Formalizing under-the-table payments to control out-of-pocket hospital expenditures in Cambodia.
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 27 US dollars 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.
Barber
Sarah
S
Institute of Business and Economic Research, University of California, Berkeley, USA.
Bonnet
Frédéric
F
Bekedam
Henk
H
D002160:Cambodia; D003363:Cost Control; D005382:Financing, Personal; D005102:Health Expenditures; D017721:Hospital Costs; D012051:Reimbursement Mechanisms