Introduction: Policymakers in each country must decide on the financing and payment system for healthcare. In addition to increasing efficiency and effectiveness, this system should reduce individuals’ out-of-pocket payments. One such system that has shown positive results globally is Diagnostic Related Groups (DRG). This study aims to identify the requirements for the implementation of DRG in Iran.
Methods: This research is a qualitative study employing conventional content analysis, conducted during 2021-2022. Data were collected through semi-structured interviews. The participnats included senior managers with at least five years of experience working in insurance organizations, the budget unit, or medical economics of the Ministry of Health or hospitals, as well as faculty members with experience in research related to payment methods. The participnats were selected based on specific criteria. After conducting 14 interviews, data saturation was achieved. The data were then analyzed using MAXQDA10 software.
Results: The most important requirements for the implementation of DRG in Iran included regulatory/executive requirements, informing and accompanying stakeholders, technical and informational infrastructures, and 10 related sub-themes.
Conclusion: For the successful implementation of the DRG system in Iran, policymakers and health system managers can leverage the experiences of other countries, train healthcare providers, calculate accurate costs, improve the accounting system, provide necessary software, develop diagnostic groups, set proportionate tariffs, and strengthen information systems. These steps will help remove implementation obstacles, attract stakeholder cooperation, and prepare the necessary technical and informational infrastructures.
