Document Type : Original Article


1 Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Department of Health Economic and Management Sciences, Health School, Mashhad University of Medical Sciences, Mashhad, Iran

2 Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Health Care Management, Health Policy and Health Economic Department, Faculty of Management and Medical Information Sciences, Kerman University of Medical Sciences, Kerman, Iran


BACKGROUND: Crises are often unavoidable events that occur around the world. Hospitals play
an important role in treating patients and preventing extensive injuries in times of crisis, requiring
adequate preparedness. In order to design a proper planning system, it is essential to be aware of
the challenges of hospitals during a crisis. The purpose of this study was to explain the challenges
of hospitals admitting COVID‑19 patients in the city of Mashhad, Iran, from the perspective of their
MATERIALS AND METHODS: This study employed a qualitative approach, using the method of
conventional content analysis and was conducted from May to July 2020. A purposive sampling
method was used to recruit the senior managers of hospitals admitting COVID‑19 patients in Mashhad.
The interviews were conducted face to face, with open‑ended questions following an interview guide
based on semi‑structured questions, and continued until data saturation was reached. Data were
analyzed using Atlas Ti software.
RESULTS: After the implementation of the interviews, first 665 initial codes were extracted from
the data, and after removing the overlapping sequences, a total of 115 codes were obtained. Three
categories (organizational challenges, extra organizational challenges, and challenges related to
information domain), 13 sub‑categories, and 33 codes were extracted from the content analysis of
the interviews. The main themes propounded in the field of challenges of COVID‑19 referral hospitals
in Mashhad were organizational challenges, extra organizational challenges, and information domain
DISCUSSION: The results of this study showed that the hospitals admitting COVID‑19 patients in
Mashhad faced many challenges. To improve the quality of services in postcrisis phase, replacing
hospitals’ equipment, revising curriculums at medical universities, staff retraining, recruiting skilled
human resources, and creating a supportive community context are necessary.
CONCLUSION: For sure, the COVID‑19 crisis will not be the last one, we have to be prepared for
the bigger health crisis.


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