INFORMAL OUT-OF-POCKET PAYMENTS FOR HEALTH CARE IN RUSSIA Moscow Public Science Foundation, "Independent Institute for Social Policy, Moscow, 2003, 144 pages

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Англоязычная версия книги "Неформальные платежи за медицинскую помощь в России" (на русском языке представлено в Демоскопе № 109-110).

В работе представлены результаты исследования, выполненного Независимым институтом социальной политики в первой половине 2002 г. при финансовой поддержке Московского общественного научного фонда и Агентства Международного развития США (the United States Agency for International Development (USAID)). На основе данных, полученных методом интервьюирования работников здравоохранения в двух российских регионах, выявлена распространенность неформальных платежей в разных видах медицинских учреждений и отделений. Показано, что неформальные платежи выступают вынужденным способом адаптации врачей и пациентов к условиям переходного периода. Выявлены правила осуществления неформальных платежей и представлены различные модели такой оплаты. Проведен анализ индивидуальных и коллективных норм, действующих по отношению к неформальным платежам, и отношения медицинских работников к возможностям их легализации. На основе этих данных проведена оценка возможных последствий легализации неформальной оплаты медицинской помощи.
Книга распространяется бесплатно.

TABLE OF CONTENTS

ABOUT THE INDEPENDENT ECONOMIC ANALYSIS SERIES
ABOUT THE STRENGTHENING ECONOMIC THINK TANKS IN RUSSIA PROGRAM

INTRODUCTION

SECTION 1. STATE GUARANTEES AND POPULATION'S PAYMENTS FOR HEALTH CARE
1.1. State regulation of economic conditions of health service provision
1.2. Residents' health care expenses (an overview of accomplished surveys)

SECTION 2. TYPES OF OUT-OF-POCKET PAYMENTS FOR HEALTH CARE
2.1. Rules governing out-of-pocket payments for health services: investigative tools used
2.2. Chargeable health services
2.3. Payments for drugs by patients obtaining services at public health care institutions
2.4. Informal payments for health services
2.4.1. What do people pay for?
2.4.2. Causes of informal payments
2.5. Prevalence of informal payments for health services
2.5.7. Centers of informal payments in hospitals
2.5.2. Informal payments in outpatient settings
2.5.3. Physicians' professional qualification and informal payments
2.5.4. The size of health professionals' "shadow" incomes

SECTION 3. RULES GOVERNING INFORMAL PAYMENTS FOR HEALTH SERVICES
3.1. Informal payment models
3.2. Redistribution of informal revenues among medical staff
3.2.1. Vertical redistribution of informal revenues: do physicians share with administrators?
3.2.2. Horizontal redistribution of informal revenues: do surgeons share with their team members and nurses?
3.2.3. Regulation of informal payments distribution among mid-level and junior medical staff

SECTION 4. HEALTH PROFESSIONALS' ATTITUDES TOWARDS INFORMAL PAYMENTS
4.1. Physicians' and nurses' attitudes towards informal payments
4.1.1. Physician groups with different attitudes towards informal payments
4.1.2. How do physicians justify informal payments
4.1.3. Cases in which physicians consider informal payments unjustified
4.1.4. Justification of informal payments by mid-level and junior medical staff
4.2. Group norms regulating informal payment practices
4.2.1. Discussion of informal payment practices by health care facilities' staff
4.2.2. Can health professionals influence informal payment practices and do they want it?
4.2.3. Can existing group norms be used to regulate informal payments?
4.3. Health authorities' and health financiers' attitudes towards informal payments
4.3.1. Social policy-makers' awareness of informal payment practices
4.3.2. Justification of informal payments by health authorities and financiers
4.3.3. Can informal payments be controlled?
4.3.4. Models of informal payment control
4.4. Health professionals' attitudes towards legalization of payments for health care

CONCLUSION

AUTHORS

GOALS AND KEY GUIDELINES OF THE INDEPENDENT INSTITUTE FOR SOCIAL POLICY (IISP)