Informal payments for healthcare services and short‐term effects of the introduction of visit fee on these payments in Hungary

Abstract

The objective of this paper is to study the short-term effects of the introduction of the visit fee in Hungary in 2007 on informal patient payments. We present the pattern of informal payments in primary, out-patient specialist and in in-patient care in the period before and shortly after the visit fee was introduced. We also analyse whether in the short run, the introduction of visit fee decreased the probability of paying informally. For the analysis, we use a dataset for a representative sample of 2500 respondents collected in 2007 shortly after the introduction of the visit fee, which contains data on informal payments for healthcare services. According to our results, 9% of the patients paid informally during their last visit to GP (2 Euros on average), 14% paid informally for specialist care (35 Euros on average) and 50% paid informally for hospitalisation (58 Euros on average). We find a significant reduction in the probability of paying informally only for elderly patients in case of in-patient care. Our results suggest that informal payments are widely spread in Hungary, especially in in-patient care. The short run potential of the introduction of the visit fee to reduce informal payments seems to be minor.

Rethinking informal payments by patients in Europe: An institutional approach

“…This has been identified in studies conducted in large geographical areas, such as in 35 European countries [26], Central Asia [30] as well as in 33 African countries [31], or in smaller studies comprising only one nation as, for example, Bulgaria [1,6,13,32,33], Poland [34,35], Hungary [2,[36][37][38][39][40], Greece [4,41], Lithuania [34,42], Russia [43,44]; Ukraine [34,45], Moldova [46], Serbia [47], Kazakhstan [48], Albania [5,49,50], Kosovo [8], Tajikistan [51,52], Kyrgyzstan [53], Taiwan [54], Cameroon [55], Tanzania [3,56] and Turkey [57]. Nevertheless, informal patient payments phenomenon is poorly examined at a cross-country level.…”

“…Indeed, most previous studies reveal that women are more likely to make informal payments for health care services [6,40,42,46,59], as do younger persons [6,45,47,49,60], better educated persons [6,[40][41][42]47,49], those having a job [41], those married [49], those living in a smaller household [40,49,50], those living in rural areas [45,60,61], and those with lower income [31,37,57,61]. By testing this hypothesis, whether these populations also have a higher institutional asymmetry can be evaluated.…”

Barriers to accessing adequate maternal care in Central and Eastern European countries: A systematic literature review

“…In Ukraine, the amount of informal payment is agreed through bargaining before birth to avoid inconveniences and is mostly paid to the obstetrician who later divides the payment among the hospital team present during the birth (Stepurko et al, 2013). In Hungary, the amount of informal payment is based on income and education; therefore, people with higher status appear to pay higher 'prices' (Baji et al, 2012).…”

Preferences of Hungarian consumers for quality, access and price attributes of health care services — result of a discrete choice experiment

“…This finding indicates that priority should be given to investments in human resources. However, policies should consider that at the moment, health care consumers already express their willingness to pay and compensate health care personnel (mainly physicians) directly, by paying via informal channels (Baji et al 2011a) These payments are widespread in the country, around 14% of the patients pay informally for specialist visits on average 35 Euros, and half of the patients pay informally in hospital care on average 58 Euros (Baji et al 2011b). These informal payments constitute the major share of physicians' income although they are rather unequally distributed between health care…”