Evidence map›Paper›PMID 40855491›Full record

SynthesisHealth research policy and systems2025

Highlighting global inequities in health services quality research: a systematic review and quantitative evidence (2014-2023).

Mihail-Vasile Pruteanu, Alina Moroșanu, Georgeta Zegan, Constantin Bogdan Mihăilă, Elena Mihaela Cărăușu

Abstract readSystematic Review
In one paragraph

Synthesis in Health research policy and systems, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Mihail-Vasile PruteanuDoctoral School, "Grigore T. Popa" University of Medicine and Pharmacy Iasi, 16 Universității Street, Code 700115, Iasi, Romania.ORCID http://orcid.org/0009-0004-7159-5037
Alina MoroșanuDoctoral School, "Grigore T. Popa" University of Medicine and Pharmacy Iasi, 16 Universității Street, Code 700115, Iasi, Romania. morosanu.alina@d.umfiasi.ro.ORCID http://orcid.org/0000-0002-4025-4764
Georgeta ZeganDoctoral School, "Grigore T. Popa" University of Medicine and Pharmacy Iasi, 16 Universității Street, Code 700115, Iasi, Romania.ORCID http://orcid.org/0000-0002-6215-6583
Constantin Bogdan MihăilăDoctoral School, "Grigore T. Popa" University of Medicine and Pharmacy Iasi, 16 Universității Street, Code 700115, Iasi, Romania.
Elena Mihaela CărăușuDoctoral School, "Grigore T. Popa" University of Medicine and Pharmacy Iasi, 16 Universității Street, Code 700115, Iasi, Romania.ORCID http://orcid.org/0000-0003-2403-3782

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHealth service quality is important for adequate and equitable health systems. However, research on this topic may reflect imbalances in global scientific production, visibility and collaboration. This study examines global trends and disparities in health service quality research over the past decade, focusing on thematic priorities, geographic distribution and structural inequities.

objectivesThis review aims to (1) analyse the evolution of the quality of health services literature over time, assessing published articles and their impacts; (2) identify key trends, themes and significant contributions; (3) examine the geographical distribution of contributions to identify which nations excel in this area; (4) identify the key journals, authors and affiliations that significantly improve the quality of health services research; (5) assess the main factors that influence the citation impact of high-quality health services research; and (6) identify gaps in the quality of health services literature and suggest future research directions based on bibliometric insights.

methodsA systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. We integrated bibliometric analysis (using co-word networks, citation counts and keyword trends) with econometric modelling to map and synthesize publication patterns, visibility and thematic priorities. Specifically, panel regression was applied to examine the structural and content-related predictors of citation impact across a longitudinal dataset of peer-reviewed studies (2014-2023). The combination of bibliometric and econometric methods enhanced the analytical depth of the systematic review, enabling quantification of disparities and explanatory insights beyond descriptive synthesis.

resultsOut of 9121 records identified, 8857 articles were included in the final analysis. The included studies covered a broad range of regions and languages. Global publication volume increased steadily, peaking in 2021. Three dominant research themes were identified: patient experience, service delivery and health outcomes. Institutions from high-income countries, particularly those in North America and Europe, accounted for the most output and citations. Articles in English had significantly higher visibility than non-English publications. Citation impact was positively associated with international collaboration and reference count but negatively associated with title length and excessive keyword use. LIMITATIONS OF EVIDENCE: The review relied on a single database [Web of Science (WoS)], which may have excluded relevant articles indexed elsewhere. Citation lag affected newer studies. The bibliometric nature of the study limits direct conclusions on the quality of interventions or clinical outcomes.

conclusionsDespite the growth in global research output, significant disparities persist in the visibility and influence of health services quality research. Linguistic, institutional and geographic factors contribute to uneven dissemination and recognition. Promoting inclusive publishing practices and fostering cross-regional collaboration are essential to reducing structural inequities and enhancing the global relevance of health systems research. REGISTRATION: The protocol is publicly available through the Protocol Exchange Platform and can be accessed at https://doi.org/10.17504/protocols.io.261ge8ypyg47/v1 .

Indexed as

BibliometricsGlobal HealthHealthcare DisparitiesHealth Services ResearchQuality of Health CareHumansBibliometricsCitation impactEconometric modellingGlobal inequitiesHealth services qualitySystematic review

Identifiers

PMID40855491
PMCPMC12376348

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.