Physical Medicine and Rehabilitation in Iran: The Strength, Weakness, Opportunity, and Threat Matrix Analysis

  • Seyed Mansoor Rayegani Professor, Physical Medicine and Rehabilitation Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  • Seyed Ahmad Raeissadat Professor, Physical Medicine and Rehabilitation Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  • Maryam Seyed-Nezhad PhD Student in Health Care Management, Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
  • Mohammad Moradi-Joo PhD Student in Health Policy, Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
  • Marzieh Babaee Professor, Physical Medicine and Rehabilitation Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  • Ali Ayoubian National Center for Health Insurance Research, Iran Health Insurance Organization, Tehran, Iran
Keywords: Strengths, weaknesses, opportunities, and threats (SWOT) analysis; Physical medicine and rehabilitation; Iran


Background: Improving the quality of rehabilitation services is one of the priorities of the health care system. The aim of this study was to identify the strengths, weaknesses, opportunities, and threats (SWOT) of physical medicine and rehabilitation (PM&R) field in Iran using the SWOT analysis.

Methods: This descriptive-analytical study was conducted in 2017 and 2018. The final list of SWOT was arranged using the Delphi technique, combining similar responses and removing marginal responses by an 8-member committee consisting of members of the Iranian Society of PM&R. Internal and external environmental factors were evaluated and measured by participants. Participants were selected from faculty members, executive planners, and residents; 18, 9, and 6 persons respectively. Finally, the strategies and strategic position were determined considering SWOT scores and using a four-cell SWOT matrix.

Results: The total score of internal environmental factors (strengths and weaknesses) in evaluation matrix was 245, indicating that there were more weaknesses than strengths. The total score of external environmental factors (opportunities and threats) in evaluation matrix was 264, which indicated that there were more opportunities than threats.

Conclusion: SWOT analysis promoted awareness among service providers regarding the current functioning of a rehabilitation program. According to the SWOT model results in this study, five development strategies were determined using opportunities and strengths. It can be assumed that the strengths may be used to benefit from opportunities as much as possible. Determining the strategies based on strategic position analysis appears to be the first priority to solve the problems of PM&R.


1. Feldman DE, Swaine B, Gosselin J, Meshefedjian G, Grilli L. Is waiting for rehabilitation services associated with changes in function and quality of life in children with physical disabilities? Phys Occup Ther Pediatr 2008; 28(4): 291-304.
2. Camden C, Swaine B, Tetreault S, Brodeur MM. Reorganizing pediatric rehabilitation services to improve accessibility: Do we sacrifice quality? BMC Health Serv Res 2010; 10: 227.
3. Olusanya B. Self-reported outcomes of aural rehabilitation in a developing country. Int J Audiol 2004; 43(10): 563-71.
4. Bhatia M, Joseph B. Rehabilitation of cerebral palsy in a developing country: The need for comprehensive assessment. Pediatr Rehabil 2000; 4(2): 83-6.
5. Landry MD, Passalent LA, Cott CA. Availability and structure of ambulatory rehabilitation services: a survey of hospitals with designated rehabilitation beds in Ontario, Canada. Physiother Can 2008; 60(3): 246-54.
6. Camden C, Swaine B, Tetreault S, Bergeron S. SWOT analysis of a pediatric rehabilitation programme: A participatory evaluation fostering quality improvement. Disabil Rehabil 2009; 31(16): 1373-81.
7. Camden C, Swaine B, Tetreault S, Bergeron S, Lambert C. Development, implementation, and evaluation of the Apollo model of pediatric rehabilitation service delivery. Phys Occup Ther
Pediatr 2013; 33(2): 213-29.
8. DeLisa JA, Gans BM, Walsh NE. Physical medicine and rehabilitation: Principles and practice. Philadelphia, PA: Lippincott Williams and Wilkins; 2005.
9. David FR, David F. Strategic management: Concepts and cases. Upper Saddle River, N: Prentice Hall; 2011.
10. Dyson RG. Strategic development and SWOT analysis at the University of Warwick. Eur J Oper Res 2004; 152(3): 631-40.
11. Johnson G, Scholes K, Whittington R. Exploring corporate strategy: Text and cases. Upper Saddle River, NJ: Financial Times Prentice Hall; 2009.
12. Kong E. The development of strategic management in the non-profit context: Intellectual capital in social service non-profit organizations. Int J Manag Rev 2008; 10(3): 281-99.
13. Stacey RD. Strategic management and organisational dynamics: The challenge of complexity to ways of thinking about organisations. Upper Saddle River, NJ: Financial Times Prentice Hall; 2007.
14. Raeissadat SA, Samadi B, Rayegani SM, Bahrami MH, Mahmoudi H. Survey of medical residents' attitude toward physical medicine and rehabilitation. Am J Phys Med Rehabil 2014; 93(6): 540-7.
15. Raeissadat SA, Bahrami MH, Rayegani SM, Babaee M, Roshan PR. Attitude, beliefs and knowledge of Iranian physiatrists toward evidence based medicine and its barriers. A crosssectional study. Eur J Phys
Rehabil Med 2016; 52(5): 755-7.
16. Raeissadat SA, Bahrami MH, Rayegani SM, Hassanabadi H, Babaee M, Najafi S, et al. Obstacles facing evidence based medicine in physical medicine and rehabilitation: from opinion and knowledge to practice. Electron Physician 2017; 9(11): 5689-96.
17. Pickton DW, Wright S. What's swot in strategic analysis? Strat Change 1998; 7(2): 101-9.
18. Thompson AA, Strickland AJ. Strategic management: Concepts and cases. Boston, MA: McGraw-Hill/Irvin; 2001.
19. Casebeer A. Application of SWOT analysis. Br J Hosp Med 1993; 49(6): 430-1.
20. Tomasovic N. Geriatric-palliative care units model for improvement of elderly care. Coll Antropol 2005; 29(1): 277-82.
21. Srivastava PK, Kulshreshtha K, Mohanty CS, Pushpangadan P, Singh A. Stakeholder-based
SWOT analysis for successful municipal solid waste management in Lucknow, India. Waste Manag 2005; 25(5): 531-7.
22. Ma MY, Wu FG, Chang RH. A new design approach of user-centered design on a personal assistive bathing device for hemiplegia. Disabil Rehabil 2007; 29(14): 1077-89.
23. Sharma M. Evaluation in community based rehabilitation programmes: A strengths, weaknesses, opportunities and threats analysis. Asia Pacific Disability Rehabilitation Journal 2007; 18(1): 46-62.
24. Sharma M, Deepak S. A participatory evaluation of community-based rehabilitation programme in North Central Vietnam. Disabil Rehabil 2001; 23(8): 352-8.
25. Kuipers P, Kendall E, Hancock T. Evaluation of a rural community-based disability service in Queensland, Australia. Rural Remote Health 2003; 3(1): 186.
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