The link between past informal payments and willingness of the Hungarian population to pay formal fees for health care services: results from a contingent valuation study

Abstract

We examine the willingness of health care consumers to pay formal fees for health care use and how this willingness to pay is associated with past informal payments. We use data from a survey carried out in Hungary in 2010 among a representative sample of 1,037 respondents. The contingent valuation method is used to elicit the willingness to pay official charges for health care services covered by the social health insurance if certain quality attributes (regarding the health care facility, access to the services and health care personnel) are guaranteed. A bivariate probit model is applied to examine the relationship between willingness to pay and past informal payments. We find that 66% of the respondents are willing to pay formal fees for specialist examinations and 56% are willing to pay for planned hospitalizations if these services are provided with certain quality and access attributes. The act of making past informal payments for health care services is positively associated with the willingness to pay formal charges. The probability that a respondent is willing to pay official charges for health care services is 22% points higher for specialist examinations and 45% points higher for hospitalization if the respondent paid informally during the last 12 months. The introduction of formal fees should be accompanied by adequate service provision to assure acceptance of the fees. Furthermore, our results suggest that the problem of informal patient payments may remain even after the implementation of user fees.

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

“…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.…”

A systematic review of empirical studies on methodology and burden of informal patient payments in health systems

“…Among 38 reviewed studies,25 have assessed informal payment in 18 countries. It should be noted that some studies have evaluated prevalence only in the form of cash or gift.…”

Mit gondolnak a családorvos-rezidensek a hálapénzről?

“…Így összevetve jelen eredményeinkkel, elmondható, hogy a két évvel korábbi felméréshez képest nőtt a családorvos-rezidensek körében a hálapénzt elutasítók aránya (50% vs. 38,3%) [27]. Vizsgálati eredményeinket árnyalja, hogy a "hálapénz-problémában" nem a családorvoslás a leginkább érintett ágazat: mind a nemzetközi, mind pedig a hazai vizsgála-tok kimutatták, hogy a fekvőbeteg-ellátás a legjobban érintett terület [4,5,[28][29][30], így eredményeink nem ál-talánosíthatóak más szakmákra, szakterületekre. A Markusovszky-ösztöndíj megléte is finomíthatja eredménye-inket: ezen ösztönző minden bizonnyal enyhíti a fiatal orvosgeneráció financiális nehézségeit, és elviekben szigorú tiltás alá vonja a hálapénz elfogadásának gyakorlatát.…”