Hosain Yasemi, Jamil Sadeghifar, Shahin Nargesi, Morteza Arab-Zozani, Khalil Momeni
Abstract:
Meeting patients’ needs and expectations is one of the core responsibilities of healthcare delivery organizations in any region. Patients have two options for receiving services; either they go to hospitals outside their area of residence to receive medical services or they are referred by physicians to receive these services.
Introduction
The main objective of any health system is to ensure the well-being of the population through the provision of high-quality services, as well as the continuous monitoring and evaluation of these services [1]. Hospitals are the most important component of the health care system and are essential pillars of care and treatment delivery.
Methods
This study was conducted in 2024 using a mixed-methods (qualitative–quantitative) design in two phases to identify the factors influencing patients’ preference for receiving healthcare services outside their place of residence and to prioritize these factors using the Analytical Hierarchy Process (AHP).
Results:
The interview participants were 15 people working in the public, private, and other sectors. The participants in this study were very diverse in terms of position. Table 2 presents the characteristics of the participants.
Discussion
In this study, the most important factors influencing patients’ preference for receiving medical services from hospitals outside their place of residence were identified and prioritized. The findings indicated that these factors could be categorized into four main themes: physician-related factors, organization-related factors, patient- and family-related factors, and socio-cultural factors.
Conclusions
Considering the high annual referral rate from the province and the large number of patients from Ilam seeking medical services in other provinces—which results in increased direct and indirect costs as well as multiple social consequences—policymakers and senior health managers in the province must plan and implement corrective interventions to reduce patient referrals and out-of-province visits.
Citation: Yasemi H, Sadeghifar J, Nargesi S, Arab-Zozani M, Momeni K (2026) Patients’ preference for receiving healthcare services from out-of-area hospitals based on the Analytic Hierarchy Process (AHP): A mixed-methods study. PLoS One 21(5): e0348888. https://doi.org/10.1371/journal.pone.0348888
Editor: Edris Hasanpoor, Maragheh University of Medical Sciences, IRAN, ISLAMIC REPUBLIC OF
Received: December 12, 2025; Accepted: April 22, 2026; Published: May 29, 2026
Copyright: © 2026 Yasemi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: Data cannot be publicly shared due to ethical restrictions involving sensitive patient information. De-identified data are available upon reasonable request to the Vice-Chancellor of Research and Technology at Ilam University of Medical Sciences (contact: rd@medilsm.ac.ir), subject to institutional approval. They are also available by contacting the corresponding author of the manuscript, Dr. Khalil Momeni (contact: momeni-kh@medilam.ac.ir; khalilmomeni1365@gmail.com).
Funding: The author(s) received no specific funding for this work.
Competing interests: The authors have declared that no competing interests exist.
