Objectives: This mixed-method study was conducted to interpret the political, economic, social and technological issues that encourage hospital managers to be aware of the conditions and be equipped to plan and perform proactively.
Results: structured interview using Douglas West framework and a researcher-made questionnaire were used to determine the effectiveness and feasibility of hospitals’ environmental factors. The key issues at micro level environment of public hospitals were related to prescription and overuse of pharmaceuticals, inequality in distribution of healthcare services and high demands for luxurious services. At macro level: higher fertility rates, hospital services tariffs, changes in the patterns of diseases and inappropriate hospital budgeting have direct impact and economic sanctions, government corruption, centralization and high bank interest rates have indirect impact on public hospitals in Iran. Generally the strategic policies are required to improve quality-based payment system, enhance the efficiency and effectiveness of services, improving fair income generation and urging positive motivations for service providers are the strategies to cope with the future changes.
Key words: public hospital, environmental scanning, strategic management, PESTLE analysis, future, Iran