Investigation of informal payments and related factors in Iran state hospitals after health system reform plan implementation

Abstract

Background: Informal payments in many developing countries, are a serious obstacle towards to improving healthcare system and has negative effects on the function of healthcare system. In order to reduce the unofficial payments and direct payments from patient's pocket, the health reform plan executed. This study was conducted to assess the Informal payments in the hospital related to government.

Methods: This study was a survey based on descriptive analytic method in Zahedan University of medical science in 2017. The study population included all patients hospitalization to the two genera) hospitals of Zahedan in 2017, in which 500 patients were selected by multistage cluster sampling. The data collection tool was a standard questionnaire that was conducted by interview method. Data were analyzed by using spss v22 and descriptive statistics and chi-square test.

Results: in this study,98%  patients were male, 484(96.8%) lived in the urban area, about 2% had informal payment, the average informal payment to nurses were 300 thousand tomans.The highest number of informal payment was in the maternity ward with 50%.The doctors didn't have any informal payment, and all of people disagreed this type of payments.

Conclusion: The results of the study showed that the rate of informal payments in the hospitals related to government in Southeast of Iran after execution of health reform plan, Is minimal. Poor economic status of the patients and well executed health reform plan are the reasons for minimal informal payments. Solutions including constant supervision on employees and realization of the health costs and proportion of insurance companies are effective steps towards elimination of informal payments.