Co-production in health policy and management: a comprehensive bibliometric review

Abstract

Background: Due to an increasingly elderly population, a higher incidence of chronic diseases and higher expectations regarding public service provision, healthcare services are under increasing strain to cut costs while maintaining quality. The importance of promoting systems of co-produced health between stakeholders has gained considerable traction both in the literature and in public sector policy debates. This study provides a comprehensive map of the extant literature and identifies the main themes and future research needs.

Methods: A quantitative bibliometric analysis was carried out consisting of a performance analysis, science mapping, and a scientific collaboration analysis. Web of Science (WoS) was chosen to extract the dataset; the search was refined by language, i.e. English, and type of publication, i.e. journal academic articles and reviews. No time limitation was selected.

Results: The dataset is made up of 295 papers ranging from 1994 to May 2019. The analysis highlighted an annual percentage growth rate in the topic of co-production of about 25%. The articles retrieved are split between 1225 authors and 148 sources. This fragmentation was confirmed by the collaboration analysis, which revealed very few long-lasting collaborations. The scientific production is geographically polarised within the EU and Anglo-Saxon countries, with the United Kingdom playing a central role. The intellectual structure consists of three main areas: public administration and management, service management and knowledge translation literature. The co-word analysis confirms the relatively low scientific maturity of co-production applied to health services. It shows few well-developed and central terms, which refer to traditional areas of co-production (e.g. public health, social care), and some emerging themes related to social and health phenomena (e.g. the elderly and chronic diseases), the use of technologies, and the recent patient-centred approach to care (patient involvement/engagement).

Conclusions: The field is still far from being mature. Empirical practices, especially regarding co-delivery and co-management as well as the evaluation of their real impacts on providers and on patients are lacking and should be more widely investigated.

Keywords: Bibliometric analysis; Co-citation analysis; Co-creation; Co-production; Co-word analysis; Health; Patient engagement; Science mapping.

Fig. 1

Data collection flow

Fig. 2

Annual scientific production

Fig. 3

Scientific production by country. The map was generated through “Biblioshiny”, a shiny app providing a web-interface for Bibliometrix software (version 1.0, https://www.bibliometrix.org/Biblioshiny.html). Different shades of blue indicate different productivity rate: dark blue = high productivity; grey = no articles

Fig. 4

Country collaboration network. Density = 0.175; Degree Centralization = 0.54; Average path length = 2.074; Bibliometrix software attributes different colour to each cluster

Fig. 5

Co-authorship network. Density = 0.006; Degree centralization = 0.023; Average path length = 3.6; Bibliometrix software attributes different colour to each cluster

Fig. 6

Co-citation network of references. Density = 0.006; Degree centralization = 0.157; Average path length = 3.116; Bibliometrix software attributes different colour to each cluster

Fig. 7

Thematic map of the field