Informal payments and intra-household allocation of resources for health care in Albania

<p>Abstract</p> <p>Background</p> <p>Informal payments for health care services can impose financial hardship on households. Many studies have found that the position within the household can influence the decision on how much is spent on each household member. This study analyses the intra-household differences in spending on informal payments for health care services by comparing the resources allocated between household heads, spouses and children.</p> <p>Methods</p> <p>Pooled data from two cross sectional surveys, the Albanian Living Standard Measurement Survey 2002 and 2005, are used to analyse both the probability and the amount paid in inpatient and outpatient health care services. A generalised Hausman specification test is used to compare the coefficients of probit and OLS models for nuclear and extended households.</p> <p>Results</p> <p>We find that due to the widespread informal payments there are no significant differences between households in the incidence of informal payments for households' members, but there are more differences in the amount paid informally. Results suggest that households strategically allocate their resources on health care by favouring individuals with higher earning potential who have invested more in human capital. Extended households pay higher amounts for spouses with higher education compared to nuclear households. On the other hand, nuclear households choose to pay higher amounts for children with a higher level of education compared to extended households.</p> <p>Conclusions</p> <p>The differences between households should be taken into account by public policies which should compensate this by redistribution mechanisms targeting disadvantaged groups. Governments should implement effective measures to deal with informal patient payments.</p> <p><b>JEL Codes: </b>I10, I19, D10</p

Avaliatividade, engajamento e valoração Appraisal, engagement and valuation

A partir do arcabouço teórico da Linguística Sistêmico-Funcional (LSF), este texto é uma réplica ao texto de Souza (2011), em que são discutidos aspectos sobre o conceito de instanciação, assim como a tradução de alguns termos do sistema de avaliatividade (Martin & White, 2005) para a língua portuguesa presentes no texto de Vian Jr (2009). O objetivo aqui é (1) reforçar os argumentos apresentados em Vian Jr (2009) para os termos avaliatividade, engajamento e valoração como correspondentes a appraisal, engagement e valuation por um lado e, por outro, (2) apontar para as incoerências no texto de Souza (2011), bem como suas posturas em relação à teoria.<br>Within the Systemic Functional Linguistics (SFL) framework, this text is a reply to Souza (2011), and the aspects discussed by the author on the concept of instantiation as well as the translation of some terms of the Appraisal system (Martin & White, 2005) into Portuguese as suggested by Vian Jr (2009). The aim is to (1) strengthen the arguments presented in Vian Jr (2009) for the terms avaliatividade, engajamento and valoração as the corresponding translations for appraisal, engagement and valuation on the one hand and, on the other, (2) point to the inconsistencies in Souza's text (2011), as well as her positions regarding the theory