Title: Formalizing under-the-table payments to control out-of-pocket hospital expenditures in Cambodia.

POPLINE Document Number: 194587

Author(s):

Barber S
Bonnet F
Bekedam H

Source citation:

Health Policy and Planning, 2004 Jul;19(4):199-208.

Abstract:

Growing evidence has demonstrated that informal fees for health services comprise a large proportion of total health spending in some countries. In 1999, individual out-of-pocket payments for health in Cambodia were estimated at US$27 per person, with a proportion paid as under-the-table fees at public facilities. By formalizing such payments and implementing resource management systems within a comprehensive health financing scheme, Takeo Referral Hospital controlled out-of-pocket patient expenditures, ensured patients of fixed prices, protected patients from the unpredictability of hospital fees and promoted financial sustainability. Utilization levels increased by more than 50% for inpatient and surgical services, and cost recovery from user fees averaged 33%. Furthermore, the hospital phased out external donor support gradually over 4 years and achieved financial sustainability. (author's)

Keywords:

Cambodia
Research Report
Evaluation
Hospital Personnel
Informal Sector
Microeconomic Factors
Fees
Hospitals
Financial Activities
Program Sustainability
Cost Effectiveness
Utilization of Health Care
Financing, Government
Developing Countries
Asia, Southeastern
Asia
Health Personnel
Delivery of Health Care
Health
Macroeconomic Factors
Economic Factors
Health Facilities
Programs
Organization and Administration
Evaluation Indexes
Quantitative Evaluation
Health Services