Title Exploring implementation experiences of services outsourcing from the perspective of public hospitals managers of Tabriz: An exploratory qualitative study

Abstract

Introduction and aim: Outsourcing of services is one of the downsizing strategies of the government, which has received attention in the health sector in recent years. Research on hospital outsourcing using a qualitative approach can provide insight into outsourcing decisions and practices. Therefore, this study investigated the motivations, perceived benefits and obstacles of outsourcing and effective implementation strategies of outsourcing in public hospitals of Tabriz city. Method and Materials: This qualitative study was conducted with the semi-structured interview method in 2023 among the managers of public hospitals in Tabriz city. With the purposeful sampling method, 14 in-depth interviews were conducted with hospital managers, contract managers and people who had sufficient experience in the field of outsourcing. Data analysis was done using content analysis method by MAXQDA-10 software. Finding: The findings were presented in four sections. Three main issues including financial, structural and managerial reasons and service delivery process emerged as reasons and motivations for implementing hospital outsourcing from the participants' point of view. 5 main obstacles such as laws and regulations, conflict of interests, organizational and financial policies, and attitudinal obstacles and obstacles related to the private sector affect the effective implementation of outsourcing. Regarding perceived benefits, managers believed that outsourcing had benefits for the hospital and patients. Finally, two extra-organizational and modern organizational strategies were extracted for the effective implementation of hospital service outsourcing. Conclusions: The results of the present study are valuable for the effective implementation of hospital outsourcing. By using these findings, managers and policy makers can make effective decisions in line with the effective implementation of outsourcing activities. They can evaluate activities for outsourcing based on the reasons and motivations provided. Also, by removing the suggested obstacles and paying attention to the suggested strategies, make a correct and effective decision in the field of outsourcing hospital activities. Keywords: Outsourcing, private sector, service purchase, public and private sector partnership, public hospitals