Health and Hospital Economics

This Chapter analyzes and highlights the most practised forms of corruption in public hospitals of Douala metropolis in Cameroon, namely corruption with theft and that without theft. The results of our analyzes show a predominance of the form without theft, this regardless of the hospital, and this allowed us to classify hospitals based on the dominant form. It appears that the General and Deido Hospitals are health facilities where corruption without theft is the least and the most practiced respectively, while the Cité des Palmiers and New Bell hospitals are those where corruption with theft is the least and the most practiced. An estimate through odds ratios revealed for instance that the odds would be about 5.46 times higher that the form without theft is not practiced at the General hospital compared to other hospitals, and about 11.11 times that it is practiced at Deido hospital compared to all hospitalsh.The problem that arises is how the State official in a monopoly situation maximizes the value of bribes collected, by selling public services to users? To answer this question, we show that the State agent in a monopoly situation can discriminate users according to their characteristics in order to collect more possible bribes. The Shleifer and Vishny’ simple monopoly model is therefore limited. The survey of patients of nine public hospitals in Douala revealed the existence of two forms of corruption at consultation: corruption without theft and corruption with theft. An evaluation of maximizing the earnings of medical doctors using odds ratios, showed that in the pursuit of these gains and whatever the form of corruption practiced, the State agent plays not only on amounts of bribes paid, but also on users’ characteristics. However, for amounts between 3,000 FCFA and 5,000 FCFA, our results revealed that the doctor will tend to practice the form of corruption without theft on men, the wealthiest, the learned and the old where he/she would draw the greatest possible gain.