Trends in Informal Payments by Patients in Europe: A Public Health Policy Approach

Background: A new institutional approach toward informal payments in healthcare views informal payments as arising when there is a misalignment between values/norms (informal institutions) and the formal rules (formal institutions) of patients. However, less knowledge is available on the effectivene...

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Autor principal:	Adrian V. Horodnic
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	informal payments by patients institutional misalignment institutional theory norms values social norms Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/4769028273cc43c08775ae28c08a3112
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spelling	oai:doaj.org-article:4769028273cc43c08775ae28c08a31122021-11-22T05:28:12ZTrends in Informal Payments by Patients in Europe: A Public Health Policy Approach2296-256510.3389/fpubh.2021.780337https://doaj.org/article/4769028273cc43c08775ae28c08a31122021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fpubh.2021.780337/fullhttps://doaj.org/toc/2296-2565Background: A new institutional approach toward informal payments in healthcare views informal payments as arising when there is a misalignment between values/norms (informal institutions) and the formal rules (formal institutions) of patients. However, less knowledge is available on the effectiveness of this approach in tackling informal payments in healthcare. This study aimed to fill this gap by evaluating the trends in the effect of institutional misalignment on informal payments made by patients.Methods: A quantitative study design with data extracted from the last three waves of special Eurobarometer surveys on corruption was used to model the propensity of European patients in 27 European Union countries and the United Kingdom to make informal payments. Multilevel logistic regression analysis was employed in order to test the relationship between the formal–informal institution misalignment and the likelihood to make informal payments. Sensitivity analyses were also performed to test the robustness of the findings.Results: The finding is that there is a strong association between the formal–informal institution misalignment and the likelihood to make informal payments for public healthcare services. Similarly, social norms play a pivotal role. When patients perceive that informal practices are widespread in the public healthcare sector they are more likely to make informal payments themselves.Conclusion: The outcome is a call for complementing deterrence measures toward informal payments in healthcare with measures aiming to reduce the formal–informal institution misalignment and to change the social norms. This can be achieved by improving the structural conditions at country level and by changing values/norms and beliefs of patients.Adrian V. HorodnicFrontiers Media S.A.articleinformal payments by patientsinstitutional misalignmentinstitutional theorynormsvaluessocial normsPublic aspects of medicineRA1-1270ENFrontiers in Public Health, Vol 9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	informal payments by patients institutional misalignment institutional theory norms values social norms Public aspects of medicine RA1-1270
spellingShingle	informal payments by patients institutional misalignment institutional theory norms values social norms Public aspects of medicine RA1-1270 Adrian V. Horodnic Trends in Informal Payments by Patients in Europe: A Public Health Policy Approach
description	Background: A new institutional approach toward informal payments in healthcare views informal payments as arising when there is a misalignment between values/norms (informal institutions) and the formal rules (formal institutions) of patients. However, less knowledge is available on the effectiveness of this approach in tackling informal payments in healthcare. This study aimed to fill this gap by evaluating the trends in the effect of institutional misalignment on informal payments made by patients.Methods: A quantitative study design with data extracted from the last three waves of special Eurobarometer surveys on corruption was used to model the propensity of European patients in 27 European Union countries and the United Kingdom to make informal payments. Multilevel logistic regression analysis was employed in order to test the relationship between the formal–informal institution misalignment and the likelihood to make informal payments. Sensitivity analyses were also performed to test the robustness of the findings.Results: The finding is that there is a strong association between the formal–informal institution misalignment and the likelihood to make informal payments for public healthcare services. Similarly, social norms play a pivotal role. When patients perceive that informal practices are widespread in the public healthcare sector they are more likely to make informal payments themselves.Conclusion: The outcome is a call for complementing deterrence measures toward informal payments in healthcare with measures aiming to reduce the formal–informal institution misalignment and to change the social norms. This can be achieved by improving the structural conditions at country level and by changing values/norms and beliefs of patients.
format	article
author	Adrian V. Horodnic
author_facet	Adrian V. Horodnic
author_sort	Adrian V. Horodnic
title	Trends in Informal Payments by Patients in Europe: A Public Health Policy Approach
title_short	Trends in Informal Payments by Patients in Europe: A Public Health Policy Approach
title_full	Trends in Informal Payments by Patients in Europe: A Public Health Policy Approach
title_fullStr	Trends in Informal Payments by Patients in Europe: A Public Health Policy Approach
title_full_unstemmed	Trends in Informal Payments by Patients in Europe: A Public Health Policy Approach
title_sort	trends in informal payments by patients in europe: a public health policy approach
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/4769028273cc43c08775ae28c08a3112
work_keys_str_mv	AT adrianvhorodnic trendsininformalpaymentsbypatientsineuropeapublichealthpolicyapproach
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Trends in Informal Payments by Patients in Europe: A Public Health Policy Approach

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