Transitional Care in Long Covid Patients, The Missing Link in the Healthcare Systems in Iran: A Qualitative Study.

Abstract

Background: Long COVID, a chronic and multisystemic consequence of coronavirus infection, significantly reduces patients' quality of life due to persistent symptoms. Transitional care (TC) is essential to ensure continuity and coordination of care and to reduce the risk of hospital readmissions. This study aims to identify the barriers to providing effective TC for long COVID patients within the Iranian healthcare system.

Materials and methods: This qualitative descriptive study used thematic analysis. Participants-10 long COVID patients, 5 family caregivers, and 16 healthcare providers-were selected via purposeful sampling from outpatient clinics and rehabilitation centers affiliated with Isfahan University of Medical Sciences, Iran. Between November 2022 and May 2023, 33 semistructured, in-depth interviews (30-40 min each) were conducted, audio-recorded, transcribed verbatim, and analyzed using MAXQDA (v. 20) until data saturation. Trustworthiness was ensured using Guba and Lincoln's criteria.

Results: Barriers to effective TC for long COVID patients were systematically classified into three main themes with 10 subthemes. The main theme included inefficient healthcare infrastructure, nonintegrated management, and lack of comprehensive continuous care.

Conclusions: The findings revealed that the Iranian healthcare system lacks integrated TC for long COVID patients. Addressing these barriers requires policy-level reforms, standardized care pathways, and investment in community-based and rehabilitation services. Strengthening TC could bridge the current gaps and significantly improve outcomes for long COVID patients in Iran. The findings provide insights into structural and operational challenges in TC delivery and highlight the need for policy reforms to improve outcomes for long COVID patients.