利益相关者对实施居家医院项目必要要求的看法：一项定性研究
Stakeholders' perspectives on the necessary requirements of implementing the Hospital-at-Home program: a qualitative study.
作者信息
Kheiry Fatemeh, Rakhshan Mahnaz, Mosadeghrad Ali Mohammad, Jahanmehr Nader, Hazrati Maryam
机构信息
Student Research Committee, Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
Community Based Psychiatric Care Research Center, Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
出版信息
BMC Health Serv Res. 2025 May 8;25(1):656. doi: 10.1186/s12913-025-12800-y.
BACKGROUND
Hospital at Home (HaH) is an effective solution to address the challenges in healthcare systems; however, the inherent complexities of this program have created obstacles in implementing it. This study was conducted to explore the perspectives of managers and policymakers in the Iranian healthcare system on the necessary requirements for the implementation of the HAH program.
METHODS
This qualitative study was conducted from December 2023 to June 2024. The 14 participants consisted of health policymakers, faculty members, and hospital managers from Tehran and Shiraz universities of medical sciences. The participants were selected by purposive sampling. Data were collected through semi-structured individual interviews. Data analysis was conducted using conventional content analysis.
RESULTS
Following data analysis, 652 initial codes were extracted, which were subsequently classified into 7 categories and 2 themes. The themes were "alignment of macro-level mechanisms in supporting the HaH program" and "organizing the HaH program within the healthcare system".
CONCLUSIONS
The study highlights that successful implementation of the HaH program in Iran is influenced by economic, legal, and socio-cultural factors, as well as the policies of the Ministry of Health and Medical Education (MOHME). Addressing the challenges in these areas requires a comprehensive and integrated approach. Additionally, the program's success depends on development of precise structures within the healthcare system, which involves configuring this program within the healthcare service processes, executive support from managers and beneficiary healthcare centers, and the development of essential infrastructure. The findings provide valuable insights for managers, policymakers, and stakeholders, offering guidance on the design and implementation of the HaH program as a supplement to routine healthcare services.
背景
居家医院（HaH）是应对医疗系统挑战的有效解决方案；然而，该项目固有的复杂性在实施过程中造成了障碍。本研究旨在探讨伊朗医疗系统中管理人员和政策制定者对实施居家医院项目必要要求的看法。
方法
本定性研究于2023年12月至2024年6月进行。14名参与者包括来自德黑兰和设拉子医科大学的卫生政策制定者、教员和医院管理人员。参与者通过目的抽样法选取。通过半结构化个人访谈收集数据。使用常规内容分析法进行数据分析。
结果
数据分析后，提取了652个初始编码，随后将其分为7类和2个主题。主题为“支持居家医院项目的宏观层面机制的协调一致”和“在医疗系统内组织居家医院项目”。
结论
该研究强调，伊朗居家医院项目的成功实施受经济、法律和社会文化因素以及卫生和医学教育部（MOHME）政策的影响。应对这些领域的挑战需要全面综合的方法。此外，该项目的成功取决于医疗系统内精确结构的发展，这包括在医疗服务流程中配置该项目、管理人员和受益医疗中心的行政支持以及基本基础设施的发展。研究结果为管理人员、政策制定者和利益相关者提供了宝贵的见解，为居家医院项目作为常规医疗服务补充的设计和实施提供了指导。
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