title: The challenges of healthcare delivery to people with multiple sclerosis in Iran.
abstract: BACKGROUND
  Multiple sclerosis (MS) is a chronic disease prevalent in young and middle-aged people. Patients with MS often have numerous complicated needs and, consequently, require a broad range of health services. Results of a number of studies indicate that patients' needs are only partially met.
  
  
  OBJECTIVE
  This study was conducted to explore the challenges of healthcare delivery to patients with MS in Iran.
  
  
  METHODS
  In this qualitative case study, 43 participants selected through purposeful sampling were interviewed using semi-structured method in the cities of Isfahan and Tehran in 2012-2013. Besides the interview, documentations relevant to healthcare delivery were collected from different sources, including websites of all Iranian universities of medical sciences, insurance organizations, patients' weblogs, news agencies, the MS Center forum for MS patients, and MS Payam bimonthly. The data were analyzed through the constant comparative analysis.
  
  
  RESULTS
  The data were categorized into four main categories, including functional challenges (diagnosis problems, failure to pay attention to patient needs, failure to follow-up, and miscommunication), administrative challenges (resource allocation and supervision), policy-making challenges (lack of comprehensive services, bureaucracy, and problems in provision of medications), and structural challenges (difficult access to services, lack of comprehensive centers, space limit, and long wait).
  
  
  CONCLUSIONS
  Despite all attempts of governmental and nongovernmental organizations for healthcare delivery to MS patients, these services cannot satisfy all needs of the patients. In this regard, service providers and administrators should pay more attention to the needs and expectations of patients and their families.
authors.affiliation: Department of Critical Care Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Ahmadreza
authors.initials: A
authors.lastname: Yazdannik
authors.affiliation: Department of Medical Surgical Nursing, Nursing and Midwifery Research Center, School of Nursing and Midwifery, Shahrekord University of Medical Sciences, Shahrekord, Iran.
authors.forename: Shahla
authors.initials: S
authors.lastname: Abolhassani
authors.affiliation: Department of Adult Health Nursing, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Fariba
authors.initials: F
authors.lastname: Taleghani
authors.affiliation: Department of Community and Family Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Ahmadreza
authors.initials: A
authors.lastname: Zamani
keywords: Health services; Iran; multiple sclerosis