Informal payments and the factors affecting it in the educational hospitals of Shiraz University of Medical Sciences

According to the negative impact of informal payment on the efficiency and equity of the health care system and considering the catastrophic expenditures made for poor and vulnerable groups, this study was conducted to investigate informal payments and the associated factors in the educational hospitals affiliated with Shiraz University of Medical Sciences.

The statistical population of the present descriptive-analytical study was all patients who were discharged from the teaching hospitals of Shiraz University of Medical Sciences (10 hospitals) in a specific month of the year 2018 (June). The sampling method was stratified random and 336 people were selected. Data collection tools were a questionnaire and a telephone interview with the patient or the patientchr('39')s family. The questionnaire consisted of 40 questions in 6 sections. Data were analyzed by using SPSS software version 23, the T-test, ANOVA, and Pearson correlation coefficient.

The present findings show that the most informal payments were payed to the physicians and then the nurses. Among the physicians, general surgeons (1241+236.12) orthopedic specialists (1041+193.64), and urologists (561+89.59) have received the highest amount, respectively. Other findings indicate that the variables of household income level, place of residence and physicianchr('39')s specialty significantly affected the amount of informal payment (P<0.05).

According to the results of the present study and in order to manage informal payments, health managers and policymakers should plan for identifying the causes of informal payment and designing effective interventions.