Assessment Of Service Quality In Health Insurance Sector A Study With Special Reference To Chennai City

This book is very useful for it is not just ‘descriptive’ in its nature, but ‘prescriptive’, too. It is descriptive in the sense that it describes the process of developing or using a metric in a problem situation, and prescriptive as it clearly prescribes how a beginner can put the theory into practice. In this globalized economy, maintaining quality of products and services has been the thrust area of interest among academicians and practitioners. Today, there are quite a good number of books and research articles available. Nevertheless, service quality measurement has always posed problems, particularly in the context of service industries due to the difficulty in the measurement of the intangibles and implied needs of the customers. The research literature is filled with articles on how to quantify the services, and there are several streams of arguments on the choice of the most ideal approach. However, the research gap lies in the answer to the question: ‘Do these measurement instruments concur in their measurement outcomes or do they give different results in the same situation?’ This book primarily makes an attempt to answer this question through a case study approach. Even though, there are several instruments for the measurement of service quality, the two most widely used instruments are SERVQUAL and SERVPERF metrics. Comprehensively, this book explains the systematic procedure of using both, the instruments in a service sector, and further, the procedure for conducting a statistical analysis so that one will be able to apply the same in any service sector. It then takes the reader through a series of tests in order to compare the two metrics, and to prove statistically if there is the same outcome in a problem situation. The results are sure to surprise the reader, and trigger the “research bent of mind” to undertake a similar study of such metrics and gain mastery over performing an independent research with very minimal guidance from a professional guide. To conclude, this book is sure to provide adequate inputs for a service quality researcher, and answer various questions wriggling in the mind of a beginner of service quality research such as: How shall I start with service quality measurement? How to collect data? How to select a sample? How to conduct a literature review? How to analyse the data? What research methodology is applicable? How to build hypothesis on my research? How to use statistical procedures? How to present the [...]

Ghana National Health Insurance Scheme (NHIS) was established in 2003 as a major vehicle to achieve the country’s commitment of Universal Health Coverage. The government has earmarked value-added tax to finance NHIS in addition to deduction from Social Security Trust (SSNIT) and premium payment. However, the scheme has been running under deficit since 2009 due to expansion of coverage, increase in service use, and surge in expenditure. Consequently, Ghana National Health Insurance Authority (NHIA) had to reduce investment fund, borrow loans and delay claims reimbursement to providers in order to fill the gap. This study aimed to provide policy recommendations on how to improve efficiency and financial sustainability of NHIS based on health sector expenditure and NHIS claims expenditure review. The analysis started with an overall health sector expenditure review, zoomed into NHIS claims expenditure in Volta region as a miniature for the scheme, and followed by identifictation of factors affecting level and efficiency of expenditure. This study is the first attempt to undertake systematic in-depth analysis of NHIS claims expenditure. Based on the study findings, it is recommended that NHIS establish a stronger expenditure control system in place for long-term sustainability. The majority of NHIS claims expenditure is for outpatient consultations, district hospitals and above, certain member groups (e.g., informal group, members with more than five visits in a year). These distribution patterns are closely related to NHIS design features that encourages expenditure surge. For example, year-round open registration boosted adverse selection during enrollment, essentially fee-for-service provider mechanisms incentivized oversupply but not better quality and cost-effectiveness, and zero patient cost-sharing by patients reduced prudence in seeking care and caused overuse. Moreover, NHIA is not equipped to control expenditure or monitor effect of cost-containment policies. The claims processing system is mostly manual and does not collect information on service delivery and results. No mechanisms exist to monitor and correct providers’ abonormal behaviors, as well as engage NHIS members for and engaging members for information verification, case management and prevention.

All the latest national & international current affairs in one Book. EduGorilla's Current Affairs guide covers all of the latest news that is especially likely to come in competitive exams. The book covers the whole year's current affairs with a chapter for each month from January to December 2023. Formulated by current affairs experts for competitive exams, the book is especially designed keeping in mind the topics asked in the current affairs asked in competitive exams. Packed with relevant study material, EduGorilla's Current Affairs are a sure-shot way to assured success. With the help of this guide, candidates can stay up to date with all the latest news. A must have for last-minute revisions and complete current affairs preparations.

This report presents a policy- and methodology-oriented discussion of factors involved in developing and analyzing quality assurance in European health care. Data are taken from research literature and interviews with representatives of national health authorities, professional organizations, and research and educational institutions. The first chapter of this report discusses a suggested conceptual framework, for a program of health care quality assurance, derived from evaluative research and industrial quality control. The second, third, and fourth chapters deal with three major variables in the framework: environment, conceptualization, and methodology. Examples of different approaches to quality assurance are given, and sources of information and measurement instruments and criteria are examined. The fifth chapter presents conclusions concerning the trends and state of quality assurance in health care. A bibliography of 179 items is appended. (FG)

"This book is a reference source for the latest research on emerging tools and methodologies for the design of healthcare models, providing expert analyses on trouble-shooting specific problems in the industry and creating optimal hospital environments"--