Authors ' conclusions There is a paucity of evidence regarding how best to reduce corruption .
Promising interventions include improvements in the  detection and punishment of corruption  , especially efforts that are coordinated by an independent agency .
Other promising interventions include guidelines that prohibit doctors from accepting benefits from the pharmaceutical industry , internal control practice s in community health centres , and increased transparency and accountability for co-payments combined with reduced incentives for informal payments .
Key messages The review suggests that some strategies to fight corruption in the health sector can have an effect on corruption .
This study shows that these strategies may have led to fewer patients giving their doctors informal payments ( low certainty evidence ) . •
The study suggests that this may have changed doctors ' attitudes about the influence of pharmaceutical companies on their choice of medicines ( low certainty evidence ) . •
We do n't know what the effects of these strategies have on healthcare or people 's health , or if these strategies had any harmful effects .
Background Corruption is the abuse or complicity in abuse , of public or private position , power or authority to benefit oneself , a group , an organisation or others close to oneself ; where the benefits may be financial , material or non- material .
It is wide-spread in the health sector and represents a major problem .
Objectives Our primary objective was to systematic ally summarise empirical evidence of the effects of strategies to reduce corruption in the health sector .
Our secondary objective was to describe the range of strategies that have been tried and to guide future evaluations of promising strategies for which there is insufficient evidence .
The extent to which increased transparency alone reduces corruption is uncertain .
Interventions to reduce corruption in the health sector What is the aim of this review ?
The aim of this Cochrane review is to assess the effectiveness of strategies to reduce corruption in the health sector .
Corruption can occur in any area of the health sector , and happens when people abuse their own position to benefit themselves , their organisation , or other people close to them .
It can take many forms , including bribes , theft , or giving incorrect or inaccurate information deliberately .
It can take money away from healthcare , lead to poorer quality care and make access to healthcare unfair , and often affects poor people the hardest .
Miscoding: a threat to the hospital care system. How to detect it?
BACKGROUND Artificially influencing the case mix of hospitals may have several deleterious consequences for the hospital care system . One distinguishes over-evaluation ( up-coding ) and under-evaluation ( under-coding ) of the case mix . Apart from its financial consequences , miscoding may cause a fracture in epidemiological time series and , by increasing artificially the severity of illness , may affect the assessment of the quality of hospital care , based on administrative data . METHODS Fixed effects models were used to assess deviant coding behavior  at the hospital level . To do so , we examined the linear evolution over time of characteristics such as length of stay and of 21 " triggering " conditions susceptible to increase the case mix of a stay . In case of deviant coding , these triggering conditions were checked to direct the audit towards fraud-suspected discharge abstract s. Hereto , a method consisting in comparing a single hospital 's linear evolution over time with the national linear evolution over time was developed , using an interaction term between linear evolution over time and hospitals . To test this methodology , fraud-directed audits were carried out in addition to the usual , at r and om audits . RESULTS Important inter-hospital differences in the linear evolution over time of several characteristics of Belgian hospitals were identified , as well as evidence not only of improving coding practice s , but also of up-coding , fraudulent under-coding and of numerous coding errors without financial impact . The coding errors , ascertained in the at r and om audit , result ed in a wrongful gain for the faulty hospitals of 28.23 days in 258 stays , whereas in case of fraud-directed audits these figures amounted up to 642.68 days in 334 stays . CONCLUSION Fraud-directed audit may constitute a valuable tool in the quality assurance of administrative data bases , improving their use in epidemiology and assessment of the quality of care
Authors ' conclusions There is a paucity of evidence regarding how best to reduce corruption .
Promising interventions include improvements in the  detection and punishment of corruption  , especially efforts that are coordinated by an independent agency .
Other promising interventions include guidelines that prohibit doctors from accepting benefits from the pharmaceutical industry , internal control practice s in community health centres , and increased transparency and accountability for co-payments combined with reduced incentives for informal payments .
Key messages The review suggests that some strategies to fight corruption in the health sector can have an effect on corruption .
This study shows that these strategies may have led to fewer patients giving their doctors informal payments ( low certainty evidence ) . •
The study suggests that this may have changed doctors ' attitudes about the influence of pharmaceutical companies on their choice of medicines ( low certainty evidence ) . •
We do n't know what the effects of these strategies have on healthcare or people 's health , or if these strategies had any harmful effects .
Background Corruption is the abuse or complicity in abuse , of public or private position , power or authority to benefit oneself , a group , an organisation or others close to oneself ; where the benefits may be financial , material or non- material .
It is wide-spread in the health sector and represents a major problem .
Objectives Our primary objective was to systematic ally summarise empirical evidence of the effects of strategies to reduce corruption in the health sector .
Our secondary objective was to describe the range of strategies that have been tried and to guide future evaluations of promising strategies for which there is insufficient evidence .
The extent to which increased transparency alone reduces corruption is uncertain .
Interventions to reduce corruption in the health sector What is the aim of this review ?
The aim of this Cochrane review is to assess the effectiveness of strategies to reduce corruption in the health sector .
Corruption can occur in any area of the health sector , and happens when people abuse their own position to benefit themselves , their organisation , or other people close to them .
It can take many forms , including bribes , theft , or giving incorrect or inaccurate information deliberately .
It can take money away from healthcare , lead to poorer quality care and make access to healthcare unfair , and often affects poor people the hardest .