Informal Patient Payments in Central and Eastern European Countries

Abstract

Informal payments for health care services are a well-known phenomenon in many health care systems around the world. Deeply ingrained informal practices accepted by both providers and consumers, and neglected by the government, seem to be a major impediment to ongoing health care reforms. The examination of level, scope and consumer’s perceptions of informal patient payments in Central and Eastern European (CEE) countries is the aim of the thesis. Based on national representative samples, the most empirical data are collected in 2010 in six CEE countries and in 2011 in three CEE countries. The results of the cross-country comparison suggest a relatively higher prevalence of informal patient payments in Romania and Ukraine, then in Hungary and Lithuania and much lower than in Poland and in Bulgaria. In the latter one, patients also meet formal service charges in the public sector. The patterns of informal patient payment confirm more incidents and higher expenditures for hospitalizations than for ambulatory care. Although users resort to informal patient pursuing better quality, quicker access and better attention, public opinions towards informal patient are quire negative and associated with corruption suggesting users’ willingness to elimination of this practice. Hereby, governments should meet public expectations and implement a strategy for dealing with informal patient payments.