TY - JOUR
TI - Informal payments in the Greek health sector amid the financial crisis: old habits die last..
AU - Souliotis, K.
AU - Golna, C.
AU - Tountas, Y.
AU - Siskou, O.
AU - Kaitelidou, D.
AU - Liaropoulos, L.
JO - The European Journal of Health Economics
PY - 2016
VL - 17
TODO - 2
SP - 159-170
PB - Springer-Verlag
SN - 1618-7598, 1618-7601
TODO - 10.1007/s10198-015-0666-0
TODO - adult;  aged;  Article;  dentist;  female;  financial crisis;  financial deficit;  Greece;  health care cost;  health care system;  health insurance;  health service;  hospital admission;  human;  income;  informal payment;  major clinical study;  male;  organization and management;  priority journal;  private hospital;  private practice;  public hospital;  reimbursement;  economic recession;  economics;  family size;  financial management;  health care cost;  middle aged;  questionnaire;  statistics and numerical data;  young adult, Adult;  Aged;  Economic Recession;  Family Characteristics;  Female;  Financing, Personal;  Greece;  Health Expenditures;  Health Services;  Humans;  Income;  Male;  Middle Aged;  Surveys and Questionnaires;  Young Adult
TODO - Background: Under-the-table informal payments are commonplace as reimbursements for health care services in Greece. As the country faces a severe financial crisis, the need to investigate the extent of such payments, their incidence and their impact on household income is pressing. Methods: A survey of 2,741 persons from across the country was conducted between December 2011 and February 2012. The sample was defined via a multistage selection process using a quota for municipality of residence, sex and age. The maximum error margin was 2.41 % with a confidence interval of 95 %. Results: The survey reports under-the-table payments for approximately 32.4 % of public hospital admissions. Private clinics, which display the bulk of out-of-pocket payments, naturally display the lowest under-the-table payments. The highest percentage of under-the-table payments in the private sector appears at visits to private practitioners and dentists (36 %). Informal payments are most frequently made upon request, prior to service provision, to facilitate access to care and to reduce waiting times, and at a much lower percentage, to post-service provision, and out of gratitude. Conclusions: This survey reveals that, due to severe financial pressure, there is a growing unwillingness of citizens to pay informally and an increasing demand for these payments as a prerequisite for access to services or to redeem services provided. This “hidden” financial burden of at least 27 % impacts negatively on the living conditions of households and is not reported as purchasing ability or cost of living. © 2015, Springer-Verlag Berlin Heidelberg.
ER -