Psychometric Analysis of Health System Resilience Scale and Assessing it in the Face of Covid-19 Crisis in Iran

Background and Objectives: The study aimed to analysis the psychometric properties of the health system resilience scale, assessing it and to introduce a conceptual model for qualitative analysis of Iran health system in the face of the civid-19 crisis.   Methods: In this Mixed-method study, the determination of face and content validity was performed using 8 experts. The structure validity was investigated in a cross-sectional study through an electronic survey of 178 actors in the Iran health system. Resilience has been assessed in five dimensions using 5point Likert scale.   Results: The percentage mean score of the Iranian health system resilience in the face of the Covid19 crisis was 41/08 and in the moderate level. The percentage mean score (standard deviation) for 5 dimension include awareness 39/2 (21), diversity 38/7 (21), self-regulation 36 (20/6), integration 39/9 (21/5) and adaptation 41/2 (21/8). Confirmatory factor analysis indicated the appropriate fit of the information with the five-component structure.   Conclusion: The maximum score of resilience dimension belongs to adaptation and the lowest to the self-regulation indicating that it requires interventions to involve the private sector, and to design a new delivery system for crisis situations. The questionnaire can be used as a standard instrument for assessing the health system resilience.