Abstract: Abstract Background Hospital at Home (HaH) is an effective solution to address the challenges in healthcare systems; however, the inherent complexities of this program have created obstacles in implementing it. This study was conducted to explore the perspectives of managers and policymakers in the Iranian healthcare system on the necessary requirements for the implementation of the HAH program. Methods This qualitative study was conducted from December 2023 to June 2024. The 14 participants consisted of health policymakers, faculty members, and hospital managers from Tehran and Shiraz universities of medical sciences. The participants were selected by purposive sampling. Data were collected through semi-structured individual interviews. Data analysis was conducted using conventional content analysis. Results Following data analysis, 652 initial codes were extracted, which were subsequently classified into 7 categories and 2 themes. The themes were “alignment of macro-level mechanisms in supporting the HaH program” and “organizing the HaH program within the healthcare system”. Conclusions The study highlights that successful implementation of the HaH program in Iran is influenced by economic, legal, and socio-cultural factors, as well as the policies of the Ministry of Health and Medical Education (MOHME). Addressing the challenges in these areas requires a comprehensive and integrated approach. Additionally, the program’s success depends on development of precise structures within the healthcare system, which involves configuring this program within the healthcare service processes, executive support from managers and beneficiary healthcare centers, and the development of essential infrastructure. The findings provide valuable insights for managers, policymakers, and stakeholders, offering guidance on the design and implementation of the HaH program as a supplement to routine healthcare services.
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