Institutional Issues in Informal Health Payments in Poland : Report on the Qualitative Part of the Study
A growing pattern within the ECA (East Europe and Central Asia) region is informal payments to doctors, hospital administrators, nurses and others connected with health service delivery. These payments have implications for governance of health sys...
| Main Authors: | , , |
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| Format: | Working Paper |
| Language: | English en_US |
| Published: |
World Bank, Washington, DC
2013
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| Subjects: | |
| Online Access: | http://documents.worldbank.org/curated/en/2001/02/3927907/institutional-issues-informal-health-payments-poland-report-qualitative-part-study http://hdl.handle.net/10986/13679 |
| Summary: | A growing pattern within the ECA (East
Europe and Central Asia) region is informal payments to
doctors, hospital administrators, nurses and others
connected with health service delivery. These payments have
implications for governance of health systems and for equity
and access, as well as for incentives for both health
providers and managers. According to the research findings,
informal payments are widespread in the Polish health
sector. They include both cash and in-kind contributions.
The study reinforces the existing anecdotal evidence as well
as evidence from studies in other countries of the ECA
Region and shows that the phenomenon has, if anything,
become more widespread over the last few years. Informal
payments are both paid voluntarily and coerced by providers
in one way or another. As this paper shows, the main reasons
for paying for medical services are to ensure quality care,
to buy future care, and to jump queues. Providers are also
paid to show gratitude and appreciation. In addition, users
contribute in-kind for ancillary services. For instance,
they bring their own sheets, food, or even medicines to the
hospital because the hospital is not providing them.
Building on the existing literature, this research is aimed
at: (1) identifying the nature, extent, and economic
dynamics (mechanisms of collection and revenue distribution
among different actors) of informal payments; (2)
understanding the leading causes of informal payments; (3)
identifying the consequences of informal payments on
accessibility and quality of care, and (4) articulating
policy options to reduce the size and negative impact of
such payments. |
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