Fraud & corruption in healthcare
Fraud and corruption in healthcare
The healthcare sector appears to be particulary vulnerable to corruption
The large amounts of money involved and the complexities of many healthcare systems play a role as well as the fact that there are many processes with high risks of bribery.
- The health sector is marked by a high degree of imbalances of information and an inelastic demand for services Vian T, Corruption and the Health Sector, [1].
- Providers have a high degree of discretion when they choose services for patients, which can put patients in a vulnerable position. In most countries, healthcare providers have assumed a cultural role as trusted healers who are above suspicion. We don't like to believe that providers could have conflicts of interest that affect their judgement, but in fact this can be the case [2].
- Systems with direct public provision are prone to low productivity when insulated from competition or external accountability [2].
- Services are also highly decentralised and individualised, making it difficult to standardise and monitor service provision and procurement.
Fraud and corruption occurs in all systems
Fraud and corruption occur whether systems are predominantly public or private, well funded or poorly funded, and technically simple or sophisticated [3].
Fraud and corruption activities can take place in any area of healthcare delivery.
The following processes stand out as having a high inherent risk of corruption [4]:
- provision of services by medical personnel
- human resources management
- drug selection and use
- procurement of drugs and medical equipment
- distribution and storage of drugs
- regulatory systems, and
- budgeting and pricing
Footnotes
- USAID and MSI, 2002; Review of corrutpion in the health sector, Health Policy and Planning 23(2), 2007
- Savedoff DW, memo to Transparency International, 2004
- The European Healthcare Fraud Directory, NHS, 2006
- U4 Anti-Corruption Resource Centre, Corruption in the health sector, U4 issue7:2008