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