Making Patients Pay: Informal Patient Payments in Central and Eastern European Countries.

Tetiana Stepurko,Wim Groot,Irena Gryga,Milena Pavlova

doi:10.3389/fpubh.2015.00192

Tetiana Stepurko, Wim Groot + Show 2 more

Open Access

https://doi.org/10.3389/fpubh.2015.00192

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Abstract

Informal patient payments are a key characteristic of nearly all Central and Eastern European health care systems (1–3). Apart from formal patient payments, which are regulated by national legislation (4) and quasi-formal charges, which are set by the health care provider in the absence of clear government regulations (5–7), there are also informal payments (also known as “under-the-table” or “envelope” payments), which comprise the unregistered patient payments for publicly funded health care services (7–9). In addition to this, there are also quasi-informal payments for goods that should be provided free of charge to the patient by the health care establishment but that patients are asked to purchase outside and bring for the treatment. Indeed, out-of-pocket patient payments are a major source of health care funding in Central and Eastern European countries (10).

Highlights

Informal patient payments are a key characteristic of most Central and Eastern European health care systems [1,2,3]
Apart from formal patient payments, which are regulated by national legislation [4] and quasi-formal charges, which are set by the health care provider in the absence of clear government regulations [5,6,7], there are informal payments, which comprise the unregistered patient payments for publicly funded health care services [7,8,9]
Studies provide evidence on the variation in the type of informal payments, timing, subject, purpose, and motivation [1, 3, 8]

Summary

Introduction

Informal patient payments are a key characteristic of most Central and Eastern European health care systems [1,2,3]. Out-of-pocket patient payments are a major source of health care funding in Central and Eastern European countries [10]. Studies provide evidence on the variation in the type of informal payments (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) [1, 3, 8].

Results

Conclusion