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Predictors of Informal Health Payments: The Example from Turkey

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Abstract

Little is known about the factors that can affect informal health payments in Turkey, which is pertinent given that Turkey has been undergoing and considering a series of reforms in the health sector. This paper aims to examine the predictors of informal payments in Turkey. The study surveyed a random sample of 3,727 people in a medium-sized city, of whom 706 received medical care for illness and/or non-illness related reasons, using a Turkey-specific version of a model questionnaire focused exclusively on informal out-of-pocket payments. Using multivariable logistic model, household health expenditure, health insurance, service type and provider ownership were found to be statistically significant predictors of informal payment. The findings suggest the supply side factors as the main drivers of informal payments and thus a need for radical changes in the supply side as well as actions to rebuild lost confidence in the health care system of Turkey.

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Notes

  1. SSK (Social Insurance Organization) is a scheme for private sector employees and blue-collar public workers.

  2. Bağ-Kur is a public scheme covering the self-employed, attached to the Ministry of Labor and Social Security.

  3. GERF (Government Employees Retirement Fund) is the pension fund for retired civil servants.

  4. Civil servants are active public employees whose health expenditures are financed through allocations from the government budget.

  5. Green Card scheme covers people who have a certain level of income assessed based on minimum wage figures and, upon the approval of financial status, are issued a card to be used in State and university facilities.

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Acknowledgement

This study was supported by Merck, Sharp and Dohme Turkey and Merck Foundation, through grants to Harvard School of Public Health and Hacettepe University School of Health Administration.

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Authors and Affiliations

  1. Department of Health Care Management, Hacettepe University, Ankara, 06100, Turkey

    Hacer Özgen, Bayram Şahin & Mehtap Tatar

  2. World Bank, Washington, DC, USA

    Paolo Belli

  3. World Bank, New Delhi, India

    Peter Berman

Authors
  1. Hacer Özgen
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  2. Bayram Şahin
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  3. Paolo Belli
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  4. Mehtap Tatar
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  5. Peter Berman
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Correspondence to Hacer Özgen.

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Özgen, H., Şahin, B., Belli, P. et al. Predictors of Informal Health Payments: The Example from Turkey. J Med Syst 34, 387–396 (2010). https://doi.org/10.1007/s10916-008-9251-8

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  • DOI: https://doi.org/10.1007/s10916-008-9251-8

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