Developing decision model for the outsourcing of medical service delivery in the public hospitals

BMC Health Services Research

Saeed Shahsavari¹  Aisa Maleki²  Omid Khosravizadeh³  Mohammad Amerzadeh³  Bahman Ahadinezhad³  Nasibeh Mansouran Tazekand⁴ 

[1] Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran;Instructor of Biostatistics, Health Products Safety Research Center, Qazvin University of Medical Sciences, Qazvin, Iran;Health products safety research center, Qazvin University of Medical Sciences, Qazvin, Iran;Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran;Student Research Committee, Qazvin University of Medical Sciences, Qazvin, Iran;

关键词: Outsourcing;    Hospital;    Medical service;    Decision model;   

DOI  :  10.1186/s12913-022-07509-1

来源: Springer

【 摘 要 】

BackgroundThe decision to outsource an activity is one of the most complex organizational decisions. This decision is also influenced by several factors and components. In order to facilitate and optimize it, for the first time in this study, a decision model for outsourcing medical service delivery in public hospitals has been developed.MethodsWe conducted this cross-sectional study in 3 stages: 1) We identified the factors affecting the outsourcing decisions, 2) an expert panel identified the influential factors. After standardization, we distributed 220 questionnaires among university staff managers and heads, nursing managers, and managers of the research units, and 3) Structural Equation Model applied to evaluate the relationship between the variables on AMOS22, at 0.05 significant level.ResultsFindings indicated the optimal level of all fit indices. The path coefficient between all identified factors with the outsourcing decision was positive (t > 1.96). Factors ranging from the most effective to least effective included monitoring and control, service type, human resource, economic and financial, executive capability, external environment, and terms and conditions.ConclusionThe proposed model provides unit evaluation to make the appropriate decision on outsourcing or non-outsourcing. Control and monitoring were the most determining factors. We recommend performing monitoring continuously as a guide and deterrent to error. We also recommend continuous monitoring and control over the quality of outsourced units and stakeholder satisfaction.

【 授权许可】

CC BY