Effective factors on the Hospital beds distribution: designing a model for Iran

Hospital beds are one of the most important and most valuable resources of the healthcare system the heterogeneous and inappropriate allocation of these expensive resources around the world has caused to consumption of the resources. The purpose of this research is to design a distribution model of hospital beds in Iran to develop and distribute optimal and cost-effective hospital beds.

This research was descriptive-analytical that has been carried out in a quantitative-qualitative combination in 2020. The research population consisted of 345 persons of health managers and experts in the field of health that was selected through multistage sampling in 5 regions of the country (North, South, Center, West, and East). In total, 23 persons of university experts were selected from each university. A researcher-made questionnaire was used to collect data. To standardize and validate the questionnaire, a qualitative assessment was done using an expert panel and a quantitative assessment was done using content validity ratio (CVR) to assess the face and content validity. Reliability assessment was done by a test-retest method use of Cronbach's alpha and also the exploratory factor analysis with Varimax rotation and AMOS statistical software version 20 and SPSS version 20 was used to determine the validity of the items. Besides, Fit indexes were utilized to determine the fit of the model.

  Based on the content validity ratio, 23 agents were confirmed by the experts from 51 effective identified factors in the questionnaire. The exploratory factor analysis identified five factors including organizational (with 7 parameters), economic (with 4 parameters), social (with 6 parameters), political (with 3 parameters), and geographic dimensions (with 3 parameters) as the main factors of hospital beds distribution, which covered 70.745 percentage of the variance of all variables. The organizational dimension had the highest effect (1.00) and the geographical dimension had the lowest effect (-0.16) on the distribution of hospital beds. Two parameters of social and economic characteristics with a factor load of 0.46 in the social dimension and efficiency and effectiveness of available centers with a factor load of 0.31 in the economic dimension were excluded from the model after conducting a confirmatory factor analysis.

This study confirmed the model of distribution of hospital beds with five organizational, social, economic, political, and geographical dimensions in which organization with high explanatory power has the greatest effect on the distribution of hospital beds. Therefore, using this model seems beneficial as a comprehensive and appropriate method in policy-making and decision-making regarding the development and distribution of hospital beds.