Just informal patient payments are not enough, ‘personal connections’ and knowledge of the ‘rules’ are also required: a logistic regression analysis of informal practices in health care in Ukraine

In Ukraine, patients and their family members face numerous barriers to health care services. In response, they use coping strategies, that are manifold and complex activities aimed at overcoming these barriers, the financial burden of the treatment, and the poor quality of health care services. The...

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Main Authors: Olena Levenets, Tetiana Stepurko, Abel Polese, Milena Pavlova, Wim Groot
Format: Article
Language:English
Published: Cambridge University Press 2025-01-01
Series:Health Economics, Policy and Law
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Online Access:https://www.cambridge.org/core/product/identifier/S1744133124000215/type/journal_article
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author Olena Levenets
Tetiana Stepurko
Abel Polese
Milena Pavlova
Wim Groot
author_facet Olena Levenets
Tetiana Stepurko
Abel Polese
Milena Pavlova
Wim Groot
author_sort Olena Levenets
collection DOAJ
description In Ukraine, patients and their family members face numerous barriers to health care services. In response, they use coping strategies, that are manifold and complex activities aimed at overcoming these barriers, the financial burden of the treatment, and the poor quality of health care services. These activities include formal and informal practices. Based on representative survey data from 2015 (N = 2,022), we identify patterns in the use of coping strategies, specific coping strategies used to secure good quality consultation and treatment, and analyse opinions and actions towards coping practices. We further analyse the factors associated with the last experience of coping and look at patterns of connection building. We find that the chances of using both money and connection as a coping strategy are higher for people with incomplete higher and highest levels of education. The size of this effect increases with the level of education. Older people, people with better health, and people with a higher opinion of the state use informal practices less, while women are more active in developing connections. The closer the relationship is with a medical doctor, the higher is the chance that such connection will be used in case of health service consumption.
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id doaj-art-a5daafe647014c97b591dec43d9392be
institution DOAJ
issn 1744-1331
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language English
publishDate 2025-01-01
publisher Cambridge University Press
record_format Article
series Health Economics, Policy and Law
spelling doaj-art-a5daafe647014c97b591dec43d9392be2025-08-20T03:13:04ZengCambridge University PressHealth Economics, Policy and Law1744-13311744-134X2025-01-0120648410.1017/S1744133124000215Just informal patient payments are not enough, ‘personal connections’ and knowledge of the ‘rules’ are also required: a logistic regression analysis of informal practices in health care in UkraineOlena Levenets0https://orcid.org/0000-0002-9654-6790Tetiana Stepurko1Abel Polese2Milena Pavlova3Wim Groot4Department of Health Services Research; CAPHRI, Maastricht University Medical Center, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The NetherlandsSchool of Health Care Management, Faculty of Health Care, Social Work and Psychology, National University of Kyiv-Mohyla Academy, Kyiv, UkraineTallinn School of Business and Governance, Tallinn University of Technology, Tallinn, EstoniaDepartment of Health Services Research; CAPHRI, Maastricht University Medical Center, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The NetherlandsTop Institute Evidence-Based Education Research (TIER), Maastricht University, Maastricht, The NetherlandsIn Ukraine, patients and their family members face numerous barriers to health care services. In response, they use coping strategies, that are manifold and complex activities aimed at overcoming these barriers, the financial burden of the treatment, and the poor quality of health care services. These activities include formal and informal practices. Based on representative survey data from 2015 (N = 2,022), we identify patterns in the use of coping strategies, specific coping strategies used to secure good quality consultation and treatment, and analyse opinions and actions towards coping practices. We further analyse the factors associated with the last experience of coping and look at patterns of connection building. We find that the chances of using both money and connection as a coping strategy are higher for people with incomplete higher and highest levels of education. The size of this effect increases with the level of education. Older people, people with better health, and people with a higher opinion of the state use informal practices less, while women are more active in developing connections. The closer the relationship is with a medical doctor, the higher is the chance that such connection will be used in case of health service consumption.https://www.cambridge.org/core/product/identifier/S1744133124000215/type/journal_articlebarriers to health carecoping strategiesinformal patient paymentsinformal practicesUkraine
spellingShingle Olena Levenets
Tetiana Stepurko
Abel Polese
Milena Pavlova
Wim Groot
Just informal patient payments are not enough, ‘personal connections’ and knowledge of the ‘rules’ are also required: a logistic regression analysis of informal practices in health care in Ukraine
Health Economics, Policy and Law
barriers to health care
coping strategies
informal patient payments
informal practices
Ukraine
title Just informal patient payments are not enough, ‘personal connections’ and knowledge of the ‘rules’ are also required: a logistic regression analysis of informal practices in health care in Ukraine
title_full Just informal patient payments are not enough, ‘personal connections’ and knowledge of the ‘rules’ are also required: a logistic regression analysis of informal practices in health care in Ukraine
title_fullStr Just informal patient payments are not enough, ‘personal connections’ and knowledge of the ‘rules’ are also required: a logistic regression analysis of informal practices in health care in Ukraine
title_full_unstemmed Just informal patient payments are not enough, ‘personal connections’ and knowledge of the ‘rules’ are also required: a logistic regression analysis of informal practices in health care in Ukraine
title_short Just informal patient payments are not enough, ‘personal connections’ and knowledge of the ‘rules’ are also required: a logistic regression analysis of informal practices in health care in Ukraine
title_sort just informal patient payments are not enough personal connections and knowledge of the rules are also required a logistic regression analysis of informal practices in health care in ukraine
topic barriers to health care
coping strategies
informal patient payments
informal practices
Ukraine
url https://www.cambridge.org/core/product/identifier/S1744133124000215/type/journal_article
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