Introduction: Informal patient payments for healthcare are common in the Western Balkans, negatively affecting
public health and healthcare.
Aim: To identify literature from the Western Balkans on what is known about informal patient payments and bought
and brought goods, to examine their effects on healthcare and to determine what actions can be taken to tackle these
payments.
Methods: After conducting a scoping review that involved searching websites and databases and filtering with eligibility
criteria and quality assessment tools, 24 relevant studies were revealed. The data were synthesized using a narrative
approach that identified key concepts, types of evidence, and research gaps.
Results: The number of studies of informal patient payments increased between 2002 and 2015, but evidence regarding
the issues of concern is scattered across various countries. Research has reported incidents of informal patient payments
on a wide scale and has described various patterns and characteristics of these payments. Although these payments have
typically been small – particularly to providers in common areas of specialized medicine – evidence regarding bought
and brought goods remains limited, indicating that such practices are likely even more common, of greater magnitude
and perhaps more problematic than informal patient payments. Only scant research has examined the measures
that are used to tackle informal patient payments. The evidence indicates that legalizing informal patient payments,
introducing performance-based payment systems, strengthening reporting, changing mentalities and involving the
media and the European Union (EU) or religious organizations in anti-corruption campaigns are understood as some
of the possible remedies that might help reduce informal patient payments.
Conclusion: Despite comprehensive evidence regarding informal patient payments, data remain scattered and
contradictory, implying that informal patient payments are a complex phenomenon. Additionally, the data on bought
and brought goods illustrate that not much is known about this matter. Although informal patient payments have
been studied and described in several settings, there is still little research on the effectiveness of such strategies in the
Western Balkans context
