Background & aim: Hospitals are the most important healthcare institutions consuming major portion of national health budgets. High operating costs, inefficient, excess capacity of hospitals have increased the necessity for appropriate use of the resources. Many countries use downsizing strategy based on a strategic direction to solve these problems. This study was conducted to design a downsizing model in hospitals of Tabriz University of Medical Sciences.

Methods: This research is a qualitative three stage study. First stage was systematic review on hospital downsizing methods using defined keywords. The second stage was holding three focus group discussions.  At this stage individuals were selected based on objective sampling method and the data were analyzed using content analysis. Finally, designed downsizing model was finalized based on results of the previous stages using three steps Delphi technique.   

Results: The results showed that many countries widely use different methods of hospital downsizing. Participated experts in focus group discussions emphasized on integration and outsourcing (as the methods for hospital downsizing) and meeting general and specific requirements for the method implementation. Determining success indicators and prioritizing hospital units that are subject to integration and outsourcing were other components of downsizing model.

Conclusion: Downsizing is one of the methods that can be used when health organizations encounter with limited resources.  However, the success of this method depends on careful planning and appropriate implementation of model steps