چالش‌های اثرگذار بر طرح تحول نظام سلامت از دیدگاه کارمندان و مدیران بیمارستان‌های استان تهران

Background: Today, the health system in Iran is struggling with many challenges. Therefore, this study aimed to analyze the challenges affecting the health system development plan from the perspective of hospital managers and employees in Tehran province. Methods: The present study was applied in terms of the purpose, and in terms of data collection method, was survey. The statistical population in this study included Tehran province hospital employees and managers. The sample size according to community sampling formula was 384, using cluster sampling. The data collection tool was a researcher-made questionnaire. The reliability of the questionnaire was confirmed by Cronbach's alpha coefficient. The validity of the questionnaire was confirmed using convergent validity. In analyzing data, single-sample t-test for checking the status of variables, confirmatory factor analysis, and also structural equation modeling method for measuring the fit of the research model and examining hypotheses using SPSS 22 and Amos 22 software. Results: The findings of the study indicate that educational factors with a regression coefficient of 5.18, service quality with a regression coefficient of 6.93, financial support with a regression coefficient of 3.35 and communication clarity with a 1.49 regression coefficient on health promotion plan, at 95 % confidence level, have a significant effect. Conclusion: The results show that training, The quality of services, financial support, and clarity of communication are the key factors in solving the challenges in the development of the health system in hospitals and treatment centers.