title: Challenges in Patient Discharge Planning in the Health System of Iran: A Qualitative Study.
abstract: BACKGROUND
  One of the main factors relating to quality of hospitals is effective discharge planning. Discharge planning promotes the quality of inpatient care and reduces unplanned hospital readmission. The current study investigated the challenges of discharge planning observed in the health system of Iran.
  
  
  METHODS
  This qualitative research was conducted using a thematic and framework analyses to identify the challenges under each themes defined by the World Health Organization (WHO), to understand barriers in developing an effective discharge planning system in Iran health system. The data was collected from detailed semi-structured interviews and sessions of focus group discussions. This study involved 51 participants including health policy makers, hospital and health managers, faculty members, nurses, practitioners, community medicine specialists and other professionals of the Ministry of Health and Medical Education (MOHME). To reduce the bias and to increase the credibility of the study, evaluation criteria from Lincoln and Guba were used. All interviews and FGDs were recorded and transcribed, then analyzed by the software MAXQDA-11 and also manually.
  
  
  RESULTS
  According to the WHO health systems framework, challenges of effective hospital discharge planning were divided into six areas, leadership/governance, service delivery, information, financing, health workforce, and medical production(themes), in which there were 5,3,2,2,3,1 subthemes respectively.
  
  
  CONCLUSIONS
  It is evident from the findings of this study that changes in the perspective of policy makers, health staff and managers, strengthening of systematic approach, and establishment of required infrastructures are essential for successful implementation of effective discharge planning in health systems in Iran.
authors.affiliation: School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.. MGholizadehm@yahoo.com.
authors.forename: Masumeh
authors.initials: M
authors.lastname: Gholizadeh
authors.forename: Bahram
authors.initials: B
authors.lastname: Delgoshaei
authors.forename: Hasan Abulghasem
authors.initials: HA
authors.lastname: Gorji
authors.forename: Sogand
authors.initials: S
authors.lastname: Torani
authors.forename: Ali
authors.initials: A
authors.lastname: Janati
mesh_terms: D001291:Attitude of Health Personnel; D017144:Focus Groups; D006801:Humans; D007407:Interviews as Topic; D007492:Iran; D010347:Patient Care Planning; D010351:Patient Discharge; D010359:Patient Readmission; D036301:Qualitative Research; D011787:Quality of Health Care