Purpose: A conservative estimate from the 2009 Global Corruption 
Perceptions Survey suggests that people who paid bribes spent 7 percent 
of their annual income on bribes. Also, every year something like 2-5% of 
the world's total production is exchanged as bribes. According to studies 
conducted in the world, more than 300 billion dollars are spent annually in 
the health and treatment sector, of which an average of ten percent is lost 
in corrupt transactions. High levels of corruption have profound negative 
consequences on society's health and well-being. The above numbers and 
statistics all indicate the existence of an important and undeniable problem 
in organizations and the health system, which causes the budget and 
expenses spent in this sector not to be spent properly and at the target 
location. This issue can leave its bad effects on the health system and the 
beneficiaries in this system (household or consumers, suppliers, providers 
and buyers) and bring negative and destructive consequences.
Materials and Methods: the research method is based on "combined 
approach"; The first phase of the research based on the method of 
"documentary review" and "grounded theory" was carried out by extracting 
corruption variables in the healthcare system. In the second phase, the 
variables were examined through the estimation of "face validity" and the 
consensus of the elites' opinion showed that the metrics have the necessary 
sufficiency to measure the variables of "perception of corruption". In the 
third phase, based on the "survey" method, the questionnaire tool was 
distributed to measure "validity" and "reliability" in the group of citizens 
(as the target group of the healthcare system) and this questionnaire was 
distributed among 130 people who referred to hospitals in Tehran and the 
city.
Findings: In order to validate the items related to citizens' perception of 
corruption in the healthcare system, it was subjected to "exploratory factor 
analysis" to identify the underlying factors in the items. After that, the 
reliability estimation based on the "internal stability" technique was done 
for the items and factors and the items with weak alpha coefficient were 
removed. In the final stage, based on Cronbach's alpha estimation, to 
estimate the "structural validity" of the research tool, a "second-order factor 
model" was designed for citizens' "perception of corruption" and the final 
measurement model was fitted.
Conclusion: Validation of the research tool showed that corruption in the 
healthcare system can be measured with four factors: "financial 
corruption", "interactional corruption", "structural corruption" and 
"supervisory corruption", and the research questionnaire has been 
introduced with 26 items.