Informal Patient Payments in Central and Eastern European Countries: [dissertation abstract]
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Date
2013-09-20T06:53:26Z
Authors
Stepurko, Tetiana
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Abstract
Description
Out-of-pocket patient payments are a major source of health care funding in Central and
Eastern European (CEE) countries. They take different forms, e.g. formal co-payments, quasiformal
charges and informal patient payments. Formal co-payments are regulated by national
legislation and quasi-formal charges are set by the health care provider in the absence of clear
government regulations. Informal payments (also known as “under-the-table” or “envelope”
payments) comprise all unregistered patient payments for publicly-funded health care
services. Informal patient payments claim more attention as ignoring these payments causes
underestimation of total health expenditure and their hidden nature imposes a great challenge
to health care provision in terms of accessibility as well as accountability and transparency.
Overall, a huge variety in the nature and patterns of informal patient payments is reported
across countries. Studies provide evidence on the variation in informal payment type (cash or
in-kind gifts given by patients or their families), timing (before, after or during service
provision), subject (out- or in-patient service), purpose (obtaining better quality or access),
and motivation (physician’s request or patient’s initiative). As recent cross-country studies on
informal patient payments are lacking, this dissertation enhances our understanding of
informal patient payments by comparing their scale and pattern across CEE.