Accountable hospital governance structure rules in Iran: a qualitative document analysis

Purpose Hospital governance accountability structures in Iran, similar to other countries, have undergone various reforms with different goals. The current study aimed to identify the rules and regulations of the hospital governance structure in Iran and how they pay attention to accountability. Design/methodology/approach This qualitative document content analysis study was conducted using hospital governance structure documents in Iran using the Ready materials, Extract data, Analyze data and Distil (READ) document analysis framework. 2,921 documents were extracted from the official government websites of Iran. After screening, seven documents related to the hospital governance structure were selected. A directed content analysis approach was used. The findings were finally future purification matched with the original documents. Findings The findings showed that documents had not addressed the inclusive governance structure of the hospital comprehensively. The medical staff organization structure is not considered in the documents, and its duties are assigned to a technical or a clinical director. Most documents addressed financial accountability. The documents did not require the hospital’s governance to have an inclusive accountability structure. However, they paid more attention to the administrative and financial autonomy of hospitals. Practical implications Accountability is one of the most essential components in the hospital's governance structure. It can increase the success of hospital efficiency, effectiveness, vision and mission fulfillment. The study result can help health services policymakers and managers formulate better organization structure rules and regulations for hospital governance accountability. Originality/value This study is the first qualitative analysis of accountable governance structure documents in Iranian hospitals. We used the READ method as a comprehensive approach for document analysis.