Validation of a Model for Implementing Health System Policies in the Social Security Organization

Abstract

The aim of the present study was to validate a model for implementing health system policies in the Social Security Organization. The present study was quantitative in method and applied in terms of purpose. The statistical population of the study included all managers and senior experts in the field of the health system of the Social Security Organization, totaling 550 individuals, from whom a sample size of 227 was determined. The main instrument for data collection in this study was a researcher-made questionnaire. The research questionnaire consisted of 105 items, and its statements were designed based on a five-point Likert scale. Content validity was used to ensure the validity of the questionnaire. To test the model and examine the relationships among variables, structural equation modeling using the partial least squares approach and SmartPLS version 3 was employed. The results showed that the model fit and predictive indices, including an adjusted R² of 0.601, GOF = 0.425, and Q² = 0.378, indicated appropriate fit and very strong predictive power of the proposed model. The validity and reliability of the constructs were also fully confirmed, with AVE values above 0.5 and CR and Cronbach’s alpha values above 0.7. The findings indicated that the most important challenges in implementing health policies in the Social Security Organization include weakness in the monitoring and evaluation system, shortage of sustainable financial resources, political interference, lack of consolidation of insurance funds, and structural inefficiency. At the same time, the behavioral index, with a mean of 3.62, had the highest status among the indices. Based on the results of the Friedman test, the priorities of the related factors were determined as free and healthy competition, alignment of expertise with duties, and reduction of out-of-pocket payments by the public, respectively. Finally, this model has high executive and policy-making applicability and can be used as an effective basis for transforming health system policies in the country, particularly in the Social Security Organization and other insurance funds.