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Year : 2017  |  Volume : 10  |  Issue : 3  |  Page : 771-772
How can we eradicate informal payments for health care in Asia?

1 Health Management Research Center, Baqiyatallah University of Medical Sciences; Faculty of Management and Economics, Tarbiat Modares University, Tehran, Iran
2 Faculty of Management and Economics, Tarbiat Modares University, Tehran, Iran

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Date of Web Publication21-Aug-2017

How to cite this article:
Meskarpour-Amiri M, Assari A, Sadeghi H, Agheli L. How can we eradicate informal payments for health care in Asia?. Ann Trop Med Public Health 2017;10:771-2

How to cite this URL:
Meskarpour-Amiri M, Assari A, Sadeghi H, Agheli L. How can we eradicate informal payments for health care in Asia?. Ann Trop Med Public Health [serial online] 2017 [cited 2021 Feb 28];10:771-2. Available from:

Dear Sir,

Informal payments (IPs) for health care are defined as any type of patients' payment to health care workers which is more than legal prices. Although IP for health care has been named differently around the world, such as “under the table” or “unofficial” payment, but despite of its different names, it has same adverse effects on health system equity and efficiency.[1],[2]

Unfortunately, IPs are a significant source of financing health system in many Asian countries.[1],[3] IPs are 85% of average payments of each patient in Bangladesh.[4] A total of 31% of health care users in Turkey have reported IPs for health care during a 2-month period of time.[5]

Also, a study in Iran has reported that 48% of discharged inpatients had at least one experience of paying informally to health care workers during a year. And the situation is not so much better in Kazakhstan, Taiwan, Russia, and also China.[1]

Unfortunately, the size of IPs for health care is still unknown in many Asian countries. But such payments seem to be more common in countries, where there is high corruption of health care workers along with inadequate monitoring of the health care system. Moreover, IPs are common where there are high direct physician-patient financial relationship and imperiously unrealistic medical tariffs.[1]

Anyway IP for care, regardless of its nature, has become an important health policy issue around the world. A special attention dedicated to overcoming IPs by European countries, but still there is little attention to this issue in lower income Asian countries while the IPs seems to be more common and complicated issue in such countries. Although some Asian countries have made serious efforts to reducing informal health payments like Iran, Taiwan and Turkey, but their efforts were not with full success due to lack of necessary attention to the nature of IPs.[1],[3] Therefore, we believe that Asian countries can overcome this dilemma only through precise attention to the nature and determinants of informal health payments in their country. But still little is known about the IPs' nature, size, and its effective factors in Asian countries. We need more information about the hidden nature of informal health payments in Asia before any policy adaption.

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Conflicts of interest

There are no conflicts of interest.

   References Top

Meskarpour-Amiri M, Assari-Arani A, Sadeghi H, Aghli-Kohneshahri L. Socioeconomic Factors Affecting Informal Payments in the Health Sector. Transylvanian Rev Admin Sci 2016;12:116-28.  Back to cited text no. 1
Meskarpour-Amiri M, Mehdizadeh P, Barouni M, Dopeykar N, Ramezanian M. Assessment the trend of inequality in the distribution of intensive care beds in Iran: using GINI Index. Glob J Health Sci 2014;6:28-36.  Back to cited text no. 2
Meskarpour-Amiri M. Government intervention to restricting corruption of health care market in Iran. BMJ 2015;348:4184.  Back to cited text no. 3
Killingsworth JR, Hossain N, Hedrick-Wong Y, Thomas SD, Rahman A, Begum T. Unofficial fees in Bangladesh: price, equity and institutional issues. Health Policy Plan 1999;14:152-63.  Back to cited text no. 4
Özgen H, Sahin B, Belli P, Tatar M, Berman P. Predictors of informal health payments: the example from Turkey. J Med Syst 2010;34:387-96.  Back to cited text no. 5

Correspondence Address:
Abbas Assari
Department of Health Economics, Faculty of Management and Economics, Tarbiat Modares University, Tehran
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1755-6783.213154

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