Designing a Public–Private Partnership Model for the Development of Metropolitan Health Tourism Networks

Abstract

This study aimed to design a comprehensive public–private partnership model for the development of metropolitan health tourism networks based on the experiences and perspectives of relevant experts and stakeholders in Tehran. This qualitative exploratory study was conducted using a grounded theory approach. The study population consisted of experts, senior managers, policymakers, academics, and professionals active in health tourism, healthcare management, tourism management, urban governance, investment, and public–private partnerships in Tehran, Iran. Participants were selected through purposive and theoretical sampling, and data collection continued until theoretical saturation was achieved. In total, 18 participants were interviewed using in-depth semi-structured interviews lasting approximately 45–75 minutes. The interviews were recorded, transcribed verbatim, and analyzed concurrently with data collection through the constant comparative method. Data analysis proceeded through open, axial, and selective coding. Credibility, dependability, confirmability, and transferability were strengthened through member checking, peer review of coding, analytical memoing, systematic documentation, and maximum variation in participant backgrounds. Analysis of the interviews generated 412 initial codes, which were reduced to 126 focused concepts, 31 subcategories, and 14 major categories organized within six grounded-theory dimensions. The principal causal conditions were growing metropolitan health tourism demand, the need for investment and resource mobilization, fragmentation of the health tourism service chain, and increasing international competitiveness. The central phenomenon was identified as an institutionalized public–private network partnership based on shared governance and coordinated value creation. Contextual and intervening conditions included regulatory arrangements, metropolitan infrastructure, human capital, destination characteristics, bureaucratic barriers, economic uncertainty, information asymmetry, and international access constraints. The principal strategies comprised integrated network governance, contractual and financial partnership mechanisms, service-chain integration, quality assurance, digital-platform development, destination branding, specialized workforce development, and continuous monitoring. Expected consequences included improved investment, service quality, destination competitiveness, governance efficiency, social development, and network sustainability. The findings indicate that sustainable metropolitan health tourism development requires a transition from fragmented organizational practices toward an institutionalized public–private network model that integrates governance, investment, service delivery, digital infrastructure, quality assurance, and international marketing within a coordinated metropolitan ecosystem.