Volume 9, Issue 6 (3-2017)
IJMEHM 2017, 9(6): 34-47 |
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Parsa M, Larijani B, Aramesh K, Nedjat S, Fotouhi A, yekaninejad S et al . Informal payments in Iran: A cross- sectional study prior to implementation of the health system reform
. IJMEHM 2017; 9 (6) :34-47
URL: http://ijme.tums.ac.ir/article-1-5913-en.html
URL: http://ijme.tums.ac.ir/article-1-5913-en.html
Mojtaba Parsa * 
1, Bagher Larijani2 , Kiarash Aramesh2 , Saharnaz Nedjat3 , Akbar Fotouhi3 , Saeid Yekaninejad3 , Nedjatollah Ebrahimian4
1, Bagher Larijani2 , Kiarash Aramesh2 , Saharnaz Nedjat3 , Akbar Fotouhi3 , Saeid Yekaninejad3 , Nedjatollah Ebrahimian4
1- Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran. , mparsa@tums.ac.ir
2- Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran.
3- Department of Epidemiology and Biostatistics, School of Public Health and Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran.
4- Islamic Azad University, Tehran, Iran.
2- Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran.
3- Department of Epidemiology and Biostatistics, School of Public Health and Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran.
4- Islamic Azad University, Tehran, Iran.
Abstract: (5482 Views)
Informal payments in clinics raise ethical concerns in healthcare delivery. This cross-sectional questioner survey aims to evaluate the prevalence and related factors of informal payment in healthcare system in Iran.
The study was carried out in 2013, prior to the implementation of the government' Health System Reform among physicians with different specialties. The questionnaire were distributed among the participants during the congresses and continuing medical education programs.
In results; of the total specialist physicians, 276 returned the questionnaires. The response rate was 81.17%. and out of 276 returned questionnaires 257 fulfilled the inclusion criteria. The prevalence of informal payments, among the physicians who were susceptible to receiving informal payments, was relatively high (63.8%). The physicians who practiced in the private sector, as well as physicians who practiced in Tehran and those who had a positive attitude towards the informal payments, received more informal payments. From the viewpoint of the respondents, the main cause of informal payments was unrealistic/unfair tariffs and the main consequence of informal payments was the rising costs of patient care.
This study showed that, unfortunately, more than half of the participants did not believe or did not decisively consider informal payments as unethical. This confirms the importance of physicians’ education about the unethical practice of informal payments. However, compare to private sectors, more supervision in public sector may be the main cause of less prevalence of informal payments in public hospitals.
In conclusion: Developing ethical guidelines to prevent informal payments as well as more realistic and fair tariffs would help to decrease the incidence of informal payments.
The study was carried out in 2013, prior to the implementation of the government' Health System Reform among physicians with different specialties. The questionnaire were distributed among the participants during the congresses and continuing medical education programs.
In results; of the total specialist physicians, 276 returned the questionnaires. The response rate was 81.17%. and out of 276 returned questionnaires 257 fulfilled the inclusion criteria. The prevalence of informal payments, among the physicians who were susceptible to receiving informal payments, was relatively high (63.8%). The physicians who practiced in the private sector, as well as physicians who practiced in Tehran and those who had a positive attitude towards the informal payments, received more informal payments. From the viewpoint of the respondents, the main cause of informal payments was unrealistic/unfair tariffs and the main consequence of informal payments was the rising costs of patient care.
This study showed that, unfortunately, more than half of the participants did not believe or did not decisively consider informal payments as unethical. This confirms the importance of physicians’ education about the unethical practice of informal payments. However, compare to private sectors, more supervision in public sector may be the main cause of less prevalence of informal payments in public hospitals.
In conclusion: Developing ethical guidelines to prevent informal payments as well as more realistic and fair tariffs would help to decrease the incidence of informal payments.
Type of Study: Research |
Subject:
Medical Ethics
Received: 2017/07/1 | Accepted: 2017/08/16 | Published: 2017/08/16
Received: 2017/07/1 | Accepted: 2017/08/16 | Published: 2017/08/16
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