Investigating The Structural Factors Affecting Implementation of the ‎Health System Policies in Iran’s Hospitals

Abstract

<strong>Background and Objective:</strong> The main purpose of this study is to identify the structural factors affecting the implementation of policies developed in the health system of the country's hospitals. Most of the developed policies undergo changes in the implementation phase which take them away from realizing their goals.<br /> <strong>Methods: </strong>Data collection method in the first stage was desk research through taking note and in the second stage was field research in which the interview tool was used in the qualitative part and the questionnaire was used in the quantitative part. The statistical population of the research is the heads of medical universities and hospitals. In this study, snowball sampling was used to select the interviewees. For data analysis, grounded theory has been used in the qualitative analysis, and the structural equation method using SPSS and Smart PLS has been used in the quantitative part of the analysis.<br /> <strong>Result</strong>: Findings of this study show that the main components include creation of team and self-governance structures in the organization to implement the policy, existence of performance appraisal system, support of senior managers, decentralized and flexible administrative structure, and formation of horizontal governmental management and managerial stability in public sector in charge of implementing health system policies. In the quantitative part of the research, according to the results of the confirmatory factor analysis of 64 questionnaires, all identified components had a positive and significant effect on the implementation of health system policies.<br /> <strong>Conclusion: </strong>According to the obtained path coefficients, the component of formation of horizontal governmental management has the greatest impact on the implementation of the health system policies of the country. And then, respectively, the components of support of senior managers, decentralized and flexible administrative structure, and existence of a performance appraisal system, creation of team and self-governance structures in the organization have the greatest impact. Finally, the component of managerial stability in the public sector which is responsible for policy implementation has the least impact on the implementation of health system policies of the country.