Skip to main content

Exploring the Practice of Making Informal Payments in the Health Sector: Some Lessons from Greece

  • Chapter
  • First Online:

Part of the book series: International Political Economy Series ((IPES))

Abstract

This chapter explores the prevalence of informal payments in public healthcare services in Greece. To evaluate the relationship between extra payments or valuable gifts (apart from official fees) and the level of acceptability of corruption, as well as the socio-spatial variations in the tendency to offer informal payments, data from a 2013 Eurobarometer survey is reported. Using logistic regression analysis, the finding is that patients with a high acceptability of corruption, those considering corruption as a very widespread phenomenon and those located in rural areas are more likely to offer, apart from official fees, extra payments or valuable gifts for healthcare services. The chapter concludes by discussing the health policy implications.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  • Aarva, P., Ilchenko, I., Gorobets, P., & Rogacheva, A. (2009). Formal and informal payments in health care facilities in two Russian cities, Tyumen and Lipetsk.Health Policy and Planing, 24, 395–405.

    Article  Google Scholar 

  • Atanasova, E., Pavlova, M., Moutafova, E., Rechel, B., & Groot, W. (2012). Out-of-pocket payments for health care services in Bulgaria: Financial burden and barrier to access.European Journal of Public Health, 23(6), 916–922.

    Article  Google Scholar 

  • Atanasova, E., Pavlova, M., Moutafova, E., Rechel, B., & Groot, W. (2013). Informal payments for health services: The experience of Bulgaria after 10 years of formal co-payments.European Journal of Public Health, 24(5), 733–739.

    Article  Google Scholar 

  • Belli, P. (2002).Formal and informal household spending on health: A multicountry study in Central and Eastern Europe. Boston, MA, Harvard School of Public Health International Health Systems Group, Central and Eastern European Health Network. Available from:https://www.hsph.harvard.edu/ihsg/publications/pdf/lac/MerckReportFINAL.pdf.

  • Burak, L., & Vian, T. (2007). Examining and predicting under-the-table payments for health care in Albania: An application of the theory of planned behavior.Journal of Applied Social Psychology, 37(5), 1060–1076.

    Article  Google Scholar 

  • Cohen, N. (2012). Informal payments for health care – the phenomenon and its context.Health Economics, Policy and Law, 7, 285–308.

    Article  Google Scholar 

  • Ensor, T. (2004). Informal payments for health care in transition economies.Social Science and Medicine, 58, 237–246.

    Article  Google Scholar 

  • European Commission. (2013).Study on Corruption in the Healthcare Sector. Luxembourg: Publications Office of the European Union.

    Google Scholar 

  • European Commission. (2014).Eurobarometer 79.1 (2013). TNS Opinion, Brussels [producer]. GESIS Data Archive, Cologne. ZA5687 Data file Version 1.0.0, DOI:10.4232/1.11855.

    Google Scholar 

  • Fotaki, M. (2009). Informal payments: A side effect of transition or a mechanism for sustaining the illusion of ‘free’ health care? The experience of four regions in the Russian Federation.Journal of Social Policy, 38(4), 649–670.

    Article  Google Scholar 

  • Gaal, P., & McKee, P. (2004). Informal payment for health care and the theory of ‘INXIT.The International Journal of Health Planning and Management, 19, 163–178.

    Article  Google Scholar 

  • Gaal, P., & McKee, M. (2005). Fee-for-service or donation? Hungarian perspectives on informal payment for health care.Social Science and Medicine, 60, 1445–1457.

    Article  Google Scholar 

  • Gaal, P., Belli, P., McKee, M., & Szocska, M. (2006a). Informal payments for health care: Definitions, distinctions and dilemmas.Journal of Health Politics, Policy and Law, 31, 251–293.

    Article  Google Scholar 

  • Gaal, P., Evetovits, T., & McKee, M. (2006b). Informal payment for health care: Evidence from Hungary.Health Policy, 77, 86–102.

    Article  Google Scholar 

  • Gordeev, V. G., Pavlova, M., & Groot, W. (2014). Informal payments for health care services in Russia: Old issue in new realities.Health Economics, Policy and Law, 9(1), 25–48.

    Article  Google Scholar 

  • Gray-Molina, G., de Rada, E.P., & Yañez, E. (1999).Transparency and accountability in Bolivia: Does voice matter? Working paper #R-381. Inter-American Development Bank. Available from:http://www.iadb.org/res/publications/pubfiles/pubr-381.pdf.

  • Kaitedlidou, D. C., Tsirona, C. C., Galanis, P. A., Siskou, O., Mladovsky, P., Kouli, E. G., et al. (2013). Informal payments for maternity health services in public hospitals in Greece.Health Policy, 109(1), 23–40.

    Article  Google Scholar 

  • Lewis, M. (2000).Who is paying for health care in Eastern Europe and Central Asia? Washington D.C.: World Bank, Europe and Central Asia Region.

    Google Scholar 

  • Liaropoulos, L., Siskou, O., Kaitelidou, D., Theodorou, M., & Katostaras, T. (2008). Informal payments in public hospitals in Greece.Health Policy, 87, 72–81.

    Article  Google Scholar 

  • Manea, T. (2015). Medical bribery and the ethics of trust: The Romanian case.Journal of Medicine and Philosophy, 40, 26–43.

    Article  Google Scholar 

  • McMenamin, I., & Timonen, V. (2002). Poland’s health reform: Politics, markets and informal payments.Journal of Social Policy, 31(1), 103–118.

    Article  Google Scholar 

  • Mokhtari, M., & Ashtari, M. (2012). Reducing informal payments in the health care system: Evidence from a large patient satisfaction survey.Journal of Asian Economics, 23, 189–200.

    Article  Google Scholar 

  • Polese, A. (2014). Informal payments in Ukrainian hospitals: On the boundary between informal payments, gifts, and bribes.Anthropological Forum: A Journal of Social Anthropology and Comparative Sociology, 24(4), 381–395.

    Article  Google Scholar 

  • Shahriari, H., Belli, P., & Lewis, M. (2001).Institutional issues in informal health payments in Poland. Available from:https://openknowledge.worldbank.org/handle/10986/13679.

  • Souliotis, K., Golna, C., Tountas, Y., Siskou, O., Kaitelidou, D., & Liaropoulos, L. (2016). Informal payments in the Greek health sector amid the financial crisis: Old habits die last….European Journal of Health Economics, 17(2), 159–170.

    Article  Google Scholar 

  • Stan, S. (2012). Neither commodities nor gifts: Post-socialist informal exchanges in the Romanian healthcare system.Journal of the Royal Anthropological Institute, 18(1), 65–82.

    Article  Google Scholar 

  • Stepurko, T., Pavlova, M., Gryga, I., & Groot, W. (2013). Informal payments for health care services – Corruption or gratitude? A study on public attitudes, perceptions and opinions in six Central and Eastern European countries.Communist and Post-Communist Studies, 46(4), 419–431.

    Article  Google Scholar 

  • Stepurko, T., Pavlova, M., Gryga, Y., Murauskiene, L., & Groot, W. (2015). Informal payments for health care services: The case of Lithuania, Poland and Ukraine.Journal of Eurasian Studies, 6(1), 46–58.

    Article  Google Scholar 

  • Szende, A., & Culyer, A. J. (2006). The inequity of informal payments for health care: The case of Hungary.Health Policy, 75(3), 262–271.

    Article  Google Scholar 

  • Williams, C. C. (2014).Confronting the shadow economy: Evaluating tax compliance and behaviour policies. Cheltenham: Edward Elgar.

    Google Scholar 

  • Williams, C. C. (2016). Tackling enterprise in the informal economy: An introductory overview.International Journal of Entrepreneurship and Small Business, 28(2/3), 139–153.

    Article  Google Scholar 

  • Williams, C. C., & Franic, J. (2016). Beyond a deterrence approach towards the undeclared economy: Some lessons from Bulgaria.Journal of Balkan and Near Eastern Studies, 18(1), 90–106.

    Article  Google Scholar 

  • Williams, C. C., & Horodnic, I. A. (2015a). Tackling the informal economy in South East Europe: An institutional approach.Journal of South East European and Black Sea Studies, 15(4), 519–539.

    Article  Google Scholar 

  • Williams, C. C., & Horodnic, I. A. (2015b). Explaining and tackling the shadow economy in Estonia, Latvia and Lithuania: A tax morale approach.Journal of Baltic Economics, 15(2), 81–98.

    Article  Google Scholar 

  • Williams, C. C., & Horodnic, I. A. (2015c). Explaining and tackling envelope wages in the Baltic Sea region.Baltic Journal of Management, 10(3), 295–312.

    Article  Google Scholar 

  • Williams, C. C., & Onoshchenko, O. (2015). An evaluation of the persistence of blat in post-Soviet societies: A case Study of Ukraine’s health services sector.Studies of Transition States and Societies, 7(2), 46–63.

    Google Scholar 

  • Williams, C. C., Horodnic, I. A., & Burkinshaw, L. (2016). Evaluating competing public policy approaches towards the informal economy: Some lessons from the United Kingdom. International Journal of Public Sector Management, 29(4), 365–380.

    Article  Google Scholar 

  • World Bank. (2001). Diagnostic surveys of corruption in Romania. World Bank. Available from: http://www1.worldbank.org/publicsector/anticorrupt/romenglish.pdf.

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Adrian V. Horodnic .

Editor information

Editors and Affiliations

Appendix

Appendix

Table 4 Variables used in analysis

Rights and permissions

Reprints and permissions

Copyright information

© 2017 The Author(s)

About this chapter

Cite this chapter

Horodnic, A.V., Williams, C.C., Polese, A., Zait, A., Oprea, L. (2017). Exploring the Practice of Making Informal Payments in the Health Sector: Some Lessons from Greece. In: Polese, A., Williams, C., Horodnic, I., Bejakovic, P. (eds) The Informal Economy in Global Perspective. International Political Economy Series. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-319-40931-3_9

Download citation

Publish with us

Policies and ethics