Informal payments for health care services – from gratitude to corruption

Open to the Public
Nador u. 11
Wednesday, February 12, 2014 - 5:00pm
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Wednesday, February 12, 2014 - 5:00pm to 7:00pm

The Public Health Research Group and the Center for Policy Studies

invite you to a presentation

Informal payments for health care services – from gratitude to corruption

Petra Baji, PhD

Corvinus University of Budapest, Maastricht University


Informal payments for health care services (defined as unofficial cash payments and gifts in kinds given to the health care personnel) present an important and challenging policy issue in most of the Central and Eastern European countries. These payments violate the transparency in the financing of the health care systems and jeopardize the accountability of the providers. They also lead to inefficient use of health care resources and inequalities in access to health care services.

Informal payments are seen as a rather complex phenomenon interrelated with different socio-cultural, legal-ethical and economic factors in a country. Various types of informal payments can be distinguished based on who initiates the payments (the patient or the provider), who receives the payment (medical staff, institution), who makes the payment (patient or relatives), what the nature of the payment is (cash or in-kind), when the payment is made (given ex-ante or ex-post), what the purpose/motivation of these payments is (patient's gratitude, tip or fee for service). Also the legal status of informal payments might differ across countries (whether it is explicitly forbidden by the law)[1].

The discussion is focused on the informal payments in Hungary and other Central and Eastern European countries, and covers the aspects of equity, social perception and public attitudes related to these payments based on the results of an international research project (ASSPRO CEE 2007) founded by the European Commission, and the recent report of ECORYS on Corruption in the Healthcare Sector[2].

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[1] Baji P, Pavlova M, Gulacsi L, Groot W. Exploring consumers' attitudes towards informal patient payments using the combined method of cluster and multinomial regression analysis--the case of Hungary. BMC Health Serv Res. 2013 Feb 15;13:62.

[2] Available at: