Journal of

Background: Informal payments are paid to individuals /health care providing organizations offering as cash or non-cash and are formed out of formal payment channels. This study aim at identifying the types of informal payments, causes, effects and policies to deal with them.

 Materials and Methods: This study was a review  one and relative  published articles identified by searching valid database ( Medlib, SID, Pub Med, Science Direct and Google Scholar)using keywords with their equal in Persian (informal payment and unofficial payment) and 128 articles were extracted. The articles refined step by step. In conclusion, 20 articles were selected according to study aims.

Results: The study findings consist of five main sections including the definition and form of informal payments, the existent causes of informal payments, effects of informal payments, statistics of informal payments in Iran and the world and policies to dealing with this important issue.

Conclusion: Due to the high prevalence of informal payments and severe negative effects on justice and respectable governance, policy-makers should focus on this issue and reduce its effects. Although, strategies to control informal payments are limited but strategies including regulation payment and medical tariffs, regulating power abuse, providing incentives and increasing responsibility of healthcare professionals, and changes in public perception are proposed.

Background: One of the main goals of health sector evolution plan is reducing the amount of out of pocket payment by patients receiving hospital services in public sectors. This study aimed to assess the amount of out of pocket payment by inpatients in public hospitals affiliated to Shahid Beheshti University of Medical Science in Tehran city in 2015.
 
Materials and Methods: In this cross-sectional study, 405 discharged patients from four public and teaching hospitals were selected using convenient sampling method. Data were collected using a researcher made checklist and investigating the hospital bills. In order to data analysis, descriptive statistics and regression analysis were utilized through SPSS Software version16.
 
Results:  The amount of out of pocket payment was 10.2 percent included 9.9 percent formal payment, 0.2 percent bought & brought goods and 0.1 percent informal payment. The most portion of the hospital costs was related to medical supplies and pharmaceuticals, surgeries services and hosteling with 32.6, 20.6 and 17.36, respectively. Type of hospital, having surgery, average length of stay, family size and gender had significant effect on the out of pocket payment amount (p ≤ 0.05).
 
Conclusion: The amount of out of pocket payment by inpatient in public hospitals was in accordance with goal of the health sector evolution plan, which reveals the appropriate government support. It is recommended to tailor and implement enormous plans regarding outpatients and private sector in national level to attain sustained reduction in out of pocket payment.