Influence of Bundled Payments for Care Cycles Strategy on the Performance of County Referral Hospitals in Kenya

Abstract

Population health is a core contributor to economic growth of countries, hence the need for countries to develop healthcare systems that yield better healthcare outcomes at affordable costs. The adoption of the value-based healthcare strategies in hospital management is meant to achieve high health outcomes at low costs. The main objective of the study was to determine the influence of bundled payments for care cycles strategy on the performance of County referral hospitals in Kenya. The research was anchored on value-based theory. The study was founded on positivism research philosophy. The study adopted a descriptive research design. The study area was the Lake Region Economic Bloc (LREB) counties in Kenya. The study population was 1400 employees of fourteen (14) county referral hospitals in the Lake Region Economic Bloc. The study adopted the stratified random sampling method, in which the management employees were stratified, and then the respondents were selected randomly within each stratum. The strata consisted of; hospital management board, departmental (top level) management and sub-departmental (middle level) management. The study sample size was four hundred and forty five (405) respondents determined using Yamane formula yielding three hundred and twelve (312) respondents plus a 30% (93) increase to cater for non-response. Primary data was collected using a questionnaire that was dropped and picked after two weeks. Content validity was checked and a content validity index (CVI) of 0.8 was attained, which met the recommended threshold of 0.75. Reliability was tested through a pilot test and an average Cronbach alpha coefficient (α) score of 0.748 was attained, which is above the recommended score of at least 0.7. Data was analyzed using descriptive statistics which include mean, standard deviation, variance, frequency distribution and percentages. For inferential statistics, the study used simple, multiple and hierarchical regression to establish the causal relationships as conceptualized. Pearson correlation was used to test the strength of the relationship between the independent and dependent variables. Data was presented in tables, graphs, pie charts, frequencies and percentages. The findings indicated that there was a significant positive relationship between bundled payments for care cycles strategy and County hospitals performance. The results indicate that 32.9% of the variance in the hospital’s performance, was attributable to bundled payments for care cycles strategy. In theory, policy and practice, the study findings supported the position that county referral hospitals ought to invest in bundled payments for care cycle’s strategy to achieve the outcomes of high quality healthcare services at affordable cost, thus enhanced performance.