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Coordination between hospitals and insurers in developing economies: an interpretive structural modeling approach

Manimay Dev (Department of Production and Industrial Engineering, National Institute of Technology Jamshedpur, Jamshedpur, India)
Dinesh Kumar (Department of Production and Industrial Engineering, National Institute of Technology Jamshedpur, Jamshedpur, India)
Dharmendra Patel (Department of Production and Industrial Engineering, National Institute of Technology Jamshedpur, Jamshedpur, India)

International Journal of Pharmaceutical and Healthcare Marketing

ISSN: 1750-6123

Article publication date: 29 May 2020

Issue publication date: 10 December 2020

133

Abstract

Purpose

The purpose of this paper is to identify the factors that influence hospitals’ selection by health-care insurers in India and to establish a hierarchical model representing the relationship among different factors and their influence on the entire scenario.

Design/methodology/approach

A survey with a set of questionnaires was conducted with different health-care insurer executives of reputed health insurance companies. The data has been gathered by using a five-point Likert scale. Their opinions were converted into a reachability matrix and an interpretive structural modeling was constructed. The final results obtained were verified by using fuzzy Matriced Impacts Croises-Multiplication Applique and Classement analysis.

Findings

The results suggested three key driving factors, National Accreditation Board for Hospitals & Healthcare Providers accreditation of the hospital, purchasing power of people in the region and national and international recognition of the hospital among the eleven factors selected for the study.

Research limitations/implications

The research mainly focuses on the health insurance benefits provided by privately owned insurance companies and do not comment on any government’s mass health insurance scheme.

Practical implications

With a small proportion of people under the umbrella of health insurance in India, these factors will assist and expedite insurer’s effort to penetrate deep into rural and urban areas enhancing availability and escalating affordability.

Originality/value

This paper presents key factors responsible for better coordination between health-care systems and insurance companies.

Keywords

Acknowledgements

The authors would like to express thanks of gratitude to the insurance experts, consultants and academicians who participated in the survey and gave their valuable time and feedback. They would also like to extend their sincere thanks to members of their Institute’s Department for their support.

Citation

Dev, M., Kumar, D. and Patel, D. (2020), "Coordination between hospitals and insurers in developing economies: an interpretive structural modeling approach", International Journal of Pharmaceutical and Healthcare Marketing, Vol. 14 No. 3, pp. 471-490. https://doi.org/10.1108/IJPHM-10-2019-0068

Publisher

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Emerald Publishing Limited

Copyright © 2020, Emerald Publishing Limited

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