Background: The rapid growth of health expenditures is a great concern for governments at present. Objectives: The present study aimed to determine the main factors affecting health care expenditures in countries with different types of the Healthcare system. Methods: We studied 25 countries with different types of Healthcare Systems, including national health insurance, traditional sickness insurance, national health services, and mixed Systems. Health expenditure per capita was estimated as a function of health care price, out-of-pocket health expenditure, income, and other exogenous factors. A random-effects model was selected instead of a fixed-effects model based on the Hausman test to assess the effect of different factors on health expenditures. Results: Income and health care price had the greatest impacts on health expenditures in countries with national health insurance and countries with mixed health care Systems, respectively. Among the variables, mortality and life expectancy had the greatest impacts on health expenditure in all types of the Healthcare system. The out-of-pocket health expenditure had the most and least impacts on health expenditures in countries with mixed health care Systems and countries with national health insurance Systems, respectively. Conclusions: The study showed that health condition and out-of-pocket health expenditure are the most important determinants of health expenditures in all health care Systems, especially the mixed health care system.

Introduction: Information Systems enable the managers to access the proper information needed to make decisions. Management decision making based on real information leads to increased efficiency and effectiveness. Problems related to information system will lead to incorrect information and consequently incorrect decisions. Therefore, this study was conducted to investigate and identify the challenges of ISs in Healthcare organizations. Methods: This study is a systematic review. PubMed/Medline, Scopus, PMC and Iranian databases such as Magiran and SID were searched from 2013 to 2018. English and Persian studies were searched using keywords including IS, Hospital Information System, Health Information Technology, Health Information System, Medical Information Reporting System, Electronic Medical Record, Electronic Health Record, Medical Informatics, Health Informatics, Nursing Information System, Nursing Informatics, hospital Management Information System, Nursing Clinical Information System, Pharmacy Information System, and Electronic Medical Record System. In the initial search, 300 studies were identified. After screening the studies using the exclusion criteria, 101 of them were selected. Then, through complete reviews of full texts of the studies, 54 of them were excluded from the study. The rest of the articles were coded by Esterberg method and 6 themes of challenges were extracted. Results: The results showed that the challenges of IS in the health system included structural, manpower, financial/support, security, process, and organizational challenges. Conclusion: To achieve the success and effectiveness of IS and make the right decisions based on the proper information, it is necessary to eliminate the issues that lead to problems in these Systems.