Evaluation of military healthcare organization's structure models in asymmetric warfare

Organizational structure has key role in the implementation of organizational goals and strategies. The purpose of this study was to provide a military healthcare structure model based on the characteristics of asymmetric in order to achieve a proper organizational structure. This mixed method study was conducted in 2009. The qualitative phase was done by in-depth interviews with 18 top managers of the healthcare system who were selected by purposeful sampling. Qualitative data were evaluated by qualitative content analysis. Then, structural models were established by focused group discussion. In the quantitative phase, the opinions of 95 military healthcare senior executives were compared considering flexibility, accuracy, decision-making and compatibility of the structural models with asymmetric war. Four organizational structure models were extracted. The “Staff-base” model gained the highest score (68.5% and 63.8% respectively) in the field of flexibility and accuracy and the “Command-base” model gained the highest score (76.3%) in the field of decision-making. There was significant relationship among all mentioned fields (p=0.007, 0.003, 0.023). Investigating the overall compatibility with asymmetric war, there was no significant relationship between the four models (p=0.9), but the “focused” model gained the maximum score (61.6%). Although there isn’t complete agreement on a specified structure to ensure all needs of asymmetric war conditions, the “command-based” structures seems more appropriate due the high speed of decision-making.