28
Natalia Carolina Cañar Muñoz
Oscar Marino López-Mallama
Mapping the scientific production on economic regulation and health
systems
Revista Criterios - vol. 32 n.o 2 Julio-Diciembre 2025 - pp. 28-45
Rev. Criterios ISSN: 0121-8670, e-ISSN: 2256-1161
https://doi.org/10.31948/rev.criterios
Mapping the scientific production on
economic regulation and health systems
Natalia Carolina Cañar Muñoz1
Oscar Marino López-Mallama2
To reference this article / Cómo citar este artículo /
Para citar este artigo: Cañar-Muñoz, N. C., & López-Mallama,
O. M. (2025). Mapping the scientic production on economic
regulation and health systems. Revista Criterios, 32(2), 28-45.
https://doi.org/10.31948/rc.v32i2.4700
Reception date: March 3, 2025
Review date: May 15, 2025
Approval date: June 26, 2025
Abstract
The study analyzed scientific literature on economic regulation and its
relationship with health systems. To this end, a bibliometric approach based on
the PRISMA-ScR principles was employed. A Scopus search based on inclusion
and exclusion criteria identified 201 articles. The results show that research in
this field started in 2006 and experienced significant growth in 2020 and 2021.
The United States leads in academic contributions, followed by other countries
with highly regulated health systems. An analysis of bibliographic networks
identified three main research clusters: the efficiency and accessibility of
health systems; competition and market governance; and regional variations in
regulatory approaches. These findings underscore the importance of economic
regulation for the sustainability and equity of health systems, and emphasize
the need for further research in the context of emerging economies.
Keywords: government regulation; audit; health; economics; health care
system; bibliometrics
1 Health Administration student, Institución Universitaria Antonio José Camacho; member of Semillero en Economía de la Salud –
SELMA, affiliated with the GISAP group, Institución Universitaria Antonio José Camacho, Santiago de Cali, Valle del Cauca, Colombia.
E-mail: ncanar@estudiante.uniajc.edu.co
2 PhD candidate in Administration with an emphasis on Government and Public Policy, Universidad del Valle. Professor, Institución
Universitaria Antonio José Camacho; member of the Semillero en Economía de la Salud – SELMA, affiliated with the GISAP group,
Institución Universitaria Antonio José Camacho, Santiago de Cali, Valle del Cauca, Colombia. E-mail: omarinolopez@admon.uniajc.
edu.co
Review article. Research conducted as part of project PS-0225 by the Semillero de Investigación en Economía de la Salud – SELMA,
affiliated with the GISAP group at the Institución Universitaria Antonio José Camacho, Santiago de Cali, Valle del Cauca, Colombia.
29
Natalia Carolina Cañar Muñoz
Oscar Marino López-Mallama
Mapping the scientific production on economic regulation and health
systems
Revista Criterios - vol. 32 n.o 2 Julio-Diciembre 2025 - pp. 28-45
Rev. Criterios ISSN: 0121-8670, e-ISSN: 2256-1161
https://doi.org/10.31948/rev.criterios
Mapeo de la producción científica sobre la
regulación económica y los sistemas de salud
Resumen
En el presente estudio, se analiza la producción científica sobre la regulación
económica y su relación con los sistemas de salud. Para ello, se empleó un
enfoque bibliométrico, a partir de los principios de la declaración PRISMA-
Scr. La búsqueda en Scopus, basada en los criterios de inclusión y exclusión,
permitió identificar 201 artículos. Los resultados señalan que las investigaciones
en este campo iniciaron en 2006, con un crecimiento notable en 2020 y 2021.
Estados Unidos lidera en contribuciones académicas, seguido de otros países
con sistemas de salud altamente regulados. El análisis de redes bibliográficas
permitió identificar tres clústeres principales de investigación: eficiencia y
accesibilidad de los sistemas de salud, competencia y gobernanza del mercado,
y variaciones regionales en los enfoques regulatorios. Estos hallazgos reflejan la
importancia de la regulación económica para la sostenibilidad y equidad de los
sistemas de salud; asimismo, se destaca la necesidad de mayor investigación en
contextos de economías emergentes.
Palabras clave: regulación gubernamental; fiscalización; salud; economía;
sistema de salud; bibliometría
Mapeamento da produção científica sobre
regulação econômica e sistemas de saúde
Resumo
O estudo analisou a literatura científica sobre regulação econômica e sua relação
com os sistemas de saúde. Para isso, foi utilizada uma abordagem bibliométrica
baseada nos princípios PRISMA-ScR. Uma pesquisa na Scopus baseada em
critérios de inclusão e exclusão identificou 201 artigos. Os resultados mostram que
a pesquisa nesse campo começou em 2006 e teve um crescimento significativo em
2020 e 2021. Os Estados Unidos lideram as contribuições acadêmicas, seguidos
por outros países com sistemas de saúde altamente regulamentados. Uma
análise das redes bibliográficas identificou três grupos principais de pesquisa:
eficiência e acessibilidade dos sistemas de saúde; concorrência e governança de
mercado; e variações regionais nas abordagens regulatórias. Essas descobertas
ressaltam a importância da regulamentação econômica para a sustentabilidade
e a equidade dos sistemas de saúde, e enfatizam a necessidade de realizar
pesquisas adicionais no contexto das economias emergentes.
Palavras-chave: regulamentação governamental; fiscalização; saúde;
economia; sistema de saúde; bibliometria
30
Natalia Carolina Cañar Muñoz
Oscar Marino López-Mallama
Mapping the scientific production on economic regulation and health
systems
Revista Criterios - vol. 32 n.o 2 Julio-Diciembre 2025 - pp. 28-45
Rev. Criterios ISSN: 0121-8670, e-ISSN: 2256-1161
https://doi.org/10.31948/rev.criterios
Introduction
Healthcare systems are dynamic and complex
structures that are constantly evolving, linking
multiple actors with diverse motivations who
interact with each other (López-Mallama, 2023;
Mantilla et al., 2023; López-Mallama et al., 2023)
Its main objective is to guarantee the health
of the population, protect their financial well-
being, and offer accessible services, all under
each country’s economic capacity (Andrade et
al., 2024; Galvis et al., 2022; Pan American
Health Organization (PAHO, 2020). To fulfill this
purpose, health systems rely on four essential
functions: stewardship, financing, resource
generation, and service provision (Montaño
& García-Perdomo, 2024; Centro de Estudios
en Protección Social y Economía de la Salud
[Proesa], 2020).
In addition to providing medical care to
individuals and communities, health systems
implement strategies that influence policies
and actions in other sectors. These strategies
aim to address the social, environmental,
and economic determinants that impact
health (Cotonieto-Martínez & Rodríguez-
Terán, 2021; García & Esquer, 2024) From an
economic perspective, these systems function
within environments where market failures
are evident, given the variety of actors and
institutions involved in the sector’s planning,
resource allocation, and regulation (Arellano,
2022). These actors interact within market,
regulatory, and governance frameworks,
giving rise to relationships of coordination,
subordination, and participation (Tacumá &
Tovar, 2021).
In the context of globalization and neoliberal
economic policies —characterized by trade
liberalization, reduced public spending,
privatization, and the deregulation of economic
inequalities— poverty and income inequality
have increased, affecting equitable access to
health services (Treacy, 2021). At the same
time, public health faces challenges arising
from demographic transition, marked by
population aging and an increase in chronic
noncommunicable diseases (UN. CEPAL, 2022;
Pinilla et al., 2021). Similarly, the epidemiological
transition has led to the development of
programs to prevent and treat prevalent and
emerging communicable diseases (Boucourt et
al., 2022)
Studying health systems from the perspective
of economic regulation allows us to analyze
their macroeconomic impact on population
health, productivity, and quality of life. At
the microeconomic level, we can study the
dynamics of agents and decision-making within
the health ecosystem. These issues are closely
linked to the third Sustainable Development
Goal (SDG), which focuses on health and
well-being. Specifically, it addresses universal
coverage (target 3.8) and health financing
(target 3.C) (Javier & Cuadros, 2022; Lomelí,
2020; United Nations, n.d.).
Although several studies have addressed
economic regulation as a factor influencing
the efficiency and equity of health systems,
previous research, such as that by Rodríguez
et al. (2024), Montaño and García-Perdomo,
(2024), and Báscolo et al. (2024), have pointed
out that there are gaps in our understanding
of how health systems, especially in emerging
economies, apply regulatory policies in the
face of economic challenges. In this regard, the
objective of this study is to analyze the state
of scientific research on economic regulation
and health systems using a bibliometric and
qualitative approach based on the PRISMA-
ScR statement. Through this analysis, we will
identify the topics studied, the authors and
agencies involved, and the emerging trends in
this field (Nasrallah et al., 2022; Osorio et al.,
2023; 2025).
Methodology
To conduct this review, the procedures stipulated
in the PRISMA-Scr statement for systematic
literature reviews (Camacho-Castro & Monge-
Olivarría, 2023; Cervantes et al., 2024; Page et
al., 2021) were integrated with the bibliometric
methods proposed by Donthu et al. (2021).
These methods allow for the evaluation and
quantification of scientific research results,
as they provide a comprehensive view of the
impact and evolution of a field of knowledge
over a given period (Arango, Espinal et al.,
2021; Rodríguez Orejuela et al., 2021).
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Natalia Carolina Cañar Muñoz
Oscar Marino López-Mallama
Mapping the scientific production on economic regulation and health
systems
Revista Criterios - vol. 32 n.o 2 Julio-Diciembre 2025 - pp. 28-45
Rev. Criterios ISSN: 0121-8670, e-ISSN: 2256-1161
https://doi.org/10.31948/rev.criterios
The methodological process was developed in stages, namely:
Source of information: The information was extracted from the Scopus database, due to its
prestige, wide coverage, and statistical analysis capabilities (Echchakoui, 2020; Pranckutė, 2021).
Search strategy: the following search equation was used (TITLE-ABS-KEY (“health systems”)
OR TITLE-ABS-KEY (“national health systems”) OR TITLE-ABS-KEY (“healthcare models”) AND
TITLE-ABS-KEY (“theory of economic regulation”) OR TITLE-ABS-KEY (“Health Care Coordination
and Monitoring”) OR TITLE-ABS-KEY (“Government Regulation”)) AND (LIMIT-TO (DOCTYPE, “ar”))
AND (LIMIT-TO (OA, “all”)).
The keywords were selected from the DeCS/MeSH terms in the BVSalud database of Bireme and
the UNESCO Thesauri (Espíndola et al., 2020; Carrillo-Vera et al., 2024; Olarte & Muñoz, 2025).
Eligibility criteria: completed research was included; article type; open access; the article
was related to the topic of the review; no language restrictions; and no publication date
restrictions. Duplicate articles in the database were excluded, as were articles whose main topic
did not correspond to the topic of the review, working papers, newsletters, technical reports,
recommendations and technical standards, books, abstracts, academic courses, conference notes,
conference proceedings, editorials, and letters to the editor (Fajardo et al., 2024).
Extraction process: Once the final sample of documents was obtained, it was downloaded in
CSV format, including all the fields provided by Scopus (Osorio et al., 2025). Microsoft Excel was
used to consolidate and systematize the information collected (Burguet & Burguet, 2020; Ramírez
et al., 2025).
Information processing: Data analysis was carried out in two stages, based on the methodology
of Donthu et al. (2021). In the first stage, performance was evaluated by analyzing individual
contributions to research using bibliometric indicators. In the second stage, a visual representation
or network map was created to examine the interconnections between the elements studied and
define trends in the field; for this purpose, VOSviewer software was used (Bukar et al., 2023;
Gómez Velasco et al., 2021; Reina-Guaña, 2024; Silva et al., 2021).
Ethical component: the review was conducted following the ethical principles of the Declaration
of Helsinki (World Medical Association, 2025) and the provisions of Resolution 8430 of 1993, which
classifies this type of study as risk-free, given that it employs retrospective documentary research
techniques and methods (Acosta-Sarasty & Zambrano-Acosta, 2022).
Results
Figure 1 shows the eligibility criteria according to the order established in the methodology, through
the development of each phase of the PRISMA flow chart. A total of 536 articles were retrieved in
the search, and 335 were excluded for not meeting the inclusion criteria. Finally, 201 were included
for descriptive analysis and eight for cluster analysis (Forero-Peña et al., 2020; Olarte & Muñoz,
2025; Orellana et al., 2024; Caballero & Mojica, 2021).
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Natalia Carolina Cañar Muñoz
Oscar Marino López-Mallama
Mapping the scientific production on economic regulation and health
systems
Revista Criterios - vol. 32 n.o 2 Julio-Diciembre 2025 - pp. 28-45
Rev. Criterios ISSN: 0121-8670, e-ISSN: 2256-1161
https://doi.org/10.31948/rev.criterios
Figure 1
PRISMA flow chart
Note. Adapted from Haddaway et al. (2022).
Performance evaluation
Chronological indicator
According to data extracted from the Scopus database, research on economic regulation and
health systems dates back to 2006. The first document, published by Dietrich (2006) that year,
concludes that pharmaceutical faculties should impart knowledge not only of chemistry, but also
of the health system, social skills, cost structures, clinical benefits, and the cost-benefit ratio of
medicines. Figure 2 shows an initial growth in publications, peaking in 2020 and 2021 with 28
publications total.
33
Natalia Carolina Cañar Muñoz
Oscar Marino López-Mallama
Mapping the scientific production on economic regulation and health
systems
Revista Criterios - vol. 32 n.o 2 Julio-Diciembre 2025 - pp. 28-45
Rev. Criterios ISSN: 0121-8670, e-ISSN: 2256-1161
https://doi.org/10.31948/rev.criterios
Figure 2
Scientific output over time
Articles
Years
Country indicator
Figure 3 shows the worldwide scientific output. Notably, the United States accounts for over
a quarter of the published documents, with 49 publications. This indicator also demonstrates
the contributions of other countries to the field of study, including the United Kingdom with 31
publications, Brazil with 28, Australia with 22, and Canada with 19.
Figure 3
Scientific output by country
Magazine indicator
Table 1 shows the ranking of the five leading journals with the most publications related to the
review topic. According to the SJR index, these journals stand out for their high international
academic impact. In the Colombian context, they are classified as TOP by Publindex.
34
Natalia Carolina Cañar Muñoz
Oscar Marino López-Mallama
Mapping the scientific production on economic regulation and health
systems
Revista Criterios - vol. 32 n.o 2 Julio-Diciembre 2025 - pp. 28-45
Rev. Criterios ISSN: 0121-8670, e-ISSN: 2256-1161
https://doi.org/10.31948/rev.criterios
Table 1
Scientific output by journal
Journal Publications Quartiles SJR
BMC Health Services Research 11 Q1 1.029
Plos One 9Q1 0.839
Health Research Policy And Systems 8Q1 1.563
Cadernos de Saude Publica 7Q2 0.765
Ciencia e Saude Coletiva 7 Q2 0.579
Indicator of most inuential authors
Table 2 lists the five most influential authors and the number of research studies they have
conducted. Brazil stands out with three publications. The h-index assesses a researcher’s work
quality and influence (Koltun & Hafner, 2021). Busse has the highest score, followed by Bernal.
Table 2
Scientific output by authors
Author Publications H-Index Affiliation
Andreazza,
Rosemarie 3 6 Universidade Federal de São Paulo; Sao Paulo,
Brasil
Andrade, Maria
Da Graça Garcia 2 7 Universidade Estadual de Campinas,
Campinas, Brasil
Araújo, Eliane
Cardoso De 2 3 Universidade Federal de São Paulo; Sao Paulo,
Brasil
Bernal-Delgado,
Enrique 223 Instituto Aragonés de Ciencias de la Salud,
Zaragoza, España
Busse, Reinhard 266 Technische Universität Berlin, Berlín, Alemania
Indicator for seminal texts
The five most cited articles, according to the Scopus database (see Table 3), cover a variety of
topics including the COVID-19 pandemic (Aquino et al., 2020), the consolidation of the hospital
market (Cutler & Scott-Morton, 2013), the use of big data in healthcare (Auffray et al., 2016),
traditional medicine (Fokunang et al., 2011), and perceptions of the pandemic (Hager et al., 2021).
This diversity reflects how research on economic regulation and health systems interrelates with
global social, political, and technological issues (Loschiavo & Fucci, 2024).
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Natalia Carolina Cañar Muñoz
Oscar Marino López-Mallama
Mapping the scientific production on economic regulation and health
systems
Revista Criterios - vol. 32 n.o 2 Julio-Diciembre 2025 - pp. 28-45
Rev. Criterios ISSN: 0121-8670, e-ISSN: 2256-1161
https://doi.org/10.31948/rev.criterios
Table 3
Most cited articles
Article title Journal Year Author (s) No. of
citations
Social distancing measures to control
the COVID-19 pandemic: Potential
impacts and challenges in Brazil
Ciencia e Saude
Coletiva 2020 Aquino et al. 355
Hospitals, market share, and
consolidation JAMA 2013 Cutler and
Scott-Morton 254
Making sense of big data in health
research: Towards an EU action plan
Genome
Medicine 2016 Auffray et al. 219
Traditional medicine: Past, present
and future research and development
prospects and integration in the
national health system of Cameroon
African Journal
of Traditional,
Complementary
and Alternative
Medicines
2011 Fokunang et al. 156
Knowledge, attitude, and perceptions
towards the 2019 Coronavirus
Pandemic: A bi-national survey in Africa
PLoS ONE 2021 Hager et al. 126
Visual representation analysis
Bibliographic coupling network
Articles are considered linked when they share one or more references in their bibliographies,
which suggests that they may cover related topics (Boeris, 2010). This analysis is based on the
strength of coupling, determined by the total number of citations or references in common (Mas-
Tur et al., 2021; Phan Tan, 2022). Figure 4 shows the bibliographic coupling network (Van Eck &
Waltman, 2014).
Figure 4
Coupling network
The bibliographic coupling network helps us identify the main trends or dominant themes in a field
of study. In this case, three clusters were identified and represented by different colors. Cluster
1 consists of the studies by Camacho et al. (2017), Vasconcellos and Morel (2012), and Walls et
al. (2020); cluster 2 involves the studies by Campbell et al. (2019), George and Iyer (2013), and
Sheikh et al. 2015; and cluster 3, the studies by Azzopardi-Muscat et al. (2017) and Ow Yong and
Koe (2021).
36
Natalia Carolina Cañar Muñoz
Oscar Marino López-Mallama
Mapping the scientific production on economic regulation and health
systems
Revista Criterios - vol. 32 n.o 2 Julio-Diciembre 2025 - pp. 28-45
Rev. Criterios ISSN: 0121-8670, e-ISSN: 2256-1161
https://doi.org/10.31948/rev.criterios
Discussion
The notable growth in 2020 and 2021 coincides
with the COVID-19 pandemic, an event that
intensified scientific production on topics related
to economic regulation in health, access to
services, financing, and government response
(Hale et al., 2021; Kickbusch & Holzscheiter,
2021). The pandemic tested the regulatory
capacity of health systems, sparking debates
about state intervention, drug price regulation,
and striking the right balance between
efficiency and equitable access to services
(Arellano, 2022; Forero-Peña et al., 2020).
The United States is known for its substantial
investment in research and development
(R&D), which has strengthened its position as
a leader in health-related scientific publications
(Gyawali et al., 2020; Woloshin et al., 2020).
Additionally, the U.S. healthcare model is
characterized by a high degree of privatization
and fragmented regulation. This has generated
sustained interest in studying regulatory
policies, costs, and healthcare reforms that
enable access to medical care (Cutler et al.,
2019; Himmelstein et al., 2020).
In Latin America, healthcare systems such as
Brazil’s prioritize universal and free care, which
requires a type of economic regulation focused
on public financing and cost control to ensure
access to care (Juárez et al., 2024; Quispe &
Avega, 2024). On the other hand, in countries
such as Mexico and Colombia, the privatization
of some services and the coexistence of private
and public insurance result in more complex
regulatory approaches that seek to balance
market competitiveness with universal coverage
(García & Esquer, 2024; López-Mallama, 2023;
Restrepo-Zea & Zapata-Cortés, 2022; López-
Mallama et al., 2024).
In Europe, economic regulation takes different
forms. Countries such as the United Kingdom,
with its National Health Service, opt for state-
planned economic regulation (Zalakain, 2022).
Germany, on the other hand, implements a
mixed model in which private insurance plays an
important role in health coverage (Fernández-
Sánchez et al., 2021). This difference in
regulatory models has direct implications for
the efficiency of the system and equity in
access to health services, as Reyes-Morales et
al. (2024) argue.
In regions such as Asia and Africa, regulatory
variations are influenced by levels of economic
development and available resources. Many
African health systems face significant
challenges in terms of infrastructure and
resources. This has led to innovations in care,
such as the integration of traditional medicine
with regulatory policies and the implementation
of pharmaceutical price regulations to limit
the impact of poverty on access (Atwoli et al.,
2022). Meanwhile, Asian countries such as China
have made progress in economically regulating
health services by integrating emerging
technologies, such as telehealth, which marks
a departure from traditional approaches that
focus on physical infrastructure (Rodríguez-
Pérez, 2024).
Journals that lead scientific production in this
field, such as BMC Health Services Research
and Health Research Policy and Systems, are
recognized for their prestige and high impact
factor. According to the SJR (Scimago Journal
Rank) index, these publications are in the Q1
quartile, reflecting their influence within the
global scientific community (Duque & Duque,
2022). Previous studies, such as that by Ávila-
Toscano et al. (2022), have shown that journals
in the Q1 quartile tend to address the most
relevant topics and disseminate knowledge to
the greatest extent. These findings suggest
that research on economic regulation and
health systems is emerging as a key area
within global health policy, indicating that it
is becoming a priority topic in these journals
(Gómez-Hurtado, 2021).
In their recent publications, the most influential
authors have had the following objective: to
analyze the contexts of influence and textual
production of the Emergency Care Network
Policy (RUE) in Brazil using the policy cycle
approach (Nogueira et al., 2024); conduct a
genealogical analysis of deafness, that is, an
analysis of the practices of knowledge and
power in Brazilian health policy (Garcia et al.,
2022); describe the elements present in medical
practice that contribute to understanding its
recognized low adherence to the guidelines
of the Brazilian Primary Health Care (PHC)
Policy (Reis et al., 2018); review working hour
regulations for residents in different countries,
with an emphasis on night shifts (Maoz et al.,
2023); and identify predictors for patients
37
Natalia Carolina Cañar Muñoz
Oscar Marino López-Mallama
Mapping the scientific production on economic regulation and health
systems
Revista Criterios - vol. 32 n.o 2 Julio-Diciembre 2025 - pp. 28-45
Rev. Criterios ISSN: 0121-8670, e-ISSN: 2256-1161
https://doi.org/10.31948/rev.criterios
who report unfavorable outcomes but high
satisfaction and vice versa, following total knee
arthroplasty (Schöner et al., 2025).
Analysis of the most cited articles provides
a clear picture of the topics that have had a
significant influence on academic literature
and global health policy. Aquino et al. (2020)
summarize the available evidence on the
impact of social distancing measures on the
epidemic and analyze the implementation of
these measures in Brazil. Cutler and Scott-
Morton (2013) discuss how hospital market
consolidation affects competition, prices, and
quality of care; Auffray et al. (2016) emphasize
the growing importance of big data in health
research and health policy formulation.
Fokunang et al. (2011) present how research
on traditional medicine can influence policy-
making and health regulation. Finally, Hager et
al. (2021) emphasize the importance of public
perceptions and attitudes in the implementation
of public health policies.
The identification of research trends revealed
three tendencies: the first focused on the
efficiency of the healthcare system and its
influence on public policy (cluster 1). Studies by
Camacho et al. (2017), Vasconcellos and Morel
(2012), and Walls et al. (2020) investigate how
economic regulation influences the performance
of health systems in terms of costs, coverage,
and access to health services. The second
focuses on market regulation and competition
in healthcare (cluster 2). The studies by
Campbell et al. (2019), George and Iyer (2013),
and Sheikh et al. (2015) focus on regulatory
aspects related to competition, the market,
and healthcare system governance. The third
cluster was regional and global perspectives
on health system regulation (cluster 3). The
studies by Azzopardi-Muscat et al. (2017)
and Ow Yong and Koe (2021) address health
regulation based on the political, economic,
and social characteristics of different societies.
Conclusions
The increase in academic research on economic
regulation and healthcare systems reflects
the scientific community’s growing interest
in addressing these issues and responds to
global factors, including the ongoing pandemic,
regulatory reforms, and the need for financial
sustainability in healthcare systems. The goal
is to achieve equitable access to healthcare for
the population.
The United States and other developed
countries’ leadership in scientific production
on economic regulation and health systems
reflects the importance of the issue in contexts
with diverse, highly regulated health systems.
However, the lower participation of developing
countries and emerging economies underscores
the importance of promoting research in
these regions to improve our understanding
of regulatory dynamics while considering
resource limitations and structural inequalities.
The presence of high-impact journals,
particularly in the Q1 and Q2 quartiles, affirms
the importance of economic regulation in
health as a primary area of research. These
publications provide decision-makers with
information to address the challenges of
economic regulation in health systems while
considering the specific characteristics of each
territory.
The most cited articles on economic regulation
and health systems encompass a wide range
of interconnected topics, including responses
to health emergencies, hospital market
consolidation, the use of data for health
decision-making, and the integration of
traditional treatments. The relevance of these
studies for understanding health systems and
economic regulation allows us to address issues
related to equity, efficiency, and sustainability
in health services.
The identified clusters illustrate the main areas
of research: the efficiency and accessibility
of health systems; market competition
and governance; and regional variations in
regulatory approaches. Addressing these issues
is essential for formulating public policies that
improve the economic performance of health
systems and ensure equitable access to quality
care for all patients.
The bibliometric review has limitations, given
that it used a single database (Scopus), which
could have excluded relevant studies indexed
in other sources. Furthermore, the selection of
articles focused on open-access publications;
while this facilitated the availability of
information, it could also have generated bias
by leaving out studies with restricted access.
38
Natalia Carolina Cañar Muñoz
Oscar Marino López-Mallama
Mapping the scientific production on economic regulation and health
systems
Revista Criterios - vol. 32 n.o 2 Julio-Diciembre 2025 - pp. 28-45
Rev. Criterios ISSN: 0121-8670, e-ISSN: 2256-1161
https://doi.org/10.31948/rev.criterios
Conict of interest
The authors declare that they have no conflicts
of interest of a personal, political, financial,
intellectual, racist, religious, or other nature.
Ethical Responsibilities
The authors declare that they did not engage
in any unethical practices or omit any legal
aspects when conducting the research.
Sources of funding
The authors declare that they have not received
any financial support for this work.
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Contribution
Natalia Carolina Cañar-Muñoz: analysis
and interpretation of results, writing the
introduction, methodology, discussion,
conclusions, and writing the original draft.
Oscar Marino López-Mallama: analysis
and interpretation of results, writing of
the introduction, methodology, discussion,
conclusions, and final draft: review and editing.
All authors participated in preparing the
manuscript, reading it, and approving it.
