Presenting a Health System Policy Model Based on “the Second Phase of the Revolution” Statement

M. Mohammadi, M. R. Mardani, S. Tootian, E. Sadeh
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Abstract

Background and Objectives: Health system policy is one of the most important issues for policy makers and managers in the health system. This study aims to present a health system policy model based on the statement of “the second phase of the revolution” and using the economic resistance approach. Methods: This is a qualitative study using grounded theory. Participants were selected by purposive and snowball sampling techniques. The data was collected by conducting in-depth and semi-structured interviews with 11 faculty members, deputies, and managers of Arak University of Medical Sciences and Qom University of Medical Sciences in Iran. The concepts for the paradigmatic model were extracted after open, axial, and selective coding. Then, the structural equation modeling was conducted using non-parametric partial least squares method. Results: Initially, 408 codes were obtained, which were reduced to 260 after screening using the content validity index. In this regard, 40 sub-themes and 13 main themes were extracted which included: Causal factors (management issues, human resources management, processes/methods), strategies (priority of prevention over treatment, health resource management, cultural enrichment, promotion of human capital in healthcare, and improvement of methods), intervening factors (economic, social, technological, and political), contextual factors, governance factors, and consequences (promoting the society health, improving economic efficiency of medical universities). Conclusion: The health system policy model based on the economic resistance approach can help promote the society health and improve the economic efficiency of medical universities in Iran.
基于“革命第二阶段”声明提出卫生系统政策模型
背景和目的:卫生系统政策是卫生系统决策者和管理者最重要的问题之一。本研究旨在提出一个基于“革命第二阶段”陈述并采用经济抵抗方法的卫生系统政策模型。方法:采用扎根理论进行定性研究。参与者是通过有目的和滚雪球抽样技术选择的。数据是通过对伊朗阿拉克医科大学和库姆医科大学的11名教员、副校长和管理人员进行深入和半结构化访谈收集的。范式模型的概念分别经过开放编码、轴向编码和选择性编码提取。然后,采用非参数偏最小二乘法对结构方程进行建模。结果:最初获得408个编码,经内容效度指数筛选后减少到260个。在这方面,摘录了40个分主题和13个主要主题,其中包括:原因因素(管理问题、人力资源管理、流程/方法)、策略(预防优先于治疗、卫生资源管理、文化丰富、促进医疗保健人力资本和改进方法)、干预因素(经济、社会、技术和政治)、背景因素、治理因素和后果(促进社会健康、提高医科大学的经济效率)。结论:基于经济抵抗方法的卫生系统政策模型有助于促进社会健康,提高伊朗医科大学的经济效益。
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