Document Type : Research Paper
Department of Public Administration, Semnan Branch, Islamic Azad University
Department of Public Administration, Shahroud Branch, Islamic Azad University,
Background and Objective: The main purpose of this study is to identify the structural factors affecting the implementation of policies developed in the health system of hospitals in Iran. Most of the developed policies undergo changes in the implementation phase which take them away from realizing their goals.
Methods: 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 and the questionnaire in the quantitative parts. The statistical population was presidents of medical universities and heads of hospitals. In this study, snowball sampling was used to select the interviewees. Grounded theory for qualitative, and structural equation modeling through SPSS and Smart PLS were used for quantitative analyses, respectively.
Result: The main components included 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, formation of horizontal governmental management and managerial stability in public sector in charge of implementing health system policies. 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.
Conclusion: 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. 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 had the greatest impact. Finally, the component of managerial stability in the public sector which is responsible for policy implementation had the least impact on the implementation of health system policies of the country.