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Exploring the changes of physicians' behaviour toward informal payment based on Health Transformation Plan in Iran: A qualitative study

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  • Minoo Alipouri Sakha
  • Telma Zahirian Moghadam
  • Hassan Ghobadi
  • Hamed Zandian

Abstract

By implementation of the Health Transformation Plan (HTP), a revised tariff system for healthcare services was executed in Iran. This study explores the changes in physicians' behaviour in facing informal payment (IP) based on HTP implementation in Iran. We conducted in‐depth semi‐structured interviews with 15 purposefully selected physicians and policy makers to explore the changes (positive, negative and no) in physicians' behaviours with and without the implementation of HTP. The interviews were conducted individually and face to face. The conventional content analysis for data analysis by MAXQDA ver.10 was used. Based on the results, regardless of the HTP implemented, market competitiveness could control physicians' demand for IP. However, unreal tariffs, irregular payments, inflation, expensive healthcare and comparing income with other occupations increase physicians' demand for IP as negative behaviour. This study explored three patterns of physicians' behavioural change because of HTP implementation: 1—positive behavioural change with four factors; 2—negative behavioural changes with two factors; and 3—no behavioural change with four factors. Various factors influenced physicians' behaviour towards IP with and without the HTP. To combat IP more efficiently, we recommend strengthening the HTP's positive interventions, compensation of physicians' target income, enhancing supervision, reducing the gap among various medical specialities and taking a systematic approach with law offenders.

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  • Minoo Alipouri Sakha & Telma Zahirian Moghadam & Hassan Ghobadi & Hamed Zandian, 2020. "Exploring the changes of physicians' behaviour toward informal payment based on Health Transformation Plan in Iran: A qualitative study," International Journal of Health Planning and Management, Wiley Blackwell, vol. 35(5), pages 1127-1139, September.
    • Handle: RePEc:bla:ijhplm:v:35:y:2020:i:5:p:1127-1139
    DOI: 10.1002/hpm.3020
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    References listed on IDEAS

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    1. Wagstaff, Adam, 2008. "Measuring financial protection in health," Policy Research Working Paper Series 4554, The World Bank.
    2. Liaropoulos, Lycourgos & Siskou, Olga & Kaitelidou, Daphne & Theodorou, Mamas & Katostaras, Theofanis, 2008. "Informal payments in public hospitals in Greece," Health Policy, Elsevier, vol. 87(1), pages 72-81, July.
    3. Imre Boncz & Júlia Nagy & Andor Sebestyén & László Kőrösi, 2004. "Financing of health care services in Hungary," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 5(3), pages 252-258, September.
    4. Owen O'Donnell & Eddy van Doorslaer & Adam Wagstaff & Magnus Lindelow, 2008. "Analyzing Health Equity Using Household Survey Data : A Guide to Techniques and Their Implementation," World Bank Publications - Books, The World Bank Group, number 6896.
    5. Chiu, Yu-Chan & Smith, Katherine Clegg & Morlock, Laura & Wissow, Lawrence, 2007. "Gifts, bribes and solicitions: Print media and the social construction of informal payments to doctors in Taiwan," Social Science & Medicine, Elsevier, vol. 64(3), pages 521-530, February.
    6. Ensor, Tim, 2004. "Informal payments for health care in transition economies," Social Science & Medicine, Elsevier, vol. 58(2), pages 237-246, January.
    7. Hyacinthe Tchewonpi Kankeu & Sylvie Boyer & Raoul Fodjo Toukam & Mohammad Abu-Zaineh, 2016. "How do supply-side factors influence informal payments for healthcare? The case of HIV patients in Cameroon," International Journal of Health Planning and Management, Wiley Blackwell, vol. 31(1), pages 41-57, January.
    8. Cherecheş, Răzvan M. & Ungureanu, Marius I. & Sandu, Petru & Rus, Ioana A., 2013. "Defining informal payments in healthcare: A systematic review," Health Policy, Elsevier, vol. 110(2), pages 105-114.
    9. Arsenijevic, Jelena & Pavlova, Milena & Groot, Wim, 2015. "Out-of-pocket payments for health care in Serbia," Health Policy, Elsevier, vol. 119(10), pages 1366-1374.
    10. Onwujekwe, Obinna & Dike, Nkem & Uzochukwu, Benjamin & Ezeoke, Ogochukwu, 2010. "Informal payments for healthcare: Differences in expenditures from consumers and providers perspectives for treatment of malaria in Nigeria," Health Policy, Elsevier, vol. 96(1), pages 72-79, June.
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