What is it about?

Confronting with a global pandemic, public healthcare systems are under pressure mak-13 ing access to healthcare services difficult for patients. This provides fertile ground for using illegal 14 practices such as informal payments to gain access. This paper aims to evaluate the use of informal 15 payments by patients during the Covid-19 pandemic and the institutions that affect the prevalence 16 of this practice. Alongside informal institutions, three aspects of formal institutions are here inves-17 tigated, namely the level of trust, transparency, and performance of the healthcare system. To do 18 so, a multilevel mixed-effect analysis of 25,744 interviews with patients conducted across the 27 19 European Union member states in October-December 2020 is conducted

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Why is it important?

The finding is that there are large disparities between countries in the prevalence of informal payments, and that the practice is more likely to occur where there are poorer formal and informal institutions, namely higher acceptability of corruption, lower trust in authorities, lower perceived transparency in handling the Covid-19 pandemic, difficult access to, and poor quality of, healthcare services, and higher mortality rates due to the Covid-19 pandemic. These findings suggest that policy measures for tackling informal payments need to address the current state of the institutional environment


Unique study showing whether people made informal payments to access health services during the Covid-19 pandemic

Professor Colin C Williams
University of Sheffield

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This page is a summary of: Informal Payments by Patients in Central and Eastern Europe during the COVID-19 Pandemic: An Institutional Perspective, International Journal of Environmental Research and Public Health, October 2021, MDPI AG, DOI: 10.3390/ijerph182010914.
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