Journal of Research and Health

en Establishment of a Performance‑Based Budgeting System: A Systematic Review with a Focus on Iran مقاله مروری Review Article <div style="text-align: justify;">Background: This systematic review examines the implementation of performance‑based budgeting (PBB) systems, an approach increasingly adopted to address inefficiencies and opacity in traditional budgeting. PBB seeks to improve resource allocation while enhancing effectiveness, transparency, and accountability in public and private organizations. Methods: This systematic review was conducted in accordance with the PRISMA guidelines. A comprehensive search was carried out in PubMed and Scopus for English-language studies and in SID, Magiran, Irandoc, and Google Scholar for Persian-language papers, covering all publications up to September 5, 2025, with no date restrictions. Eligible studies were original research articles in English or Persian focusing on PBB implementation. Exclusion criteria included brief communications, letters, conference abstracts, and inaccessible documents. After title, abstract, and full-text screening, 107 articles met the eligibility criteria. Results: Findings revealed that most of the reviewed studies originated from Iran (63.6%) and the United States (15.9%). This distribution likely reflects both the language scope and database coverage of the search strategy, which included English- and Persian-language sources, as well as the strong research attention given to PBB in the Iranian public-sector context. Across the 107 included studies, the most frequently reported determinants of effective PBB implementation were improving operational mechanisms, structural and legal reform, training and capacity building, and strengthening information-technology infrastructure. These findings indicate that successful PBB implementation depends on a combination of institutional, operational, human-resource, and technological capacities rather than on technical budgeting changes alone. Conclusion: This review indicates that the implementation of performance‑based budgeting varies considerably across contexts, reflecting differences in institutional readiness and administrative capacities. Rather than functioning as a uniform technical model, PBB emerges as a context‑dependent reform whose success is shaped by the availability of essential organizational and technical foundations.</div> Performance-Based Budgeting, Budget System Implementation, Performance Evaluation 10 10 http://jrh.gmu.ac.ir/browse.php?a_code=A-10-2805-3&slc_lang=en&sid=1 Mahdi Dorri Saghi MDorri@gmail.com 1 100319475328460048448 No Head of Budget Planning and Performance Monitoring Department, Vice President for Management and Resources Development, Gonabad University of Medical Sciences, Gonabad, Iran Fatemeh Ameri fatemehameri97166016@gmail.com 2 100319475328460048449 Yes Department of Budget Planning and Performance Monitoring, Vice President for Management and Resources Development, Gonabad University of Medical Sciences, Gonabad, Iran. Ali Alami alialami65@hotmail.com 3 100319475328460048450 No Department of Epidemiology and Biostatistics; Social Determinants of Health Research Center, Gonabad University of Medical Sciences, Gonabad, Iran.