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Unofficial payments for acute state hospital care in Kazakhstan. A model of physician behaviour with price discrimination and vertical service differentiation

Author

Listed:
  • Xavier, Ana

    (Catholic University of Leuven, Belgium)

  • Robin Thompson

Abstract

We consider a discriminatory pricing and service differentiation model where: a)state physicians exploit their monopoly position and adjust quality to the unofficial payment made, and b)patients, perceiving state provision as poor, pay unofficially to improve it. Applying OLS and probit analysis to survey data on patients discharged from Almaty City hospitals, and using admission wait, length of stay (LOS) and a subjective categorical variable as quality measures. Unofficial payments are positively associated with surgical admission wait and the subjective quality of care while negatively associated with hospital LOS. Evidence suggests that price discrimination and service differentiation takes place in Kazakhstan.

Suggested Citation

  • 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 224, Royal Economic Society.
    • Handle: RePEc:ecj:ac2003:224
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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. Hunt, Jennifer, 2007. "How corruption hits people when they are down," Journal of Development Economics, Elsevier, vol. 84(2), pages 574-589, November.
    3. Quoc-Anh Do & Trang Van Nguyen & Anh Tran, 2013. "Do People Pay Higher Bribes for Urgent Services ?," Working Papers hal-03460769, HAL.
    4. Quoc-Anh Do & Trang Van Nguyen & Anh Tran, 2013. "Do People Pay Higher Bribes for Urgent Services ?," Working Papers hal-03460769, HAL.
    5. Jennifer Hunt, 2007. "Bribery In Health Care In Peru And Uganda," Departmental Working Papers 2007-02, McGill University, Department of Economics.
    6. repec:hal:spmain:info:hdl:2441/3tk4fhvbi18ndq2n4gs2e9pp6j is not listed on IDEAS
    7. Elisabetta Reginato & Isabella Fadda & Paola Paglietti & Aldo Pavan, 2021. "Informal Payments and Performance in the Health Care Sector: Possible Relationships in a Sub-National Perspective," International Journal of Business and Management, Canadian Center of Science and Education, vol. 15(3), pages 126-126, July.
    8. World Bank, 2011. "Albania - Out-of-Pocket Payments in Albania’s Health System : Trends in Household Perceptions and Experiences 2002-2008," World Bank Publications - Reports 2784, The World Bank Group.
    9. Hunt, Jennifer, 2007. "How corruption hits people when they are down," Journal of Development Economics, Elsevier, vol. 84(2), pages 574-589, November.
    10. 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.
    11. Hunt, Jennifer & Laszlo, Sonia, 2012. "Is Bribery Really Regressive? Bribery’s Costs, Benefits, and Mechanisms," World Development, Elsevier, vol. 40(2), pages 355-372.
    12. Hunt, Jennifer, 2010. "Bribery in health care in Uganda," Journal of Health Economics, Elsevier, vol. 29(5), pages 699-707, September.
    13. Quoc-Anh Do & Trang Van Nguyen & Anh Tran, 2013. "Do People Pay Higher Bribes for Urgent Services ?: Evidence from Informal Payements to Doctors in Vietnam," Sciences Po publications info:hdl:2441/3tk4fhvbi18, Sciences Po.

    More about this item

    Keywords

    transition economies; unofficial or informal payments for health care; length of stay; ordered probit and marginal effects;
    All these keywords.

    JEL classification:

    • I1 - Health, Education, and Welfare - - Health
    • P3 - Political Economy and Comparative Economic Systems - - Socialist Institutions and Their Transitions

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