Identifying factors affecting hospital holding administration in Social Security Organization in Iran using Structural Equations Modeling

Introduction: Hospitals, major components of health system, have a high contribution to healthcare resources. Therefore, considering the importance of hospital holding in effective and efficient hospital management, the current study aimed to identify and explain the role and importance of factors affecting hospital holding administration in Iran Social Security Organization. Methods: This was an applied-descriptive study. First, the variables and key factors affecting hospital holding administration were extracted through a literature review and an interview with 15 content experts. Based on the results a questionnaire was developed and distributed among 405 staff and line managers and experts working in the Social Security Organizations in Iran. Data were analyzed by SPSS23 and AMOS24 using exploratory and confirmatory factor analyses Structural Equations Modeling.   Results: Five factors affecting hospital holding administration were identified including strategic planning, financing, decision rights, monitoring and evaluation, and accountability. Financing and decision rights, with factor loadings of 0.83 and 0.44, had the most and least significant effects on Social Security Organization hospital holding administration, respectively. Conclusion: All five factors are required for effective and efficient hospital holdings administration; however, it is recommended to pay more attention to financing and monitoring and evaluation.