lawrence, 2007. "Gifts, bribes and solicitions: Print media and the social construction of informal payments to doctors in Taiwan," Social Science & Medicine, Elsevier, vol. 64(3), pages 521-530, February.
    15. Tomini, Sonila & Groot, Wim, 2012. "Paying informally for public health care in Albania: scarce resources or governance failure?," MERIT Working Papers 070, United Nations University - Maastricht Economic and Social Research Institute on Innovation and Technology (MERIT).
    16. 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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