Developing decision model for the outsourcing of medical service delivery in the public hospitals

Abstract Background: The decision to outsource an activity is one of the most complex organizational decisions. This decision is also infuenced by several factors and components. In order to facilitate and optimize it, for the frst time in this study, a decision model for outsourcing medical service delivery in public hospitals has been developed. Methods: We conducted this cross-sectional study in 3 stages: 1) We identifed the factors afecting the outsourcing decisions, 2) an expert panel identifed the infuential factors. After standardization, we distributed 220 questionnaires among university staf managers and heads, nursing managers, and managers of the research units, and 3) Structural Equation Model applied to evaluate the relationship between the variables on AMOS22, at 0.05 signifcant level. Results: Findings indicated the optimal level of all ft indices. The path coefcient between all identifed factors with the outsourcing decision was positive (t>1.96). Factors ranging from the most efective to least efective included monitoring and control, service type, human resource, economic and fnancial, executive capability, external environment, and terms and conditions. Conclusion: The proposed model provides unit evaluation to make the appropriate decision on outsourcing or non-outsourcing. Control and monitoring were the most determining factors. We recommend performing monitoring continuously as a guide and deterrent to error. We also recommend continuous monitoring and control over the quality of outsourced units and stakeholder satisfaction. Keywords: Outsourcing, Hospital, Medical service, Decision mode