Skip to main content

Table 1 Environmental impact matrix (micro environment)

From: A comprehensive environmental scanning and strategic analysis of Iranian Public Hospitals: a prospective approach

DimensionsFactorsImpact of factorsPotential opportunities/threats
Customer, public and mediaMore inclination towards using luxurious health servicesIncreased costs, higher quality services, overuse of complicated expensive technologies− 3
More demand for high quality health servicesHigher costs, human resources, expensive equipment− 2
Increase in average incomeIncrease in hospital income+ 5
Increase in purchasing powerIncrease in hospital income+ 5
Education level and health literacy improvementDecrease in hospitalization period and increase of bed turnover rate+ 3
Organic and green products attitudeDecrease in diseases and demand for health services which will lead to quality improvement in public hospitals+ 3
Environment protection and green energy use attitudeIncrease in hospital expenses for healthy waste disposal and use of latest technologies with green energy+ 1
Increase in people’s share in health services paymentsIncrease in hospital specific income+ 3
DistributorsUnfair bed distributionLonger patient wait times leading to disorder and lower quality of services− 4
Unfair specialized human resources distributionLonger patient wait times and non-responsiveness− 5
SuppliersIncrease in prescription of drugs out of Iranian official list of drugsInability to supply drugs and lower quality of services− 2
Increase in the number of prescriptions containing antibioticsPatients’ resistance to treatment and higher doses of drugs leading to medicine supply issues− 2
Increase in the number of prescriptions containing injectionsPatients’ resistance to treatment and higher doses of drugs leading to medicine supply issues
Increase in design costs and equipping hospitals with clean rooms
− 2
Increase in the number of self-medication cases in patientsIncrease in the number of patients with no appointments leading to longer patient wait times− 3
StakeholdersDelayed payment to hospitals by insurance companiesHospitals being indebted and therefore unable to supply medicine and consumer products or purchasing low quality products that in turn will lead to patient dissatisfaction. In addition, delay in personnel reimbursement can result in lack of satisfaction and motivation to provide high quality care.− 5
Full-time status of clinical faculty members (non-permissibility of simultaneous work in both public and private sectors)Shorter patient wait times and more responsiveness+ 4
Freedom of speech in media, multiplicity of political parties, civil rights, meetings or campaigns to support or ban health policies (social - political)Compromised reputation of public hospitals due to myriad economic and political issues− 2
CompetitorsMore inclination towards receiving home care and nursing careShorter wait times and improved quality of services and opportunities for launching home care+ 3
Growth in usage of health promotion softwareDecreased rate of referring to hospitals and shorter wait times+ 2
Growth of clinics and private hospitalsShorter wait times in public hospitals and improved quality of services+ 5
Important basic infrastructures (facilities and installations) in Iran and the city in which the hospital is locatedRemote medical services and electronic medical record option+ 5
Good academic and knowledge developments in Iran and the city in which the hospital is locatedImproved treatment processes and quality of services and patient satisfaction+ 3
A chance to make the required investments for research and development in IranImproved treatment processes and quality of services and patient satisfaction+ 4
Good developments in high-end technologies in hospitalsImproved treatment processes and quality of services and patient satisfaction+ 3
Availability of high-end technologies in the relative industry of hospitalsHigher hospital expenses− 2
Available required communication structures
Good developments in information and communication technology
Remote medical services and electronic medical record option+ 5
Electronic commerce option for hospitalsIncome generation
Growth of medical tourism industry
+ 4
Using social media to promote hospital productsIncome generation+ 4