Health Policies Based on Patient Satisfaction: Comparison
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Healthcare decision-makers increasingly face a changing and ever-evolving landscape, forcing them to formulate public policies based on the results from different scientific investigations. This articlentry evaluates the field of research on patient satisfaction as a basis for health policies. The analysis was carried out with a sample of 621 articles published between 2000 and 2020 in the Scopus database.

  • patient satisfaction
  • health policy
  • health system
  • Scopus
  • bibliometric analysis
  • research trends

1. Introduction

The European Commission created the European Core Health Indicators (ECHIs), which are health indicators of the European Union whose objective is to obtain comparable and reliable data to contribute to the production of policies. The data emanating from these indicators will give an indication of the appropriate health policies to apply [1].

Seen from another point of view, the extension of the life expectancy of the people, and the improvement of their quality of life, could be an inconvenience for the health system of a country that offers its population universal access to medical care [2][3][4]. TWe highlight the importance of agents understanding political processes and implementing good health policies are highlighted because they will be the ones who can contribute to the continuous improvement of the services provided [5][6]. The latter takes the premise that patient satisfaction is a strong indicator of the quality of health services [7][8][9][10][11][12].

A previous investigation revealed that Europe contributes approximately one-third of the world’s scientific production related to public health [13]. Additionally, thwere are can find bibliometric studies that deal with articles that evaluate the quality of health services [14] or the existing institutional commitment in health organisations [15]. There are also bibliometric articles on health economics [16] and even the particular effect of telemedicine on patient satisfaction [17], along with the study of scientific activity on a specific disease [18]. Our study goes further because its objective is to study the scientific production on patient satisfaction as a basis for formulating public policies.

The objective of the health system will be to improve the health of the population, to which policymakers will need to analyse patients’ perceptions of it [19]. Scientific results constitute an input capable of transforming reality and/or solving problems [20]. Furthermore, it is indisputable that the product of health research must incorporate political content. The latter is because, although science can find significant findings on improving the population’s health, it will be the political actors who will be able to translate them into reality [6]. Accordingly, scientists are increasingly required to demonstrate the politically relevant benefits of their findings [21][22].

2. Current Insights

TWe studied the temporal evolution of the theme was studied from the point of view of keywords and the number of publications found. The most prolific authors and journals, collaborative relationships between countries, and scientific distribution were also analysed. Using the Scopus database, a sample of 621 articles published between 2000 and 2020 was obtained.
Although we could find that the first published articles were published in 1979 [23][24], scientific production on this subject began to flourish after 2000. Less than 11% of the total articles published correspond to the 1979–1999 period, which shows the interest generated after this time. This fact could be connected with the generation of the European Community Health Indicators (ECHI), which the European Union created to measure, among other things, the satisfaction of patients with the health system. The first part of the ECHI ended in 2001 [25]. The ECHI indicators arose to gather information that is not easy to obtain but useful for generating public policies [25][26].
Another turning point can be considered the financial crisis of 2008. After that year, 73.10% of the total scientific production was on PS and HP. The 2008 financial crisis caused a decrease in health budgets [27], so the study of satisfaction in these contexts became attractive. Analysis of patient satisfaction before and after the crisis is helpful to contribute to the formulation of public policies that improve the quality of the health system [28]. For example, considering that the length of stay is the primary determinant of the cost of hospitalisation, analyses will be carried out to reduce this stay without reducing the quality of care [29].
The main subject area is Medicine, followed by Nursing and Social Sciences, which is logical because health policy and patient satisfaction are framed within these large study groups. However, patient satisfaction from the point of view of health investment management and the application of resources is not widely covered. The following data can prove this: The business management area covers only 1.44% and the economic area 1.08%.
The two most productive authors are British and have six articles each. Bower P., belonging to the University of Manchester, is in first place, and Roland M, a member of the University of Cambridge, is second. These two authors are also leaders in the number of citations. However, the statehood belonging to the Harvard School of Public Health, Blendon R.J, is the author with the most extensive experience (13 years) and the highest value of citations per article (86). In this field of research, the most proliferating institution with the most significant impact is the University of Manchester, with 14 published articles and an h-index of 11. However, the institution with the highest number of citations is the London School of Hygiene and Tropical Medicine. The Imperial College London has the highest number of citations per article.
In order of importance, the five most productive countries are the United States, the United Kingdom, Canada, Australia, and Germany. All of them, except Canada, are also included in the list of the five most cooperative. The United States leads the position of both rankings with 185 articles published and 89 collaborations. On the contrary, the United Kingdom has the best quality measured according to the number of citations received, with an h-index of 33.
This study improves research on PS and HP because it allows us to visualise the state of scientific production and, above all, with the evolution of keywords, to identify possible future avenues of research. In this sense, we determined that the five most important topics studied in the current literature are: Intensive Care Units, Cost, Aid, Feasibility-study, and Human.
On the other hand, the strategic diagram allowed us to identify four emerging or decadent themes (Risk Factors, Rehabilitation Centre, City, and Health Status Indicators). For the study of the keywords, the period analysed was divided into two. However, in both sub-periods, the engine keyword with the highest h-index is the same: Human. Additionally, this keyword use leads in the number of documents, being 193 in the first ten years of study and 301 in the last ten years, which is logical because it is a global and generic issue. Perception is a theme that grew between the first period (4 documents) and the second period (25 papers). This contribution is relevant to the research because we can see that the patient's perception of perceived health services is increasingly considered when deciding what investments, expenses, and practices to carry out.
Of the five most productive journals, four are of British nationality. The first place is Social Science and Medicine, and the second is BMC Health Services Research, with 19 and 18 published articles, respectively. It was to be expected to find journals that deal with the subject of health in general terms. For this reason, other bibliometric studies on health services also find them among the most prolific [30]. In third place is an Irish journal that surpasses the previous ones in trajectory, being its first publication in 2001 and its last in 2019. Eight of the eleven most productive journals in 2019 belonged to quartile 1 in the Scimago Journal Rank (JCR).
Although no bibliometric studies were found on the formulation of public policies based on the patients’ satisfaction in the health system, an analysis of scientific production was found on closely related topics, such as the quality of the health system [14] and the application of marketing to public services [31].

3. Conclusions

AWe carried out a bibliometric study were  carried out based on 621 articles from the Scopus database on PS and HP published between 2000 and 2020. The study revealed that the scientific production on the subject was not significant in terms of quantity in previous years. However, from the year 2000, production began to accelerate.  The latter is estimated We estimate the latter to be due to the appearance of the ECHI indicators. Therefore, starting in 2010, a greater preoccupation can be observed in studying the perception of patients.
It'sWe believed that researchers must understand the political processes in health matters. At the same time, politicians have to communicate with researchers because it will be the only way scientific discoveries can be applied in real life and improve the population's health and quality of life.
Finally, we want to underline that two potent tools have been used: VOSviewer and SciMAT. In the bibliography, it can be observed that, in general, only a single bibliometric tool is used.

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