All published articles of this journal are available on ScienceDirect.
The Amount of Informal Payments among Patients Referring to Public Hospitals: A Cross-Sectional Study from the Capital of Iran
Tahereh Rahimi3
Omolbanin Atashbahar2
Jamshid Bahmaei4
Maryam Radinmanesh5
Authors Info & Affiliations
Abstract
Introduction
Informal payments are considered a systemic form of corruption that is a major obstacle to reforming healthcare systems in many contexts and has adverse effects on the functioning of these systems. This study aimed to determine the extent of informal payments in selected governmental hospitals in Tehran, the capital of Iran, in 2024.
Methods
A cross-sectional descriptive-analytical study was conducted on 336 patients discharged from selected hospitals. Data were collected using a standard questionnaire measuring informal payments that had been used in previous studies in Iran. Data analysis was performed using SPSS 23 software. For this purpose, descriptive statistics including frequency and percentage, Mann-Whitney, and Kruskal-Wallis tests were used.
Results
The results showed that 19.94% (67) of the participants made informal payments in cash or as gifts to healthcare providers. The total amount of informal cash payments made was US$1235.75 (840 million Iranian Rials). There was a statistically significant relationship between the amount of informal payments to physicians and the length of hospital stay (p = 0.021)
Discussion
The persistence of informal payments indicates systemic weaknesses in financial transparency, monitoring, and income regulation mechanisms within the public healthcare sector. These findings highlight the need for structural reforms to address the economic and ethical drivers of informal payments. By emphasizing equitable compensation, patient education, and strict oversight, healthcare policymakers can reduce financial inequities and enhance trust between patients and providers.
Conclusion
The findings of this study show the occurrence of informal payments in the hospitals studied. Given the harmful effects of these payments, it is recommended to educate patients and hospital staff, adjust staff income levels in line with inflation, improve the quality of care, and strengthen monitoring mechanisms.