Introduction: Justice in the health system is a fundamental principle of sustainable development in societies, requiring precise assessment tools. This study aimed to design and validate a scale for assessing justice indicators in the Iranian health system.
Methods: A sequential exploratory mixed-methods approach, emphasizing the quantitative part, was used. The tool was designed based on indicators from the qualitative section and validated using face (qualitative and quantitative), content (CVR and CVI), and concurrent validity. Construct analysis was performed through exploratory and confirmatory factor analysis. The research population included 900 clients from health centers affiliated with Shahroud University of Medical Sciences in 2022. Cluster and systematic sampling methods were used, with 889 fully completed questionnaires collected. Data were analyzed using SPSS and LISREL software.
Results: In the qualitative part, nine key dimensions of justice were identified. The tool's validity was confirmed with face, content (CVR and CVI from 0.80 to 1.00 and 0.83 to 0.97, respectively), and concurrent validity. Exploratory and confirmatory factor analyses showed a nine-factor structure with good fit indices (RMSEA=0.040, CFI=0.99). Reliability was confirmed with a Cronbach's alpha coefficient of 0.923.
Conclusion: The scale for assessing justice in the Iranian health system is valid and reliable, suitable for research and policy-making related to justice in the health system. It provides a comprehensive and accurate measurement of justice indicators, crucial for identifying the health system's strengths and weaknesses.