Informal payments and performance in the health care sector: possible relationships in a sub-national perspective

The paper explores the relationship between corruption and performance dimensions of the Italian regional health care systems (RHSs). In Europe, Italy shows the widest sub-national in performance and corruption levels. The research focuses on petty corruption in health care. So-called informal payments are the most common form and were measured using data from the European Quality of Government Index Survey. The performance of Italian RHSs was assessed using key indicators divided into three analytical dimensions: health status; access to care; and quality of care. OECD Health Data was used as source data for health status and access to care. As a proxy for quality of care, the study used avoidable mortality, with data drawn from the Italian National Institute of Statistics (ISTAT). The study formulated a research hypothesises that petty corruption has a negative influence on RHS performance. The findings showed considerable regional differences. The results did not confirm the research hypotheses. However, informal payments did show an adverse effect on renunciations to specialist medical examinations due to costs.