Results: OOP payments account for 45 % of total health expenditures. Sixteen percent of outpatients and
30 % of inpatients reporting that they made OOP payments when seeking care at a health facility in 2012,
more than two-thirds of whom also reported paying for medicines at a pharmacy. Among those who paid
anything, 36 % of outpatients and 82 % of inpatients reported paying informally, with the proportion increasing over
time for inpatient care. Although many patients consider these payments to be gifts, around one-third of IPs appear to
be forced, posing a threat to health care access. Patients perceive that payments are driven by the limited list of
reimbursable medicines, a desire to receive better treatment, and fear or extortion. Providers suggested irrational
prescribing and ordering of tests as drivers. Providers may believe that IPs are gifts and do not cause harm for patients
and the health system in general.
Results: OOP payments account for 45 % of total health expenditures. Sixteen percent of outpatients and30 % of inpatients reporting that they made OOP payments when seeking care at a health facility in 2012,more than two-thirds of whom also reported paying for medicines at a pharmacy. Among those who paidanything, 36 % of outpatients and 82 % of inpatients reported paying informally, with the proportion increasing overtime for inpatient care. Although many patients consider these payments to be gifts, around one-third of IPs appear tobe forced, posing a threat to health care access. Patients perceive that payments are driven by the limited list ofreimbursable medicines, a desire to receive better treatment, and fear or extortion. Providers suggested irrationalprescribing and ordering of tests as drivers. Providers may believe that IPs are gifts and do not cause harm for patientsand the health system in general.
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