فهرست نشریات علمی دسترسی آزاد ایران

INTRODUCTION: Hospitals are one of the most important institutions in providing health‑careservices. Highly experienced specialists, advanced technology, and decisive decisions about patients’deaths and lives are all gathered in a dynamic and unique organization called Hospital. A huge portionof human, financial, and equipment resources are allocated to teaching hospitals; however, thesehospitals are always faced with a lack of funding. The purpose of this study was to investigate thefinancial challenges of teaching hospitals and providing solutions.MATERIALS AND METHODS: A qualitative study was conducted using face‑to‑face interviewswith a purposeful sample of 37 top and middle managers in the level of the Ministry of Health, itsuniversities, teaching hospitals, and its affiliated departments in Tehran. Thematic analysis approachwas used to analyze the data by applying MAXQDA10 software.RESULTS: Six themes among the reasons for financial challenges in teaching hospitals wereinsufficient funding for the educational and research sections and paying more attention to treatment,increased financial burden due to presence of medical student, indigent patients, disability in budgetmanaging due to their dependence on medical universities, relative autonomy of hospitals, andpayment systems. Among other factors, there are also insurance problems arisen from increaseddeductions on bills due to insurance astringency and delayed payment.CONCLUSION: The findings of the present study indicated that the major financial challengesof teaching hospitals faced severe financial problems, which had a negative effect on their entireactivities and led to weakness in the implementation of their missions. Considering budget divisionamong three defined missions of teaching hospitals (treatment, research, and education), the largestshare of budget was allocated to treatment. Therefore, an appropriate and definite budget divisionis suggested to improve the allocation of resources to all three missions and to enhance staff’s andpatients satisfaction.