How do patient characteristics influence informal payments for inpatient and outpatient health care in Albania: Results of logit and OLS models using Albanian LSMS 2005

Tomini, Sonila; Maarse, Hans

doi:10.1186/1471-2458-11-375

Cited by 37 publications

(55 citation statements)

References 17 publications

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“…We have explored the phenomenon in the context of Iran's health system by involving three main stakeholders. Previous studies have reported that people make informal payments to express gratitude (3,24,25), to get additional or better services (3,26), or because of cultural norms ingrained in their tradition, and weak laws (25). This study indicates that all of the above mentioned factors affect patients' decisions to make such payments, although some of them seem to play a more important role.…”

Section: Discussionmentioning

confidence: 61%

Informal Payments in Healthcare: A Case Study of Kerman Province in Iran

Nekoei‐Moghadam

Esfandiari

Ramezani

et al. 2013

Int J Health Policy Manag

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Background: Informal payments for health care, which are common in many countries, can have negative effects on health care access, equity and health status as they lead people to forgo or delay seeking care, or to sell assets to pay for care. Many countries are putting reforms in place with the aim of reducing informal payments. In order to be successful, such policies should be informed by the underlying causes of such payments. This study attempts to explore why, how, and in what ways informal payments occur. Methods: We conducted face-to-face interviews with a purposeful sample of 45 participants, including patients, healthcare providers and officials, in Kerman province in Iran, in 2010. The research participants were asked about the nature of informal payments, the reasons behind both asking and making those payments. We analysed the data using content analysis. Results: We found that people make informal payments for several reasons, namely cultural, qualityrelated and legal. Providers ask for informal payments because of tariffs, structural and moral reasons, and to demonstrate their competence. Informal payments were found to be more prevalent for complex procedures and are usually asked for directly. Conclusion:Informal payments are present in Iran's health system as in other countries. What makes Iran's condition slightly different from other countries is the peculiarity of reasons behind asking informal payments and the disadvantages associated with these kinds of payments. Iran could overcome this dilemma by precise investigation of the reasons to inform appropriate policy formulation. Some policies such as raising salaries, justifying the tariffs and cost-sharing, defining a benefits package of services, and improving accountability and transparency in the health system could be taken by the government to alleviate the problem.

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Section: Discussionmentioning

confidence: 61%

Informal Payments in Healthcare: A Case Study of Kerman Province in Iran

Nekoei‐Moghadam

Esfandiari

Ramezani

et al. 2013

Int J Health Policy Manag

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“…Some studies have reported a meaningful relationship between informal payment behavior with gender, age, educational level, place of residence, health insurance coverage and household economic status (6,13,22,(38)(39)(40)(41)(42). This discrepancy in the results can be attributed to the study setting (hospi- tal or household), the type of surveyed patients, country of study, and the data analysis methods.…”

Section: Discussionmentioning

confidence: 99%

Informal Payments for Inpatient Services and Related Factors: A Cross-Sectional Study in Tehran, Iran

et al. 2018

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Background: Informal payments, as one of the components of out-of-pocket (OOP) payments, are often a form of corruption and outside the official bill. The purpose of the present study was to investigate the frequency of informal payments for inpatient services and its related factors in Tehran, Iran. Methods: In this cross-sectional study, the samples included 450 patients who were admitted to hospital's clinics affiliated to Shahid Beheshti University of Medical Sciences in Tehran, to receive follow-up and post-surgical care. After obtaining patient consent, data were collected via a 28-item questionnaire included two parts of patient's demographic characteristics and informal payments experience that it's validity and reliability were confirmed. Data were analyzed using descriptive statistics and regression analyses in SPSS 16 software. Results: The findings showed 21.1% of the patients had informal payments, paid voluntarily, mostly in cash, for service's staff, in public hospitals, after discharge and, due to the employees' proper behavior and attention. The average informal payments per patient were 5,304,630 IRR (175.4 USD). There was no significant relationship between the informal payment behavior and the patient demographics characteristics (P > 0.05). Conclusions: Despite the efforts made in the HTP to eliminate informal payments in inpatient services, the goal has not been fully realized. A part of the payments was paid at the provider's request and before the patient's admission that these compulsory informal payments are illegal and unethical and therefore, must be controlled and eradicated. Policymakers can take steps to reduce informal payments by improving the healthcare quality, supervision, setting salary and benefits, enforcing laws, and increasing staff incentives.

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“…The existence and magnitude of such informal payments is often attributed to a mix of causal factors (Gaal and McKee, 2005;Tomini and Maarse, 2011). Often the phenomenon is linked to the legacies of 'Semashko' systems formerly implemented in post-communist CEE and FSU countries (MCKee 1991).…”

Section: Introductionmentioning

confidence: 99%

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

Tomini¹,

Groot²

2013

Applied Economics

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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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How do patient characteristics influence informal payments for inpatient and outpatient health care in Albania: Results of logit and OLS models using Albanian LSMS 2005

Cited by 37 publications

References 17 publications

Informal Payments in Healthcare: A Case Study of Kerman Province in Iran

Informal Payments in Healthcare: A Case Study of Kerman Province in Iran

Informal Payments for Inpatient Services and Related Factors: A Cross-Sectional Study in Tehran, Iran

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

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