Paying informally for public health care in Albania: scarce resources or governance failure?

Sonila Tomini & Wim Groot


Informal payments for health care are common in most former communist countries. This paper explores the demand side of these payments in Albania. Using tobit and Heckman selection models we control for individual determinants of informal payments in outpatient and inpatient health care. Propensity score matching techniques are used to investigate the changes in the characteristics of people paying informally over the different years. Our findings suggest that vulnerable groups in society remain less protected against such payments and policy measures have not reached the most deprived regions of the country.

Key words: informal payment, health policy, Heckman selection model, propensity score matching.

JEL Codes: I18, I1, P36, C24

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