Effects of Out-Of-Pocket Payment, Money Value on Insurance Claims and Patient Case Mix Index on Revenue Generation among Not-For-Profit Hospitals in Kisumu County, Kenya

Weisiko Innocent Alvin, Dr. Scholastica Odhiambo, Dr. Yasin Ghabon — Mon, 28 Apr 2025 00:00:00 +0000

Purpose: Effective revenue cycle has become crucial in today's hospital business environment. Hospitals are confronted with stricter regulations and billing requirements, more thorough preauthorization, and precertification, underpayments and greater delays in payments. This study provided an analysis of the determinants of revenue generation with key focus on out-of-pocket spending, money value of insurance claims and patient case mix index among not-for-profit hospitals in Kisumu County.

Methods: The study utilized Baumol’s model of sales maximization. A correlational research design was employed and secondary panel data was used from revenue statements of 39 not-for-profit hospitals in Kisumu County for the period 2019-2023. Data was analyzed using descriptive statistics and regression analysis and presented in the form of tables.

Results: A positive and significant relationship was found between out-of-pocket payments (β=0.259, P =0.002), monetary value on insurance claims (β=0.169, p=0.031), outpatient revenue (β= 0.152. P=0.031), inpatient revenue (β=0.244, P=0.000) and revenue generation.

Conclusion: The study concluded that when patients pay more out-of-pocket, more revenue is realized by hospitals. More insurance claims by the hospitals resulted in more revenue and the patient case mix index has a positive and significant relationship with revenue generation among Not-For-Profit Hospitals in Kisumu County. The study recommended that not-for-profit hospitals should encourage more patients to subscribe for health insurance coverage; a mix of inpatient and outpatient index be allowed as they both contribute to increased revenue generation; and the government should formulate policies that will guide the not-for-profit hospitals to come up with standardized charges to ensure they remain financially sound while providing quality and affordable services.

Determinants of Manufacturing Sector Growth in the East African Community

Wako Ibrahim Kisu, Micheal Samanya, Nakalembe Immaculate — Tue, 03 Jun 2025 00:00:00 +0000

This study examined the factors influencing manufacturing sector growth in East African Community (EAC) member states from 2001 to 2021, focusing on inflation, Foreign Direct Investment (FDI), lending rates, and Domestic Credit. Panel data was utilized. Results indicate that inflation and lending rates significantly impact manufacturing sector growth, while Domestic Credit and FDI do not show significant effects. The study highlights the importance of maintaining macroeconomic stability through effective inflation control measures and sound monetary policies to facilitate manufacturing sector growth. The report also stresses the necessity of steady and affordable loan rates for manufacturers, which can be attained through focused interventions and rewards for financial institutions. Attracting FDI to the manufacturing sector remains crucial, and governments should actively pursue such opportunities. Continued research is recommended to deepen our understanding of the complexities surrounding manufacturing sector growth. These actions collectively aim to bolster industrialization and economic growth in EAC member states, ultimately promoting prosperity throughout the region.

Journal of Economics

Effects of Out-Of-Pocket Payment, Money Value on Insurance Claims and Patient Case Mix Index on Revenue Generation among Not-For-Profit Hospitals in Kisumu County, Kenya

Determinants of Manufacturing Sector Growth in the East African Community