Influential Factors on Strategic Purchasing of Healthcare Services in Iranian Social Security Organization- Indirect Healthcare Sector

The Goal of the present study was to determine the influential factors on strategic purchasing of healthcare services by of Iranian Social Security Organization (ISSO) as the largest purchaser of healthcare services in Iran. In order to achieve the above goal the literature was reviewed to explore the relevant theories and models, as well as the important factors for the strategic purchasing in healthcare services. In this review however the main focus was put on the experiences gained by countries such as England, Germany, Portugal, Estonia, Australia and New Zealand.After reviewing the theories, models, and the available statistics in this area, a questionnaire was developed to seek the view point of the Iranian Social Security Organizationʹs key managers, and personnel about the important influential factors on strategic purchasing of health care services in indirect healthcare system of ISSO. The questions were measure using a 5 point Likert scale (where 5= totally agree, and 1= totally disagree). An exploratory and a confirmatory factor analysis were used to analyze the data.The findings indicated that nine variables such as 1- purchasing priority, 2- allocating resources, 3- payment mechanism , 4- organization structure, 5- price, 6- contract, 7- providers, 8- service utilizers, and 9- purchasing strategy were effective in strategic purchasing of healthcares services from investigated subjectsʹ point of view. These variables, however clustered themselves around two factors in exploratory factor analysis, and explained 62.9 % of the total variance of strategic purchasing of healthcare services or were explained by two underlying traits in confirmatory factor analysis. These traits were called procedures and contextual factor. "Procedures" factor reflects the approach or pattern by which the ISSO chooses to purchase healthcare services for the insured individuals, and it showed to have three elements - variables 1-3 stated in above."Contextual" factor is viewed as the context in which the purchasing occurs in, and it contains five variables such as variable 4- 9 stated in above. General conclusion is that for strategic purchasing of healthcare services at least nine different factors play an important role and needs to be taken under consideration by the ISSO.