A comprehensive performance audit model in the public health sector using the grounded theory approach

Background: Performance auditing is one requirement for public sector managers to be accountable to the public. It offers an unbiased evaluation of the responsibilities, effectiveness, or expenses linked to implementing policies, programs, or operations in the public sector. This paper aims to develop a performance auditing model in the health sector. Methods: This qualitative study is based on grounded theory. A sample of 16 individuals, including university professors specializing in performance auditing and managers and experts, particularly those with a background in the public health sector service designing and development, were selected using theoretical sampling. The interviews were analyzed using Strauss and Corbin’s three-stage coding process, and summarization and analysis were carried out using MAXQDA software. Results: Based on the results, the concepts related to contextual conditions include formulating appropriate laws and regulations (as the main category) and two subcategories. In causal conditions, empowerment and utilizing specialized and efficient human resources (as the main category) and five subcategories were extracted. The central phenomena consist of laying the groundwork for performance auditing (main category) and three subcategories. Two main categories for strategies and actions were identified: managing internal organizational goals and controlling internal policies, with two subcategories for each. In the intervening conditions, intra-organizational economic factors (main category) and three subcategories were determined. Finally, the outcomes include organizational structuring and productivity (two main categories), with two subcategories for each. Conclusion: several factors are crucial for improving performance auditing in the health sector, including empowering and utilizing specialized and efficient human resources, implementing appropriate laws and regulations, managing organizational goals, structuring the organization effectively, controlling internal policies, considering internal economic factors, establishing a framework for performance auditing, and enhancing organizational productivity.