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Background: Hospital services are the most expensive medical service in modern health care systems. Intense care beds, in particular, are more important. The present study was conducted to design and validate a measuring tool for the factors affecting the distribution of hospitals' intensive care beds in Iran. Methods: In this mixed method study, first, all known factors affecting the distribution of hospitals' intensive care beds were extracted by reviewing related literature. Then, all 60 confirmed items were categorized into different dimensions. Face validity and content validity of the questionnaire was done by 20 medical experts through qualitative and quantitative methods. Validity and reliability indices, content validity index (CVI), content validity ratio (CVR), and Cronbach's alpha were measured. SPSS software were used for data analysis and significance level was set at less than .05. Results: From the 60 suggested items, 34 were confirmed by the expert panels and all items had CVR and CVI scores higher than 0.83 and 0.81, respectively. CVR and CVI for all 34 items were 0.88 and 0.89, respectively. Also, Cronbach's alpha coefficient (0.75) indicated a suitable internal consistency. The value of S-CVI / Ave was also calculated to be 0.92. Conclusion: In this study, a valid tool was designed to identify the factors affecting the distribution of hospitals' intensive care beds. This tool consists of 6 dimensions: demographic, geographic, economic, sociopolitical, organizational, and constructional.
RESUMEN
Introduction: Hospital beds, human resources, and medical equipment are the costliest elements in the health system and play an essential role at the time of treatment. In this paper, different phases of the NEDA 2026 project and its methodological approach were presented and its formulation process was analysed using the Kingdon model of policymaking. Methods: Iran Health Roadmap (NEDA 2026) project started in March 2016 and ended in March 2017. The main components of this project were hospital beds, clinical human resources, specialist personnel, capital medical equipment, laboratory facilities, emergency services, and service delivery model. Kingdon model of policymaking was used to evaluate NEDA 2026 development and implementation. In this study, all activities to accomplish each step in the Kingdon model was described. Results: The followings were done to accomplish the goals of each step: collecting experts' viewpoint (problem identification and definition), systematic review of the literature, analysis of previous experiences, stakeholder analysis, economic analysis, and feasibility study (solution appropriateness analysis), three-round Delphi survey (policy survey and scrutinization), and intersectoral and interasectoral agreement (policy legislation). Conclusion: In the provision of an efficient health service, various components affect each other and the desired outcome, so they need to be considered as parts of an integrated system in developing a roadmap for the health system. Thus, this study demonstrated the cooperation process at different levels of Iran's health system to formulate a roadmap to provide the necessary resources for the health sector for the next 10 years and to ensure its feasibility using the Kingdon policy framework.