شناسایی و رتبه بندی موانع استقرار نظام بودجه ریزی عملیاتی در نظام سلامت اردبیل با متد MADM

Introduction
Operating budget. Is responsible for implementation and creation, but due to various organizational and non-organizational obstacles, it has not been implemented yet. Although the implementation of operational budgeting has been emphasized in the law, so far few organizations, including medical science organizations, have considered the implementation of this system in their organizations and are only able to take the first steps to create it. Are. Operational budget system; But due to the problems facing this project, the above organizations abandoned their work after some time. One of the problems of not implementing this law is the lack of model and research in this field at the national level. Therefore, what has made the researcher interested in this topic is that until now no research has been done in the field of identifying and ranking the barriers to operational budgeting in the health system with the MADM method. This question should be answered, what are the obstacles of establishing operational budgeting system in Ardabil health system? And how is it rated?
Materials and Methods
The mentioned research, in terms of the purpose of an applied research and because it deals with the identification and ranking of obstacles to the establishment of the operational budgeting system in the Ardabil health system with the MADM method in the existing conditions, the current research was in terms of field implementation and in terms of descriptive, analytical and exploratory methods. Descriptive information is usually through Questionnaires, interviews or observations are collected; and in analytical research, he used multi-criteria decision making technique with AHP method. In exploratory research, it is to know the situation about which there is no necessary knowledge, in this research, the statistical community consists of "experts and specialists and managers of financial affairs of Ardabil health system". Saati and Vargas state that the number of 5 to 7 experts in the field of decision-making is sufficient to answer multi-indicator decision-making questionnaires. Therefore, the selected sample is based on the snowball method and the data analysis method in two stages. In this way, 40 people were selected for the first questionnaire (factor screening questionnaire) and 10 people were selected for the second questionnaire (pairwise comparison matrix questionnaire). He used books, articles, theses, etc. to gather information in the field of theoretical foundations and research literature. In the executive part, the researcher conducted an interview to collect data from experts and financial managers of Ardabil Health System, and after the findings of the research, the data was categorized and screened, and a questionnaire was designed and given to the respondents to prioritize and weight the data with pairwise comparisons using the AHP technique. (Experts and specialists of financial affairs of Ardabil health system) is placed. In the first step of this research, a screening questionnaire was used to identify and refine the barriers to establishing operational budgeting with the Delphi technique. In this questionnaire, financial experts were asked to determine the importance of each factor; and in the second stage; a paired questionnaire with AHP technique was designed and used to rank the barriers to establishing operational budgeting in order to determine the priority and rank of each of the barriers. Expert Choice and SPSS software should be used to analyze the research findings.
Discussion and Results
In the surveys carried out, opinions were collected from the statistical community of experts and specialists in the financial affairs of the Ardabil health system. In order to better understand and facilitate the research path, identification obstacles were divided into 6 main categories from the beginning. By conducting intuitive studies and taking advantage of experts, the initial list of obstacles consisting of 82 items was compiled. After determining the statistical population, questionnaires were prepared in order to identify the most important barriers and screen them, and finally, using the Delphi method, 6 main barriers and 22 secondary barriers were included; Obstacles related to planning, 2. Obstacles related to management, 3. Obstacles related to preparation and approval, 4. Obstacles related to credit allocation, 5. Obstacles related to supervision and 6. Obstacles related to training as obstacles to the establishment of operational budgeting system in the system. What are the health of Ardabil to be identified
Conclusions
The results of the research indicate that the obstacles to the establishment of the operational budgeting system include 6 main obstacles, including 1. Obstacles related to planning, 2. Obstacles related to management, 3. Obstacles related to preparation and approval, 4. Obstacles related to credit allocation, 5. Obstacles related to supervision and 6. Barriers related to training and 22 sub-barriers were identified. in obstacles 1; transparent policy with a weighted value of 0.531 and 2 obstacles; Failure to institutionalize the culture of accountability among hospital managers and heads with a weighted value of 0.645 and 3 obstacles; The number of miscellaneous rows and concentrated rows in the budget with a weight of 0.602 and in obstacles 4; Inadequate understanding of how budgetary consequences affect the way of allocating valuable resources with a weight of 0.539 and in 5 obstacles; lack of an efficient internal monitoring system with a weighted value of 0.564 and 6 barriers; The absence of a university course with the title of budgeting with a weight of 0.669 is the most important in the first place.