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ИД «Финансы и кредит»






National Interests: Priorities and Security

Socio-economic factors determining the population participation in informal payment for medical care

Vol. 10, Iss. 46, DECEMBER 2014

Available online: 6 December 2014

Subject Heading: Social sphere

JEL Classification: 

Pages: 25-36

Zasimova L.S. Gaidar Institute for Economic Policy, Moscow, Russian Federation

Kaneva M.A. Gaidar Institute for Economic Policy, Moscow, Russian Federation

Importance The problem of informal payment for medical care, which has assumed the particular acuteness in the transition period of the Russian economy, remains relevant at present as well. The informal payments have a number of negative consequences: they reduce the health care system transparency; they also result in unequal treatment of medical personnel to those who can pay more informally and to those who are not able to carry out informal payments. The informal payments constitute a barrier to quality medical care.
     Objectives The purpose of the present study, which continues the study of the foreign and Russian economists, is the analysis of the causes and socio-economic factors that encourage the Russian citizens to carry out an informal payment for medical care in the current economic conditions. To achieve the target goals, we have analyzed the statistical and sociological data and have built three specifications of logistic regression to determine the specification of the individual characteristics of the people inclined to carry out informal payment.
     Methods The study showed that high incomes and availability of voluntary health insurance policy (VHIP) make the greatest contribution to the change in the probability of selection of an informal payment for out-patient treatment. At the same time, the likelihood of informal payment is practically not related with the individual characteristics of a person (gender, age, availability of children).
     Results Based on those calculations, we concluded that the informal payments for health care in our country is connected with the individual characteristics of a person, and with the organization of health care and the modern institutional environment, and the reduction of the size of the informal payment is only possible by modifying the system of health care arrangement in our country.
     Conclusions and Relevance The findings can be used when formulating the modernization directions and for Russian health care reform.

Keywords: informal payment, healthcare, medical aid, out-patient treatment


  1. Zasimova L.S. Gosudarstvennaya politika i problemy lekarstvennogo obespecheniya v regionakh Rossii [Public policy and the problem of drug provision in the Russian regions]. Regional'naya ekonomika: teoriya i praktika – Regional economics: theory and practice, 2009, no. 29, pp. 66–73.
  2. Zasimova L.S., Kadyrov F.N. et al. Vnedrenie novykh tekhnologii v meditsinskikh organizatsiyakh: zarubezhnyi opyt i rossiiskaya praktika [The introduction of new technologies in healthcare organizations: foreign experience and the Russian practice]. Moscow, NRU HSE Publ., 2013, 272 p.
  3. Kaneva M.A. Osnovnye napravleniya razvitiya sistemy zdravookhraneniya na federal'nom i regional'nom urovne (na primere Novosibirskoi oblasti). V kn.: Aktual'nye problemy razvitiya Novosibirskoi oblasti i puti ikh resheniya [The basic directions of the health system development at the Federal and regional level (the case of the Novosibirsk region). In: Topical issues of the Novosibirsk region development and the ways of their solving]. Novosibirsk, Institute of Economics and Industrial Engineering, Siberian Branch of RAS Publ., 2014, 112 p.
  4. Potapchik E.G., Selezneva E.V., Shishkin S.V. Dostupnost' meditsinskoi pomoshchi dlya naseleniya (po materialam monitoringa ekonomicheskikh protsessov v zdravookhranenii) [The population access to health care (based on monitoring of economic processes in healthcare)]. Available at: Link. (In Russ.)
  5. Selezneva E.V. Uchastie razlichnykh grupp naseleniya Rossii v oplate meditsinskoi pomoshchi [The participation of different groups of the Russian population in health care payment]. Available at: Link. (In Russ.)
  6. Shishkin S.V., Besstremyannaya G.E. et al. Rossiiskoe zdravookhranenie: oplata za nalichnyi raschet [The Russian health care: cash payment]. Available at: Link. (In Russ.)
  7. Shishkin S.V., Bogatova T.V. et al. Neformal'nye platezhi za meditsinskuyu pomoshch' v Rossii [Informal payments for medical health care in Russia]. Available at: Link. (In Russ.)
  8. Shishkin S.V., Burdyak A.Ya., Selezneva E.V. Razlichiya v dostupnosti meditsinskoi pomoshchi dlya naseleniya Rossii [Differences in access to medical health care for the Russian population]. Sotsial'naya politika: ekspertiza, rekomendatsii, obzory – Social policy: expertise, recommendations, reviews, 2008, no. 8, pp. 135–158.
  9. Shishkin S.V., Popovich L.D. Analiz perspektiv razvitiya chastnogo finansirovaniya zdravookhraneniya [An analysis of the prospects for private financing of health care]. Moscow, IEPP Publ., 2009, 125 p.
  10. Shishkin S.V., Potapchik E.G., Selezneva E.V. Chastnyi sektor zdravookhraneniya v Rossii: sostoyanie i perspektivy razvitiya [The private health sector in Russia: the status and development prospects]. Voprosy Economiki, 2013, no. 4, pp. 94–112.
  11. Chernets V.A., Chirikova A.E., Shishkin S.V. Neformal'naya oplata meditsinskikh uslug: tendentsii institutsional'nykh izmenenii. V kn.: Rossiiskoe zdravookhranenie: sotsial'no-ekonomicheskie vyzovy [Informal payment for medical services: trends of institutional changes. In: Russian health care: the socio-economic challenges]. Moscow, NISP Publ., 2008, pp. 229–283.
  12. Chirikova A.E., Shishkin S.V. Vzaimodeistvie vrachei i patsientov v sovremennoi Rossii: vektory izmenenii [Interaction between doctors and patients in modern Russia: vectors of changes]. Mir Rossii – World of Russia, 2014, no. 2, pp. 154–182.
  13. Balabanova D., McKee M. Understanding Informal Payments for Health Care: the Example of Bulgaria. Health Policy and Planning, 2002, no. 62, pp. 243–273.
  14. Ensor T. Informal Payments for Health Care in Transition Economies. Social Science & Medicine, 2004, no. 58, pp. 237–246.
  15. Gaal P., Belli P.C., McKee M., Szócska M. Informal Payments for Health Care: Definitions, Distinctions, and Dilemmas. Journal of Health Politics, Policy and Law, 2006, no. 31(2), pp. 251–293.
  16. Health for All. Database. World Health Organization. Available at: Link.
  17. Implementing Health Financing Reform: Lessons from Countries in Transition. Edited by J. Kutzin, C. Chasin, M. Jakab. World Health Organization, on behalf of the European Observatory on Health Systems and Policies, 2010.
  18. Lewis M. Who Is Paying for Health Care in Europe and Central Asia? Available at: Link.
  19. Lewis M. Informal health payments in Central and Eastern Europe and the Former Soviet Union: issues, trends and policy implications. Funding health care: options for Europe. Buckingham, Open University Press, 2002, pp. 184–205.
  20. Shahriari H., Belli P., Lewis M. Institutional Issues in Informal Health Payments in Poland. Report on the Qualitative Part of the Study. February 2001. Available at: Link.

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