The Effect of Clinical Factor on the Health System Integration

Document Type : Original Article


1 Department of Nursing, Mahabad Branch, Islamic Azad University, Mahabad,

2 Department of Health Services Management, Science and Research Branch, Islamic Azad University, Majlis Research Center, Tehran, Iran



Integration in the health system can improve the coordination and continuity of care for the patient. Clinical integration can facilitate the continuous, comprehensive, and coordinated provision of services at the individual level. This study was conducted to determine the effect of clinical variables on the integration of Iran's health system in 2017–2018.
This is an applied research which has been used in different stages of review, comparative, and quantitative methods in terms of necessity. In the first stage, various patterns of the theory and practice of integration of the health system were studied through library studies. Then, the common and noncommon dimensions of these patterns were set in a comparative table. After determining the variables of various patterns of integration, a questionnaire was developed, and its validity and reliability were confirmed. At the field stage, a survey of 506 experts and management experts of hospitals, data were collected, and exploratory and confirmatory factor analysis was performed.
Based on the results of the exploratory factor analysis in the clinical field, “the development of multifaceted care plans and team meetings” with the highest score of 0.649 was the most important. Regarding the standard coefficients of correlation analysis, the effect of the clinical factor on integration was 0.91. Furthermore, “case management,” “providing continuous care,” and “using protocols and clinical guidelines” with 0.79 factor load are the most important factors in the clinical integration of the health system.
The health system can increase the quality of care through the development of multifaceted care plans and multiple team meetings, the development of coordination and continuity of care, focusing on the needs of patients, and step up the development of integration in the health system.