Introduction: Trying to contain hospital costs is one of the biggest challenges facing the Iranian health system. In this study, we attempted to identify the key factors affecting hospital costs, hospital cost containment approaches, and to tailor intervention packages accordingly.
Methods: This study was conducted in three stages. In the first stage, by searching databases and expanding the total cost formula for a hospital from the health system perspective, key factors affecting hospital costs were identified. In the second stage, cost control approaches, intervention packages, and their prioritization criteria were identified in a panel of experts with the participation of 4 faculty members of the School of Management and Medical Informatics. In the third stage, the matrix scoring for intervention packages was completed and prioritized by 21 hospital managers.
Results: By expanding the formula of the total cost (C=P×Q), three factors of technology, productivity, and inflation in the Price field (P), and three factors of covered population, Utilization and overuse in the Quantity field (Q) were identified. For these key factors, 17 components were identified, which 9 components were intervenable. Then, based on expert panel members' opinion, 10 intervention packages were defined. These packages were prioritized by five criteria including: "effectiveness, appropriateness, feasibility, efficiency, and painlessness". Finally, the five most important intervention packages were selected as: "prevention of inappropriate use of services", "production of low-cost hospital services", "reducing inpatient costs", " containing drug costs" and " containing capital medical equipment costs" respectively.
Conclusions: Considering financing problems of the Iran health system, attention to cost containment approaches is very important especially from the health system perspective. This study showed that by identifying key cost factors and cost control approaches, special intervention packages could be formulated that are relatively painless and in line with upstream policies.

Introduction: Due to the importance of distributive justice in health services, many studies have been conducted in Iran. However, the accuracy of the methodology of most of these studies indicates weaknesses and inaccuracies, and the results of some studies do not correspond to tangible facts; Therefore, in this critique, by evaluating the methodology of these studies, an attempt has been made to identify their weaknesses and introduce alternative solutions.
Methods: This is a critical study that was conducted in 2020 on 40 articles in the field of measuring the level of access and development with health indicators. The period of articles is from 2002 to 2019. To review the articles, first the full text of the article was received and read, according to the methodology and also according to their results, the article was reviewed. Frequent objections were then selected and corrected.
Results: After reviewing the articles, 7 types of problems were in 3 categories, which are: correct identification of indicators (including number - grading - weight - type and unit - removal of overlaps), selection of tools Suitable for ranking and using complete and appropriate databases.
Conclusion: By using more comprehensive and complete indicators, more accurate calculation of indicators, and more appropriate methodology that calculates the weight of indicators correctly, More accurate results would be achieved.