Abstract
BACKGROUND: Developing countries are increasingly partnering with non-state actors through contracts to improve healthcare access, efficiency, and quality. This paper explores how to design a model for outsourcing non-clinical services in public hospitals. METHODS: In this study, data were gathered through structured online questionnaires. Participants included health policymakers, outsourcing experts, and public hospital managers. Questionnaire validity (CVI = 0.83, CVR = 0.61) was confirmed by 30 experts, with Cronbach's alpha (0.85) ensuring reliability. Data were analyzed using SPSS, LISREL, and factor analysis. RESULTS: Results showed planning, decision-making, performance management, contracts, communication, and knowledge management significantly impacted healthcare outsourcing. Planning had the strongest effect (β=0.94), while knowledge management had the weakest (β=0.34). CONCLUSIONS: The findings guide hospital managers in optimizing non-clinical outsourcing through strategic planning, performance management, contract oversight, and communication. By focusing on these areas, public hospitals in Iran can enhance operational efficiency and improve patient care quality.