Table 4 . Proportion (%) of the views on the downsides of IHEAP .
| Disadvantage | To a large extent | To some extent | To a small extent | No effect | Do not know |
| Over-reliance on judgment of surveyors | 42 | 22 | 22 | 14 | 0 |
| Routinization and bureaucratization | 40 | 26 | 21 | 12 | 1 |
| Disappointing and discouraging hospitals | 31 | 25 | 30 | 14 | 0 |
| Extra burden of work to hospitals | 14 | 28 | 39 | 19 | 0 |
| Deviating hospitals from their mission | 14 | 17 | 39 | 28 | 0 |
| Not fitting well with other quality-improvement activities | 14 | 25 | 41 | 17 | 3 |
| Incurring undue cost on hospitals | 11 | 17 | 58 | 14 | 0 |
| Diverting resources from clinical concerns | 8 | 19 | 48 | 22 | 3 |
| Average | 21.75 | 22.37 | 37.25 | 17.50 | 0.87 |
IHEAP: Iranian Hospital Evaluation and Accreditation Program