Factors Affecting Hospital Network Management in the Social Security Organization of Iran

Background: Hospitals are considered the most important consumer units in the health system. Based on the effect of the hospital network in optimal and efficient hospital management, this study aimed to identify and explain the role of factors influencing hospital network management in the Iranian Social Security Organization (ISSO). Methods: This study was conducted by a mixed method in 2018. First, variables and factors affecting the management of hospital networks were extracted from the literature review and through interviews with 15 experts, and a questionnaire with 40 questions was developed. Then, it was distributed among 448 experts in the healthcare section of the ISSO all over the country, and 405 questionnaires were completed and collected. Data were analyzed via exploratory and confirmatory factor analysis and structural equations using SPSS23 software and AMOS24 software. The validity of the questionnaire was determined via expert judgment (CVRs = 0.40) and reliability was estimated by Cronbach's alpha coefficient (α = 0.87). Results: Based on the confirmatory factor analysis, financing, monitoring and evaluation, accountability, strategic planning, and decision rights were identified as key factors affecting hospital network management. Financing with standard coefficients of 0.83 had the highest and decision rights with standard coefficients of 0.44 had the lowest effect on hospital network management of the ISSO. Conclusion: To efficient hospital network management of the ISSO, while emphasizing all identified factors, special attention should be paid to financing and modifying the method of budgeting and using suitable monitoring and evaluation mechanisms.