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dc.contributor.author Baji, Petra
dc.contributor.author Rubashkin N
dc.contributor.author Szebik, Imre
dc.contributor.author Stoll K
dc.contributor.author Vedam S
dc.date.accessioned 2018-06-15T07:20:34Z
dc.date.available 2018-06-15T07:20:34Z
dc.date.issued 2017
dc.identifier 85026766600
dc.identifier.citation pagination=86-95; journalVolume=189; journalTitle=SOCIAL SCIENCE & MEDICINE;
dc.identifier.uri http://repo.lib.semmelweis.hu//handle/123456789/5524
dc.identifier.uri doi:10.1016/j.socscimed.2017.07.015
dc.description.abstract BACKGROUND: In Central and Eastern Europe, many women make informal cash payments to ensure continuity of provider, i.e., to have a "chosen" doctor who provided their prenatal care, be present for birth. High rates of obstetric interventions and disrespectful maternity care are also common to the region. No previous study has examined the associations among informal payments, intervention rates, and quality of maternity care. METHODS: We distributed an online cross-sectional survey in 2014 to a nationally representative sample of Hungarian internet-using women (N = 600) who had given birth in the last 5 years. The survey included items related to socio-demographics, type of provider, obstetric interventions, and experiences of care. Women reported if they paid informally, and how much. We built a two-part model, where a bivariate probit model was used to estimate conditional probabilities of women paying informally, and a GLM model to explore the amount of payments. We calculated marginal effects of the covariates (provider choice, interventions, respectful care). RESULTS: Many more women (79%) with a chosen doctor paid informally (191 euros on average) compared to 17% of women without a chosen doctor (86 euros). Based on regression analysis, the chosen doctor's presence at birth was the principal determinant of payment. Intervention and procedure rates were significantly higher for women with a chosen doctor versus without (cesareans 45% vs. 33%; inductions 32% vs. 19%; episiotomy 75% vs. 62%; epidural 13% vs. 5%), but had no direct effect on payments. Half of the sample (42% with a chosen doctor, 62% without) reported some form of disrespectful care, but this did not reduce payments. CONCLUSION: Despite reporting disrespect and higher rates of interventions, women rewarded the presence of a chosen doctor with informal payments. They may be unaware of evidence-based standards, and trust that their chosen doctor provided high quality maternity care.
dc.relation.ispartof urn:issn:0277-9536
dc.title Informal cash payments for birth in Hungary: Are women paying to secure a known provider, respect, or quality of care?
dc.type Journal Article
dc.date.updated 2018-06-04T12:09:06Z
dc.language.rfc3066 en
dc.identifier.mtmt 3279873
dc.identifier.wos 000410016000010
dc.identifier.pubmed 28787630
dc.contributor.department SE/AOK/I/Magatartástudományi Intézet
dc.contributor.institution Semmelweis Egyetem


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