Resilience model of public health sector during unknown pandemics: a grounded theory approach for COVID-19 in Iran.

Abstract

Background: During health crises, the demand for government healthcare services rises sharply due to increased patient admissions, resource shortages, and systemic pressure. The resilience of public hospitals in critical conditions is essential for maintaining healthcare services, reducing mortality, and ensuring system sustainability. This study aims to develop a resilience model for the public healthcare sector in response to unknown pandemics, with a focus on COVID-19.

Methods: This qualitative study employed a grounded theory approach. Participants included 25 senior and mid-level managers and medical personnel from hospitals affiliated with the COVID-19 response center in Shiraz. Data were collected through semi-structured interviews, observations, field notes, and memoing. Data analysis was conducted using MAXQDA-2010 software and Corbin and Strauss's constant comparison method.

Results: Findings indicate that resilience in the public health sector during the pandemic was influenced by four key factors: infrastructure and supply chain management, financial management, human resource management, and crisis management. Among these factors, the preparedness of the health system played a central role in determining resilience.

Conclusion: To enhance resilience in future pandemics, Policymakers should prioritize sustainable financing, strengthen supply chain mechanisms, and improve human resource management to ensure effective crises response.