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

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

Abstract


This study established the effect of TQM on performance of E-Claims Systems in medical insurance firms in Kenya; a case of NHIF, Kenya. The specific objectives were to establish the effect of leadership on performance of E-Claims systems in medical insurance firms in Kenya; to assess the effect of training on performance of E-Claims system in medical insurance firms in Kenya and to examine the effect of teamwork on performance of E-Claims Systems in medical insurance in Kenya. The specific objectives of the study were guided by three variables: leadership practices, training interventions and teamwork activities. The study was guided by Public Value Theory and Stakeholders Theory which informed the study variables. The study adopted descriptive research design because the study was intended to gather quantitative and qualitative data, which described the effect of TQM and performance of E-Claims System in medical insurance firms in Kenya. The target population consisted of 300 employees drawn from NHIF. The study sample size relied on primary data collection. Data was analyzed using quantitative technique, descriptive statistics (mean and standard deviation), inferential statistics (Pearson correlation and regression analysis) as well as statistical package of social sciences (SPSS version 21.0) to develop regression model for the study. The study findings established that there is significant positive relationship between leadership practices, training interventions, teamwork activities and performance of E-Claims Systems. The study recommended that government should help in formulating policies and laws that govern public sector organizations whose main mandate is service delivery to ensure quality of service to customers. The study further indicated that further studies should be undertaken to determine the extent of how other total quality management practices can influence performance of the e claims systems in medical insurance. Further studies should also be done in the private insurance firms for comparative analysis.

Key Words: Total Quality Management, Leadership, Training and Teamwork, Performance 

CITATION: Echulet, E., Kirima, L., Owino, M., & Obunga, F. (2023). Total quality management on performance of electronic claims systems in medical insurance firms in Kenya:  A case of National Health Insurance Fund, Kenya. The Strategic Journal of Business & Change Management, 10 (3), 347 – 366. 


Full Text:

PDF

References


Adong, O. (2021). Leadership style, teamwork and performance of national water and sewerage corporation (NWSC) projects (Doctoral dissertation, Makerere University, Business School).

Aghimien, D., Aigbavboa, C., Thwala, W., & Mothiba, H. (2019). Total Quality Management Practices in Construction Project Delivery in Outh Africa. In IOP Conference Series: Material Science and Engineering, 640 (1), 12-104.

Al Idrisi, A., & Ozutler, H. (2021). The Impact of Quality Management on the Project Performance of SMEs: A Case Study in Tripolibya. Suleyman Demire Universities Iktisadi be Idari Bilimler Fakuitesi Dergisi, 26 (4), 391-411.

Alawode, G., & Adewole, D. (2021). Assessment of the design and implementation challenges of the National Health Insurance Schemes in Nigeria: a qualitative study among sub-national level actors, healthcare and insurance providers. BMC Public Health , 21 (1), 1-12.

Alshrbaji, M., Mohammed, M., & Shamayleh, A. (2022). The Impact of Total Quality Management and Perceived Service Quality on Patient Satisfaction in Healthcare: A Systematic Review. In 2022 Advances in Science and Engineering Technology International Conference (ASET), 1-6.

Amunga, J., & Musasia, A. (2021). The Gender Stem Gap and its Impact on Sustainable Development goals and the Big Four Agenda in Kenya: A Synthesis of Literature. International Journal of Contemporaru Educaktion , 4 (1), 1-12.

Angole, J., & Akello Abal, J. (2022). Training and Organizational Performance: A Case of Education Service Sector in Lira District Local Government.

Berber, N., Slavic, A., & Aleksic, M. (2020). Relationship between perceived teamwork effectiveness and team performance in banking sector of Serbia. Sustainability, 12 (20), 8753.

Bryman, A. (2016). Social Research Methods. Oxford University Press.

Bryman, A., & Bell, E. (2015). Business research methods. USA: Oxford University Press.

Cao, N. (2018). Application of project quality management to increase the successful rate of car project: a case study in China. International Journal of Services Technology and Management, 24 (3), 246-262.

Chen, Y., & Chong, O. (2021). Using the Best Value Approach to Improve Construction Project Performance in the Chinese Construction Industry. Journal for the Advancement of Performance Information and Value, 13 (1), 47.

Creswell, J., & Creswell, J. (2017). Research design: Qualitative, quantitative, and mixed methods approaches. USA: Sage publications.

Ejike, I., & Nelson, U. (2021). Teamwork and Organizational Performance in Nigeria (A Study of Nigeria Bottling Company, Owerri, Imo State).

Garg, G., & Kothari, C. (2014). Research Methodology, Methods and Techniques. New Delhi, India: New Age International Publishers

Ibrahim, A., & Daniel, C. (2019). The Effect of Total Quality Management on Project Management. European Journal of Business and Management, 222-1905.

Kabirfar, K., & Mojtahadi, M. (2019). The Impact of Engineering, Procurement and Construction (EFC) phases on project performance: A case of large scale residential construction projects. Building , 9 (1), 15.

Kanapathipillali, K. (2021). The Impact of Training and Innovation on Organizational Performance in the Hospitality Industry in Malaysia: Job Satisfatcion as Mediator. European Journal of Human Resource Management Studies , 5 (2).

Karimi, A., & Pimplikar, S. (2020). Quality Management System (QMS) at Residential Construction Project.

Kassahun, E. (2021). The Effect of Leadership Styles on Project Performance: A Case of Ethiopian Road Authority (ERA) (Doctoral dissertation, St. Mary's University).

Khwae, G., & Amoozegar, A. (2021). Examining the Importance of Organizational Culture, Employee Commitment and Leadership on Project Performance of Organizations in Malaysia.

Kwarteng, A., Akazili, J., Welaga, P., Dalinjong, P., Asante, K., & Sarpong, D. (2020). The state of enrollment on the National Health Insurance Scheme in rural Ghana after eight years of implementation. International journal for equity in health , 19 (1), 1-14.

Marshall, A., Witthayapipopsakul, W., Chotchoungchatchai, S., Wangbanjongkun, W., & Tangcharoensathien, V. (2022). Contracting the Private Health Sector in Thailand's Universal Health Coverage. medRxiv .

Mugenda, O., & Mugenda, A. (2013). Research Methods, Quantitative and Qualitative Approaches. Nairobi: Acts Press.

Mungai, P. (2021). Private Public Partnership and Project Performance of Commercial State Corporations in Kenya.

Mutole, J. (2019). Influence of strategic leadership practices on the performance of Non-Governmental organizations listed in the environmental campaign by United Nations Environmental Programme (UNEP) in Kenya (Doctoral dissertation, JKUAT-COHRED).

Mwendwa, C. (2021). Strategic Leadership Practices and Performance of Standard Group Plc (Doctoral dissertation, University of Nairobi).

Newaz, A., Sikder, A., Rahman, M., & Uluagac, A. (2021). A survey on security and privacy issues in modern healthcare systems: Attacks and defenses. ACM Transactions on Computing for Healthcare , 2 (3), 2-44.

Ngala, F. (2018). Students' Perception of Quality of Lecture Hall Resources Used in Teacher Education Programmes in the Universities in Nakuru County, Kenya. Kabarak Journal of Research & Innovation , 5 (2), 115-132.

Njang'iru, A., Muhoho, J., & Abayo, R. (2020). Influence of quality management on cost performance of construction projects: A case of lifts and escalators companies in Kenya. In M Radujkovic and M Sjekavica 2017 June Project Management Success Factors Creative Construction Conference 2017 Primosten Croatia 19- International Academic Journal of Information Sciences and Project Management , 3 (6), 84-99.

Njeri, N., & Ngufi, P. (2021). Role of Conflict Resolution on the Performance of a Project Team in Kiambu County, Kenya.

Olufayo, B., & Akinbo, T. (2021). Training gap identification as determinants of employees' job performance in gas and energy company in delta state, nigeria. Journal of Human Resource Management , 9 (4), 108-119.

Oyetunji, A., Adebiyi, J., & Olatunde, N. (2019). Leadership behaviour and worker performance in the Nigerian construction industry. The Journal of Values-Based Leadership , 12 (2), 13.

Park, Y., & Canaway, R. (2019). Integrating traditional and complementary medicines with national healthcare systems for universal health coverage in Asia and the Western Pacific. Health Systems & Reforms , 5 (1), 24-31.

Saints, G. (2018). Characterizing the quality journey of total quality management in relation to the financial performance of SMEs under crisis conditions: the case for Greece.

Samwel, J. (2018). Impact of employee training on organizational performance-case study of drilling compnaies in geita, shinyanga and mara regions in tanzania. International Journal of Managerial Studies and Research , 6 (1), 36-41.

Sila, J., & Gakobo, J. (2021). Material Management and Project Performance of Construction Companies in Nairobi City County, Kenya. International Academic Journal of Information Sciences and Project Management , 3 (6), 368-391.

Wangui, O. (2018). Effect of total quality management practices on operational performance of food manufacturing firms in Nairobi County, Kenya (Doctoral dissertation, Egerton Univerisity).

Wanjogu, B., & Waithaka, P. (2021). Total Quality Management and Organizational Performance of Deposit Taking Micro Finance Institutions in Nyadarua County, Kenya. International Journal of Business Management, Entreprenuership and Innovation, 3 (1), 121-135.

Yap, J., Leong, W., & Skitmore, M. (2020). Capitalising teamwork for enhancing project delivery and management in construction: Empirical study in Malaysia. Engineering, Construction and Architectural Management, 27 (7), 1479-1503.

Yuniarti, Y. (2022). The Effects of Education and Training Program, Facilities and Infrastracture Completeness, Organizational Support on Employee Performance Through Satisfaction as Variable Mediation. Budapest International Research and Critics Institute (BIRCI-Journal): Humanities and Social Sciences, 5 (2).




DOI: http://dx.doi.org/10.61426/sjbcm.v10i3.2710

Refbacks

  • There are currently no refbacks.


Creative Commons License
This work is licensed under a Creative Commons Attribution 3.0 License.

PAST ISSUES:
20242023202220212020201920182017201620152014
Vol 11, No 2 [2024]Vol 10, No 4 [2023]Vol 9, No 4 [2022]Vol 8, No 4 [2021]Vol 7, No 4 [2020]Vol 6, No 4 [2019]Vol 5, No 4 [2018]Vol 4, No 4 [2017]Vol 3, No 4 [2016]Vol 2, No 2 [2015]Vol 1, No 2 [2014]
 Vol 11, No 1 [2024] Vol 10, No 3 [2023] Vol 9, No 3 [2022]Vol 8, No 3 [2021]Vol 7, No 3 [2020]Vol 6, No 3 [2019]Vol 5, No 3 [2019]Vol 4, No 3 [2017]Vol 3, No 3 [2016]Vol 2, No 1 [2015]Vol 1, No 1 [2014]
  Vol 10, No 2 [2023] Vol 9, No 2 [2022]Vol 8, No 2 [2021]Vol 7, No 2 [2020]Vol 6, No 2 [2019]Vol 5, No 2 [2018]Vol 4, No 2 [2017]Vol 3, No 2 [2016]  
  Vol 10, No 1 [2023] Vol 9, No 1 [2022]  Vol 8, No 1 [2021]Vol 7, No 1 [2020]Vol 6, No 1 [2019]Vol 5, No 1 [2018]Vol 4, No 1 [2017]Vol 3, No 1 [2016]   


Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.