Towards effective policy measures to reduce informal payments in healthcare: addressing sample selection bias and measurement error in surveys

IF 3.4 3区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Health Policy Pub Date : 2025-06-01 DOI:10.1016/j.healthpol.2025.105367

Maria Felice Arezzo , Giuseppina Guagnano , Colin C. Williams , Adrian V. Horodnic

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引用次数: 0

Abstract

Previous research has primarily utilized surveys to assess the extent of informal payments, identify key drivers, and recommend policy interventions. However, reliance on surveys presents challenges, including representativeness issues and social desirability bias, which may result in underestimated prevalence and misinformed policy measures. The aim of this paper is to evaluate the influence of these biases on estimating the prevalence of informal payments and on the development of effective policies to reduce informal payments. Reporting data from the third wave of Life in Transition Survey conducted in 2016 across 34 countries, a significant misalignment between reported and (estimated) actual behaviours regarding informal payments was found. The results of a Probit model adjusted for sample selection and measurement error revealed that, among those who made informal payments, approximately 20 % of respondents declared the opposite while the global prevalence of individuals making informal payments in the analysed countries is approximately 18 %. The implications for policy measures towards informal payments in public healthcare are then discussed.

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采取有效的政策措施减少医疗保健中的非正式支付：解决调查中的样本选择偏差和测量误差

以前的研究主要利用调查来评估非正式支付的程度，确定关键驱动因素，并建议政策干预措施。然而，对调查的依赖带来了挑战，包括代表性问题和社会可取性偏见，这可能导致低估流行率和错误的政策措施。本文的目的是评估这些偏见对估计非正式支付的普遍程度和制定减少非正式支付的有效政策的影响。2016年在34个国家进行的第三波转型生活调查报告数据显示，报告和（估计的）关于非正式支付的实际行为之间存在重大偏差。根据样本选择和测量误差调整的Probit模型的结果显示，在进行非正式付款的人中，大约20%的受访者表示相反，而在分析的国家中，个人进行非正式付款的全球流行率约为18%。然后讨论了对公共医疗保健中非正式支付的政策措施的影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Health Policy 医学-卫生保健

CiteScore

6.40

自引率

6.10%

发文量

157

审稿时长

3-8 weeks

期刊介绍： Health Policy is intended to be a vehicle for the exploration and discussion of health policy and health system issues and is aimed in particular at enhancing communication between health policy and system researchers, legislators, decision-makers and professionals concerned with developing, implementing, and analysing health policy, health systems and health care reforms, primarily in high-income countries outside the U.S.A.