Background and Objectives: Social Security Organization (SSO) provides healthcare services to the insured directly and indirectly. The purpose of this study was performance trend analysis of direct and indirect treatment of the SSO over the past 25 years and examining the correlation between them.

Materials and Methods: In this descriptive study that required data were obtained from SSO website, trend of direct and indirect treatment sectors performance of SSO was analyzed during the past 25 years (1993 to 2018) using Dynamic Multiple Attribute Decision Making (DMADM) with the help of Excel 2010 software by considering each year as an alternative and 21 key attributes that weights were determined using Entropy method. Also, Pearson correlation coefficient between direct and indirect treatment performance was calculated with the help of SPSS 16 software.

Results: The trend of both types of treatment was incremental until 2007, then direct treatment was decreasing, but indirect treatment up to 2013 had a decreasing trend and after that had an increasing trend. The correlation coefficient of Pearson was equal to 0.912 until 2013 and from 2013 onwards equal to -0.991 (p-value ≤0.05 for both) which shows a direct, strong and significant relationship between the performance of direct and indirect treatment up to 2013 and strong, significant and inverse relationship afterwards.  

Conclusions: According to the results of data analysis, it seems that new strategy of SSO has been providing more healthcare services indirectly by healthcare purchasing from government and private sectors.