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Dimensions of Health System Performance Assessment: A Scoping Review.

Khadije Safizade¹, Hossein Dargahi^1,2, Alimohammad Mosadeghrad¹

¹Department of health Management, Policy, and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

Iranian Journal of Public Health

|July 10, 2026

Summary

This study identifies key dimensions for health system performance assessment in Iran. A new framework, incorporating qualitative feedback, offers a comprehensive structure for evaluating Iran

Keywords:

Health Health system assessment Monitoring and evaluation Performance management

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Area of Science:

Health Services Research
Public Health Policy
Healthcare Management

Background:

Performance assessment is crucial for understanding health system operations.
Identifying assessment aspects is the primary step.
This study focuses on Iran's health system performance assessment dimensions.

Purpose of the Study:

To identify the dimensions of health system performance assessment in Iran.
To develop a comprehensive framework tailored to Iran's context.

Main Methods:

A scoping review of Persian and English databases (2000-2024).
Identification and synthesis of 17 existing frameworks/models.
Development of a new framework using framework analysis.

Main Results:

Identified 6 main dimensions and 28 sub-dimensions for health system performance assessment.
Developed a logic model (inputs, outputs, outcomes).
Key dimensions include Governance, Infrastructure, Knowledge, and Standards of Care.

Conclusions:

The consolidated framework differs from previous ones by emphasizing qualitative feedback.
Offers a comprehensive structure for Iran's health system performance evaluation.
Considers Iran's specific environmental context for tailored assessment.