Governments' application of a new operational budgeting method requires that they and their subsidiaries be transparent, accountable to, and take responsibility against people. The commercial public concerned with health centers, hospitals, etc., and it is natural that transparency and accountability of medical universities with regard to the costs incurred and revenues earned are seen to be their most basic demands. Therefore, this article aimed to investigate the factors affecting performance-based budgeting to improve public transparency and accountability. The present study was applied in terms of objectives, descriptive in terms of the nature of a survey correlation. The statistical population was comprised of the staff at Mazandaran University of Medical Sciences (1906 people). The sample volume was estimated to be 322 people based on Cochran's formula as they were selected by multi-stage relative stratified sampling method. To collect information, a researcher-made questionnaire was provided based on the literature review and research background, and a survey of subject-related experts was conducted involving 82 items. The face and content validity of the items were confirmed by experts. Cronbach's alpha was also estimated to be greater than 0.7, which indicated the internal consistency of the items and confirmed the reliability. To analyze the data, structural equation modeling (SEM) was used via Emus software. The findings illustrated that considering the value of t above 1.96, the standard path coefficients were as follows: causal condition variable on the main category was 0.40, main category variable on strategies (guidelines) 0.50, underlying condition variable on strategies (guidelines) 0.51, intervening variable conditions on strategies (guidelines) 0.32, and strategies variable (guidelines) on the results (outcomes) 0.83, indicating the positive and significance of these relationships. تفاصيل المقالة