Mapping the research trends on health insurance purchase: a bibliometric analysis and systematic review

Abstract Background Health insurance plays a vital role in reducing healthcare costs and promoting equitable access to medical services. However, coverage gaps persist in many regions, impeding progress toward universal health coverage as outlined in the UN Sustainable Development Goals. This study aims to comprehensively review recent research on health insurance purchasing, focusing on patterns, trends, methodologies, and key thematic areas. Methods A combination of bibliometric analysis and systematic review was employed to analyze health insurance purchasing literature. The Theory-Context-Methodology (TCM) framework guided the systematic review, with performance analysis conducted to evaluate publication trends and contribution patterns. Bibliographic coupling and co-occurrence analysis were used to identify the major themes and frontier topics. Results The study examined diverse theoretical perspectives and methodological approaches, with a focus on developed and emerging markets. The performance analysis revealed a steady increase in publications, with the United States and China emerging as leading contributors. Quantitative methods dominated in developed markets, while qualitative approaches were more prevalent in emerging markets. Key research themes included policy reforms and consumer behavior, with frontier topics such as cultural and financial factors and urban–rural insurance integration gaining prominence. Conclusions This study enhances the understanding of global health insurance purchasing research, particularly highlighting the need for further exploration in emerging markets. The findings provide valuable insights for future research, especially regarding evolving insurance systems and their impact on healthcare access and equity.