肯尼亚医疗保险公司电子索赔系统性能的全面质量管理:以肯尼亚国家健康保险基金为例

Strategic Journal of Business & Change Management Pub Date : 2023-09-02 DOI:10.61426/sjbcm.v10i3.2710

LAURA ECHULET, LUCY KIRIMA, PhD, MOSES OWINO, PhD, FREDRICK OBUNGA

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引用次数: 0

摘要

本研究旨在探讨全面质量管理对肯尼亚医疗保险公司电子理赔系统绩效的影响;肯尼亚的NHIF病例。具体目标是建立领导力对肯尼亚医疗保险公司电子索赔系统绩效的影响;评估培训对肯尼亚医疗保险公司电子索赔系统绩效的影响，并检查团队合作对肯尼亚医疗保险电子索赔系统绩效的影响。研究的具体目标由三个变量指导:领导实践、培训干预和团队合作活动。本研究以公共价值理论和利益相关者理论为指导，为研究变量提供信息。本研究采用描述性研究设计，因为本研究旨在收集定量和定性数据，描述肯尼亚医疗保险公司TQM和电子索赔系统绩效的影响。目标人群包括从国民健康基金抽取的300名雇员。研究样本量依赖于原始数据收集。数据分析采用定量技术、描述性统计(均值和标准差)、推理统计(Pearson相关和回归分析)以及社会科学统计软件包(SPSS 21.0版)建立回归模型。研究发现，领导实践、培训干预、团队活动与电子理赔系统绩效之间存在显著的正相关关系。研究建议，政府应协助制订政策和法律，规管以提供服务为主要任务的公营机构，以确保向顾客提供优质服务。研究进一步表明，应进行进一步的研究，以确定其他全面质量管理实践对医疗保险索赔系统绩效的影响程度。还应对私营保险公司进行进一步的研究，以便进行比较分析。关键词:全面质量管理，领导力，培训与团队合作，绩效引用:Echulet, E.， Kirima, L.， Owino, M.， &;奥本加，F.(2023)。肯尼亚医疗保险公司电子索赔系统性能的全面质量管理:以肯尼亚国家健康保险基金为例。商业战略杂志;管理学报，2010(3)，347 - 366。

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TOTAL QUALITY MANAGEMENT ON PERFORMANCE OF ELECTRONIC CLAIMS SYSTEMS IN MEDICAL INSURANCE FIRMS IN KENYA: A CASE OF NATIONAL HEALTH INSURANCE FUND, KENYA

........................................................................................................................................................ xi DEFINITION OF TERMS ................................................................................................................................. xii LIST OF ABBREVIATIONS ............................................................................................................................ xiii CHAPTER ONE ...................................................................................................................................................

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Strategic Journal of Business & Change Management

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