A survey on present status of health services priority setting in Iran

Objective(s): To analyze the process of priority setting at different levels of Iran’s health system. Methods: In this qualitative study, 19 Experts of different levels of health system were interviewed. The semi- structured interview guide was designed based on literature review and four initial in depth interviews. Framework analysis method was used for the analysis of qualitative data. Results: Eight themes and 22 sub-themes regarding health priority setting were identified: Health priority at macro-level; Priority setting between and within medical universities; Priority setting criteria; Measuring costs and outcomes; Resource shift; Public participation; and Resource allocation decision rule. Health sector share of public budget was unrealistic and was based on historical patterns. Political factors and lobbying influenced resource allocation between and within medical universities. Resource allocation was mainly structure based and health factors were least influential. Although resource shifting was possible within programs but it was impossible within them, Public participation in priority setting was not sufficient and systematic, decision making on resource allocation was mainly based on needs and judgment. Conclusion: Some priority setting activities are in progress, but they do not tend to be either comprehensive or systematic. In order to improve priority setting, developing an approach which enables stakeholderschr('39') involvement is suggested.