Highlight Global Inequities in Health Services Quality Research: A Systematic Review and Quantitative Evidence (2014–2023)

Highlight Global Inequities in Health Services Quality Research: A Systematic Review and Quantitative Evidence (2014–2023) | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Highlight Global Inequities in Health Services Quality Research: A Systematic Review and Quantitative Evidence (2014–2023) Mihail-Vasile Pruteanu, Alina Moroșanu, Georgeta Zegan, Elena Mihaela Cărăușu, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6603791/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 25 Aug, 2025 Read the published version in Health Research Policy and Systems → Version 1 posted 11 You are reading this latest preprint version Abstract Background Health 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. Methods A systematic review followed PRISMA 2020 guidelines, combining bibliometric and econometric methods. Peer-reviewed articles published between 2014 and 2023 were retrieved through comprehensive searches of international databases. Bibliometric indicators assessed publication trends, co-authorship networks, thematic focus, and citation patterns. Econometric modeling explored factors associated with citation impact and international collaboration. Results Out of 9.763 records identified, 8.857 articles were included in the final analysis. 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 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. Conclusions Despite 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 is essential to reducing structural inequities and enhancing the global relevance of health systems research. health services quality systematic review bibliometrics citation impact global inequities econometric modeling Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 25 Aug, 2025 Read the published version in Health Research Policy and Systems → Version 1 posted Editorial decision: Revision requested 09 Jun, 2025 Reviews received at journal 09 Jun, 2025 Reviewers agreed at journal 09 Jun, 2025 Reviews received at journal 08 Jun, 2025 Reviews received at journal 04 Jun, 2025 Reviewers agreed at journal 04 Jun, 2025 Reviewers agreed at journal 03 Jun, 2025 Reviewers invited by journal 03 Jun, 2025 Editor assigned by journal 08 May, 2025 Submission checks completed at journal 08 May, 2025 First submitted to journal 06 May, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6603791","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":466644348,"identity":"b26262e9-3c5b-4e46-b172-71f250e4acd1","order_by":0,"name":"Mihail-Vasile Pruteanu","email":"","orcid":"","institution":"Grigore T. 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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.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA systematic review followed PRISMA 2020 guidelines, combining bibliometric and econometric methods. Peer-reviewed articles published between 2014 and 2023 were retrieved through comprehensive searches of international databases. Bibliometric indicators assessed publication trends, co-authorship networks, thematic focus, and citation patterns. Econometric modeling explored factors associated with citation impact and international collaboration.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eOut of 9.763 records identified, 8.857 articles were included in the final analysis. 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 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.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eDespite 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 is essential to reducing structural inequities and enhancing the global relevance of health systems research.\u003c/p\u003e","manuscriptTitle":"Highlight Global Inequities in Health Services Quality Research: A Systematic Review and Quantitative Evidence (2014–2023)","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-06-06 14:54:04","doi":"10.21203/rs.3.rs-6603791/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-06-09T14:42:43+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-06-09T13:12:45+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"2217190619379267381357235369406398169","date":"2025-06-09T12:41:54+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-06-08T06:20:17+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-06-04T08:47:07+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"95721635845147292172168775769746997886","date":"2025-06-04T06:01:52+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"242195703873561406011274617887940674411","date":"2025-06-04T03:15:23+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-06-03T15:54:07+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-05-08T13:54:22+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-05-08T13:47:34+00:00","index":"","fulltext":""},{"type":"submitted","content":"Health Research Policy and Systems","date":"2025-05-06T13:51:57+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"health-research-policy-and-systems","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"hrps","sideBox":"Learn more about [Health Research Policy and Systems](http://health-policy-systems.biomedcentral.com/)","snPcode":"12961","submissionUrl":"https://submission.nature.com/new-submission/12961/3","title":"Health Research Policy and Systems","twitterHandle":"@HarpsJournal","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"e2f22256-5f48-4231-bdb7-62bd0b45cc9d","owner":[],"postedDate":"June 6th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-09-01T16:05:24+00:00","versionOfRecord":{"articleIdentity":"rs-6603791","link":"https://doi.org/10.1186/s12961-025-01376-y","journal":{"identity":"health-research-policy-and-systems","isVorOnly":false,"title":"Health Research Policy and Systems"},"publishedOn":"2025-08-25 15:57:07","publishedOnDateReadable":"August 25th, 2025"},"versionCreatedAt":"2025-06-06 14:54:04","video":"","vorDoi":"10.1186/s12961-025-01376-y","vorDoiUrl":"https://doi.org/10.1186/s12961-025-01376-y","workflowStages":[]},"version":"v1","identity":"rs-6603791","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6603791","identity":"rs-6603791","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}