Document Type : Original Article
Authors
1 Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
2 Bam university of Medical Sciences, Bam, Iran.
3 Department of Health Management, Policy and Economics, Faculty of Management and Medical Informatics Sciences, Kerman University of Medical Sciences, Kerman, Iran
4 Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
Abstract
Background: The Health Transformation Plan (HTP) was launched in May 2014 (Ordibehesht 1393) in hospitals affiliated with the Ministry of Health, with the objectives of financial protection, equity in access, and improvement of service quality. Hospitals, as key units of the health system, require performance evaluation using hospital indicators such as bed occupancy rate, number of surgeries, length of stay, and mortality. This study investigated the factors influencing changes in these indicators in university and non-university hospitals of Kerman University of Medical Sciences.
Methods: A qualitative study employing a content analysis approach was conducted. Semi-structured interviews were held with 22 experts (hospital managers, faculty members, quality improvement specialists, and accreditation experts) from October to December 2023 until data saturation was reached. The data was analyzed using MAXQDA 2020 software.
Results: Fifteen main categories of influential factors were identified. These included: support for chronic and vulnerable patients, reduction in out-of-pocket payments, increase in the number of insured individuals, increase in the elderly population, quality of services, nature of the disease, staff shortages, increase in beds, equipment shortages, tariff changes, referral system, accreditation, major surgeries, and nature of hospital wards/specialties. Solutions proposed included optimizing admission/discharge processes, personnel training, and bed management.
Conclusion: The Health Transformation Plan increased demand but exacerbated supply challenges (resource shortages) and the COVID-19 shock. Strengthening capacity and dynamic management are essential for the sustainability of the achievements
Keywords
)