Informal Patient Payments and Bought and Brought Goods in the Western Balkans – A Scoping Review

Mejsner, Sofie Buch; Karlsson, Leena Eklund

doi:10.15171/ijhpm.2017.73

Cited by 12 publications

(12 citation statements)

References 29 publications

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“…It has been stated that informal patient payment is an apparent sociocultural phenomenon that develops by passing the time [72,73]. Lost trust, corruption, and value culture, public/ patient awareness and community participation were the common aspects of this complicate social phenomenon, which was proved in national and international studies [17,18,34,37,41] .…”

Section: Discussionmentioning

confidence: 99%

New insight into the informal patients’ payments on the evidence of literature: a systematic review study

Pourtaleb

Jafari

Seyedin

et al. 2020

BMC Health Serv Res

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Background: Nowadays, a growing literature reveals how patients use informal payments to seek either better treatment or additional services, but little systematic review has been accomplished for synthesizing the main factors. The purpose of this study was to analyze the content of literatures to demonstrate the factors for informal patient payments. Methods: In this systematic review study, PubMed, Web of Science, Wiley Online Library, Science Direct, Ovid, Scopus, and Iranian databases were investigated without time limitation for eligible English and Persian studies. Achieved data were analyzed using content analysis approach and MAXQDA 10 software. Results: Themes related to informal payments in external context of health system were demographic features of health service consumers, patient's personality features and social & cultural backgrounds of the community. Health system challenges' themes were about stewardship weakness, and sustainable financing and social protection weakness. These were followed by human resources' organizational behavior challenges, drugs, medical products, and services delivery provision process challenges and finally change management weakness for reducing and dealing with IPs. Conclusion: It appears that improving the quality of health care services and accurate monitoring of delivery processes, along with performing some strategies for regulating payroll and medical tariffs, strict rules and regulations and improving health staff motivation, would be effective ways against informal payments. Improving the health insurance contribution, promoting transparency & accountability in health system especially in financing, identify precise control mechanism, using empower patient/public related approach, modifying community perception, reinforcing social resistance to unofficial payments and rebuilt lost social capital in health care are some of the other recommendations in this field. To practice these strategies, a comprehensive and systemic vision and approach is needed, however, the key point is that before applying any strategy the impact of this strategy on access, efficiency, equity, and other health systems' goals and policies should be investigated due to the consideration.

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Section: Discussionmentioning

confidence: 99%

New insight into the informal patients’ payments on the evidence of literature: a systematic review study

Pourtaleb

Jafari

Seyedin

et al. 2020

BMC Health Serv Res

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“…It posits that users' primary motivation for making IP is the prospect that they will receive a quicker and a higher quality of care that is more personalized and convenient and has shorter wait times and that they will have access to more advanced or specialized care and services [2,[45][46][47]. As an illustration, Riewpaiboon and colleagues detailed how a Thai woman made informal payments to an obstetrician to get better services during her pregnancy [48], while several other studies confirmed that IP resulted in a better relationship between users and healthcare personnel and consequently in higher levels of satisfaction for users [4,5,49,50]. On the other hand, IP eases the inefficiencies of administering public healthcare in a situation where healthcare workers believe that they are not being paid adequately and so have the expectation of IP, while concurrently, users expect to pay out-of-pocket to underpaid professionals for more or better-quality service [15,41,51,52].…”

Section: Methodsmentioning

confidence: 99%

“…In other words, they may feel dissatisfaction that they have to make IP to receive higher quality and faster services since they believe that such quality and speed should be available without additional "grease the wheels" IP. Second, users could make "grease the wheels" IP to get better and faster services, but after receiving services, they may be unsatisfied with the quality and speed of services which they received [5]. Hence, they may question whether such quality and speed justify making "grease the wheels" payments.…”

Section: Satisfaction With Healthcarementioning

confidence: 99%

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How Different Motivations for Making Informal Out-Of-Pocket Payments Vary in Their Influence on Users’ Satisfaction with Healthcare, Local and National Government, and Satisfaction with Life?

Habibov

Auchynnikava

Fan

et al. 2021

BioMed Research International

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Background. The dominant view in the literature is that informal payments in healthcare universally are a negative phenomenon. By contrast, we theorize that the motivation healthcare users for making informal payments (IP) can be classified into three categories: (1) a cultural norm, (2) “grease the wheels” payments if users offered to pay to get better services, and (3) “sand the wheels” payments if users were asked to pay by healthcare personnel or felt that payments were expected. We further hypothesize that these three categories of payments are differently associated with a user’s outcomes, namely, satisfaction with healthcare, local and national government, satisfaction with life, and satisfaction with life of children in the future. Methods. We used microdata from the 2016 Life-in-Transition survey. Multivariate regression analysis is used to quantify relationships between these categories of payments and users’ outcomes. Results. Payments that are the result of cultural norms are associated with better outcomes. On the contrary, “sand the wheel” payments are associated with worse outcomes. We find no association between making “grease the wheels” payments and outcomes. Conclusions. This is the first paper which evaluates association between three different categories of informal payments with a wide range of users’ outcomes on a diverse sample of countries. Focusing on informal payments in general, rather than explicitly examining specific motivations, obscures the true outcomes of making IP. It is important to distinguish between three different motivations for informal payment, namely, cultural norms, “grease the wheels,” and “sand the wheels” since they have varying associations with user outcomes. From a policy making standpoint, variation in the links between different motivations for making IP and measures of satisfaction suggest that decision-makers should put their primary focus on situations where IP are explicitly asked for or are implied by the situation and that they should differentiate this from cases of gratitude payments. If such measures are not implemented, then policy makers may unintentionally ban the behaviour that is linked with increased satisfaction with healthcare, government, and life (i.e., paying gratitude).

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“…More than 50% of the sample had a negative attitude towards informal payments but about 27% of respondents had a positive attitude towards the practice. It also reported that Albania, one of the poorest countries in Europe, provides most health care services free of charge, but still more informal payments to medical personnel are common [15]. Its studies suggested that 60-70% of Albanian citizens made informal payments to hospital doctors in order to receive services.…”

Section: Introductionmentioning

confidence: 99%

Informal Payments in Public Hospitals of Malawi - A Case of Kamuzu Central Hospital

Namangale

Chiumia

2021

Preprint

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Background: Informal payments in public health facilities act as a barrier to accessing quality healthcare services especially for the poor people. There is growing evidence that in most low-income countries, most poor people are unable to access quality health care services due to demands for payments for services that should be accessed for free. This research was aimed at investigating informal payments for health care services at Kamuzu Central Hospital, one of the referral public hospitals in Malawi. Results of this study provide evidence on the magnitude and factors influencing informal payments in Malawi so that relevant policies and strategies may be made to address this problem. Methods: The study employed a mixed methods research design. The quantitative study component had a sample size of 295 patients and guardians at Kamuzu Central Hospital (KCH). The qualitative study included 7 in-depth interviews with key informants (health workers) and 3 focus group discussions with guardians. Each FGD had 10 people. Thus, in total the whole qualitative sample constituted 52 participants. Quantitative data was analyzed using Excel and STATA. Qualitative data was analyzed using thematic content analysis approach. Results: 80% of patients and guardians at KCH had knowledge of informal payments. About 47% of the respondents admitted paying informally to access health care services at KCH and 87% of the informal payments were made at the request of a health worker. The study identifies lack of knowledge, fear and desperation by patients and guardians, low salary for health workers and lack of effective disciplinary measures as some of the key factors influencing informal payments in the public health sector in Malawi. Conclusion: Informal payments exacerbate inequality in the access of health care services that should be provided for free. Specifically, poor people have limited access to quality health care services when informal payments are demanded. This practice is unethical and it infringes on people’s rights to universal access to health care. There is need to strengthen the public health care system in Malawi by formulating deliberate policies that will deter informal payments.

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Informal Patient Payments and Bought and Brought Goods in the Western Balkans – A Scoping Review

Cited by 12 publications

References 29 publications

New insight into the informal patients’ payments on the evidence of literature: a systematic review study

New insight into the informal patients’ payments on the evidence of literature: a systematic review study

How Different Motivations for Making Informal Out-Of-Pocket Payments Vary in Their Influence on Users’ Satisfaction with Healthcare, Local and National Government, and Satisfaction with Life?

Informal Payments in Public Hospitals of Malawi - A Case of Kamuzu Central Hospital

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