Jelena Arsenijevic1, Milena Pavlova2, Wim Groot3. 1. Department of Health Services Research, CAPHRI, Maastricht University Medical Center, Faculty of Health, Medicine and Life Sciences, Maastricht University, The Netherlands. Electronic address: jarsenijevic@gmail.com. 2. Department of Health Services Research, CAPHRI, Maastricht University Medical Center, Faculty of Health, Medicine and Life Sciences, Maastricht University, The Netherlands. 3. Department of Health Services Research, CAPHRI, Maastricht University Medical Center, Faculty of Health, Medicine and Life Sciences, Maastricht University, The Netherlands; Topinstitute Evidence-Based Education Research (TIER), Maastricht University, The Netherlands.
Abstract
BACKGROUND: This study focuses on out-of-pocket payments for health care in Serbia. In contrast to previous studies, we distinguish three types of out-of-pocket patient payments: official co-payments, informal (under-the-table) payments and payments for "bought and brought goods" (i.e. payments for health care goods brought by the patient to the health care facility). METHODS: We analyse the probability and intensity of three different types of out-of-pocket patient payments in the public health care sector in Serbia and their distribution among different population groups. We use data from the Serbian Living Standard Measures Study carried out in 2007. Out-of-pocket patients payments for both outpatient and inpatient health care are included. The data are analysed using regression analysis. RESULTS: The majority of health care users report official co-payments (84.7%) and payments for "bought and brought goods" (61.1%), whereas only 5.7% health care users declare that they have paid informally. Regarding the regression results, users with an income below the poverty line, those from rural areas and who are not married are more likely to report payments for "bought and brought goods, while young and more educated users are more likely to report informal patient payments. CONCLUSION: Overall, the three types of out-of-pocket payments are not correlated. Payments for "bought and brought goods" take the highest share of the total annual household budget. Serbian policymakers need to consider different strategies to deal with informal payments and to eliminate the practice of "bought and brought goods".
BACKGROUND: This study focuses on out-of-pocket payments for health care in Serbia. In contrast to previous studies, we distinguish three types of out-of-pocket patient payments: official co-payments, informal (under-the-table) payments and payments for "bought and brought goods" (i.e. payments for health care goods brought by the patient to the health care facility). METHODS: We analyse the probability and intensity of three different types of out-of-pocket patient payments in the public health care sector in Serbia and their distribution among different population groups. We use data from the Serbian Living Standard Measures Study carried out in 2007. Out-of-pocket patients payments for both outpatient and inpatient health care are included. The data are analysed using regression analysis. RESULTS: The majority of health care users report official co-payments (84.7%) and payments for "bought and brought goods" (61.1%), whereas only 5.7% health care users declare that they have paid informally. Regarding the regression results, users with an income below the poverty line, those from rural areas and who are not married are more likely to report payments for "bought and brought goods, while young and more educated users are more likely to report informal patient payments. CONCLUSION: Overall, the three types of out-of-pocket payments are not correlated. Payments for "bought and brought goods" take the highest share of the total annual household budget. Serbian policymakers need to consider different strategies to deal with informal payments and to eliminate the practice of "bought and brought goods".
Authors: Kristijan Krstic; Katarina Janicijevic; Yuriy Timofeyev; Evgeny V Arsentyev; Gvozden Rosic; Sergey Bolevich; Vladimir Reshetnikov; Mihajlo B Jakovljevic Journal: Front Public Health Date: 2019-12-13