Functional-Informational Factors Affecting Health System Integration

Integration in the health system has many benefits for patients, providers, and the system itself. This research was conducted to determine the functional and informational variables affecting the integration of Iranian health system in period of years 2017-18. The present exploratory study was conducted in two phases. In the first phase, factors affecting health system integration were extracted from the literature as well as from interviews with experts in healthcare administration. In the second phase, data from the first phase were integrated, and a model of health system integration was designed resulting in a researcher-made questionnaire. The model was validated through qualitative (i.e., expert opinion), and quantitative (i.e., exploratory and confirmatory factor analysis) approaches. The data were collected from 506 specialists in hospitals in 5 provinces of Iran. Exploratory and confirmatory factor analysis was used to analyze the data. According to the results of exploratory factor analysis in the functional-information dimension, "information management" was the most important item with 0.665 of factor load. Regarding the standard coefficient of confirmatory factor analysis, the effect of the functional-information factor on integration was 0.95. The existence of a referral system, the existence of a decision supporting system, and the management of financial resources, also had the greatest importance in the integration of the health system with 0.79 of factor load. The health system can provide the necessary support for health system integration through management of financial, human, and information resources, as well as the development of information systems and electronic health records, and performance monitoring. It can also integrate clinical, financial, and management information in order to improve the quality of care.