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Presentation

Session: Posters
Room: TBA
Time: Fri 13:00-14:30

Presenter: Sonila Tomini (Maastricht University. Maastricht Graduate School of Governance)

Abstract

Informal health care payments are a significant part of out of pocket payments in many former communist countries. If formal arrangements fail to provide the protection and fairness in health care provision, the market for informal payments may put the burden on the household’s budget. During health care events, individuals within one household may decide to strategically allocate their scarce resources by supporting certain members more than others. This decision may be influenced by the type of family, importance of the event, or the type of services required.

This paper looks at the family impact of informal payments in health care by analyzing intra-household allocation of resources for such payments over their members. We use pooled data from two cross sectional surveys, Living Standard Measurement Survey 2002 and 2005, in Albania, and analyze both the probability and the amount paid in inpatient and outpatient services. We also explore different types of families in order to learn more on the behavior of households in such situations. Seemingly unrelated estimations are used to compare coefficients of probit and OLS models. This allows us to see whether there are differences between what is paid in outpatient and inpatient for different members of the household.

Our results show that households tend to differentiate between their members when it comes to the amount paid in each service. In inpatient care, they pay much more for spouses, children, parent or siblings than for non-relatives. In outpatient care they pay more for spouses or non-relatives and less for children, parents or siblings. We do not find any significant change between different types of families. The differences between the amount paid in inpatient and outpatient suggest that the type of services and also formal arrangements influence the amount that households allocate to different members of the family as informal payment in health care. This is very important considering that the consequences of such payments are felt mostly by poor households with higher number of children and elderly.

Key Terms

intra-household, informal payments, out of pocket

Authors:

Sonila Tomini (Maastricht University. Maastricht Graduate School of Governance) , WIm Groot (Maastricht University. Department of Health Organization, Policy and Economics; Topinstitute Evidence-Based Education Research (TIER)) and Milena Pavlova (Maastricht University. Department of Health Organization, Policy and Economics)

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