Requirements for Effective Hospital-to-Home Transitional Care in Low- and Middle-Income Settings: Insights from Iranian Stakeholders

Introduction: Hospital-to-home transitional care can reduce readmissions and improve patient outcomes, but implementation barriers differ across health systems. Understanding system-level requirements in low- and middle-income countries contexts is essential to inform feasible policy and implementation strategies. This qualitative study aimed to identify system-level requirements for effective hospital-to-home transitional care from the perspectives of key healthcare stakeholders in Iran, as an example of a low- and middle-income health system. Methods: This qualitative study employed conventional qualitative content analysis, following Graneheim and Lundman, and explicitly applied Braun and Clarke’s six-phase framework for content analysis to guide coding and theme development. A diverse group of stakeholders, including healthcare managers, physicians, nurses, and health policy officials, was selected using purposive sampling. The data were collected through 15 semi-structured interviews and were subjected to a detailed analysis. Results: Four key themes were identified in the analysis: process, infrastructure, motivational, and regulatory requirements, encompassing 14 subthemes. Key subthemes included the need for integrated care models, robust health information systems, broader insurance coverage, and effective regulatory mechanisms. Conclusion: The findings show that a multidimensional approach is necessary to be applied in effective hospital-to-home transitional care in Iran, including holistic policymaking, development of infrastructure, specialized human resources, and intersectoral coordination. These insights can inform future health policy and implementation strategies in similar low- and middle-income countries settings.