PDF(Pubmed)
Abstract：
Confronted with a global pandemic, public healthcare systems are under pressure, making access to healthcare services difficult for patients. This provides fertile ground for using illegal practices such as informal payments to gain access. This paper aims to evaluate the use of informal payments by patients during the COVID-19 pandemic and the institutions that affect the prevalence of this practice. Various measurements of formal and informal institutions are here investigated, namely the acceptability of corruption, the level of trust, transparency, and performance of the healthcare system. To do so, a logistic regression of 10,859 interviews with patients conducted across 11 Central and Eastern Europe countries in October-December 2020 is employed. 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.
摘要：
面对全球大流行，公共医疗系统面临压力，使患者难以获得医疗服务。这为利用非正规支付等非法行为获取渠道提供了沃土。本文旨在评估COVID-19大流行期间患者使用非正式付款的情况以及影响这种做法患病率的机构。这里调查了正式和非正式机构的各种衡量标准，即腐败的可接受性，信任的程度,透明度，和医疗保健系统的性能。要做到这一点，对2020年10月至12月在中欧和东欧国家进行的10,859例患者访谈进行了逻辑回归.调查结果是，各国之间在非正式支付的普遍性方面存在很大差异，这种做法更有可能发生在正规和非正规机构较差的地方，即腐败的可接受性更高，对当局的信任度较低，处理COVID-19大流行的透明度降低，难以接近,质量差，医疗保健服务,以及COVID-19大流行导致的更高死亡率。这些发现表明，解决非正式付款的政策措施需要解决体制环境的现状。
