Analysis of the Coronary Care Unit Bed Allocation policy and Selecting the most suitable model for optimal allocation in Iran: a multiphase study

Abstract

Abstract Background This study aimed to conduct a policy analysis on allocating Coronary Care Unit (CCU) beds and clarifies the well-suited model for the allocation of CCU beds in Iran. Methods As a multiphase study, this was conducted in 4 steps including a literature review, semi-structured interviews, an analysis of the policymaking process, and the Delphi study. The models of bed allocation and their criteria, and also the challenges of CCU bed allocation, were explored through literature review and semi-structured interviews. The CCU beds allocation policy was analyzed using Walt and Gilson's Health Policy Triangle (HPT). The suitable model for the optimal allocation of CCU beds in Iran was chosen by the Delphi method. Results Findings were reported in four dimensions of the policy analysis triangle, including content, context, process, and actors. Various social, economic, environmental, and political factors affect policy development. Allocating policy emphasizes fair distribution of resources, and full access to health services, and encourages the private sector. Achieving efficiency of hospital bed utilization put bed allocation on the agenda in Iran. Thorough literature review, 11 models and 14 indicators were found. After conducting interviews, the number of indicators increased to 58 cases and the CCU bed allocation challenges were identified. The Trend Model was picked through the Delphi study as a framework for CCU bed allocation. Conclusion Using the results of the present study and the proposed model can help to allocate hospital beds, especially CCU beds, optimally and efficiently. However, challenges and barriers identified by this study require consideration during the development of the proposed model. Also, managers and policymakers require information about the most effective strategies to reduce the need for CCU beds in the future. It is recommended that future studies and scenario planning be taken into consideration prior to the optimal allocation of hospital beds in the future.