With resource constraints and rising costs, medical universities need financial transparency, efficient costing, and an indigenous accounting information system to improve the health economy. The aim of this study was to design and validate a model for diagnosing the health economy in the country’s medical universities, with an emphasis on the accounting information system.This research employed an exploratory mixed-methods design (qualitative–quantitative).In the qualitative phase, using grounded theory (Strauss and Corbin approach), 23 in-depth interviews were conducted with faculty members, managers, and financial experts, and the data were coded in MAXQDA. As a result,140 conceptual codes were organized into six categories: causal conditions, contextual conditions, intervening conditions, the core phenomenon, strategies, and consequences. In the quantitative phase, a researcher-developed 78-item questionnaire was distributed among 400 participants, and 389 questionnaires were analyzed.Validity and reliability were confirmed using CFA, AVE, HTMT, Cronbach’s alpha, and composite reliability, and the model was tested via PLS-SEM in SmartPLS4. The results showed that causal (β = 0.433), contextual (β = 0.427), and intervening conditions (β = 0.310) explained about 50% of the variance in the core phenomenon (R² = 0.499).The core phenomenon had significant effects on strategies(β = 0.682) and consequences (β ≈ 0.435), and strategies showed the strongest direct effect on consequences (β = 0.638).This model provides an indigenous framework for reducing inefficiency and rent-seeking, increasing transparency, and improving resource allocation. It also identifies strengthening the accounting information system, integrating information systems, and enhancing the professional status of accountants as prerequisites for reforming the health economy.