Challenges of Implementing the International Patient Department (IPD) Regulations in University hospitals: A qualitative and case study

Abstract

Background: Medical tourism represents one of the most rapidly expanding segments within the global tourism industry, characterized by accelerated market growth and increased international patient mobility. In light of the application of regulations for establishing International Patient departments (IPD), in Iran and the strategic role of hospitals as primary service delivery nodes, this study seeks to systematically identify and analyze the operational and managerial challenges encountered by university hospitals in the effective implementation of these regulations. Methods: This qualitative, cross-sectional study was conducted in 2024 (year 1403 in the Iranian calendar). Semi-structured interviews were held with 18 managers and experts involved in health tourism at university hospitals in a metropolis from Iran. Written informed consent was obtained from the interviewees. The data were analyzed using thematic analysis supported by MAXQDA, version 24. Findings: The challenges reported by participants were organized into 13 main categories: Ethical issues, financial issues, marketing strategies, monitoring and supervision, equipment and supplies, medication management, physical infrastructure, information and communication technology, process management, legal matters, customer orientation, advocacy, and human resource management. These categories included 79 detailed sub-themes. Conclusion: Given the variety of challenges identified, the study offers recommendations to improve the implementation, review, and clarification of the regulations to support better management of medical tourism services in hospitals. © 2026, Isfahan University of Medical Sciences(IUMS). All rights reserved.