The complaints come as health officials report a growing shift from private to public hospitals because of financial hardship, with the country's nursing workforce at roughly half the national standard.
Rising costs and pressure on public hospitals
Four hospitals refused to admit a patient because they lacked specialist doctors, forcing the patient to seek private treatment at a cost of 200 million rials (about $76) in a single night, according to an account sent to Iran International.
The US dollar is trading at around 2.62 million rials in Iran, reflecting the sharp decline in the national currency's purchasing power.
Iran's minimum monthly base wage stands at around 166 million rials ($63), meaning the patient's single-night medical bill exceeded a full month's minimum wage, even before other living expenses.
Another patient said an emergency department at a public hospital charged around 100 million rials (about $38), provided no invoice and said emergency expenses were not covered by insurance.
A resident of Shiraz described worsening conditions at hospitals, where shortages of doctors and nurses have disrupted patient care.
Economic hardship and higher medical tariffs have shifted 30 to 40 percent of patient visits from private facilities to public hospitals this year, Yaser Foroughi, deputy for treatment at Iran University of Medical Sciences, said.
Other patients described overwhelmed medical staff struggling to meet growing demand despite efforts to provide adequate care.
Patients face steep bills and demands for unofficial payments
Several citizens described doctors requesting cash or gold coins outside formal hospital payment procedures before performing surgery.
One patient said a doctor at Tehran's Atieh Hospital quoted 4 billion rials for leg surgery alone, with at least two weeks of hospitalization due to an infection and accommodation for a companion expected to cost another 15 billion rials.
Others complained about rising out-of-pocket expenses and insurance coverage that failed to meet their medical needs.
Equipment shortages and long treatment delays
Patients said hospitals were running short of basic supplies, forcing them to purchase items including bedsheets, syringes and gloves themselves.
Healthcare workers and patients had previously told Iran International in September that syringes, sterile gauze, intravenous cannulas and latex gloves were either scarce or subject to rationing.
Another patient said MRI machines at public hospitals were frequently broken or required waits of up to three months for appointments.
Some private hospitals were also refusing supplementary health insurance, according to accounts submitted to Iran International.
One person said emergency services refused to dispatch an ambulance for their 73-year-old mother, who has cancer, after she fell, because two hours had passed since the fall.
Several patients also complained about declining patience among hospital staff when dealing with patients and their families.
Nurses say they are doing the work of two people
Iran's nursing workforce stands at roughly half the national standard, forcing individual nurses to carry the workload of two people, Ahmad Nejatian, head of Iran's Nursing Organization, said on October 17.
Nurses work an average of 80 hours of overtime each month, Nejatian said.
Healthcare workers linked deteriorating services to severe staffing shortages, exhaustion and inadequate pay.
One nurse said better salaries and living conditions, comparable to those in Persian Gulf countries, Europe and the United States, would improve healthcare workers' ability to care for patients.
A patient hospitalized for 12 days, however, described nurses continuing to treat patients respectfully and work diligently despite severe staff shortages and demanding conditions.
Low wages deepen pressure on healthcare workers
One healthcare worker said medical staff were expected to provide specialized care, particularly in intensive care units, on monthly salaries of just 250 million to 300 million rials ($95–$115), with a housing allowance of 10 million rials (about $4).
Another citizen blamed the government's economic policies for making it increasingly difficult for healthcare workers to concentrate on their duties.
Some nurses have gone months without receiving their salaries, leaving them with little motivation to train new staff, a medical trainee told Iran International in September.
The accounts point to mounting pressure on Iran's healthcare system, with rising treatment costs pushing more patients toward overstretched public hospitals as staff shortages, low wages and equipment shortages constrain the care available to them.
