A Bibliometric Analysis of Hospital Financial Performance: Emerging trends and future directions

Background: The financial performance of hospitals significantly influences the quality and sustainability of healthcare services, particularly amid rising operational costs and evolving healthcare regulations. While various financial metrics have been studied, there remains a lack of comprehensive bibliometric analyses that map the growth, emerging themes, and future research directions in this field. This study aims to fill that gap by examining the development and patterns of hospital financial performance research. Methods: A bibliometric analysis was conducted using the SPAR-4-SLR protocol on 2,387 publications retrieved from the Scopus database, spanning from 2014 to October 12, 2024. Bibliometric techniques such as co-authorship, keyword co-occurrence, and citation analysis were performed using VOS viewer to identify research trends, leading contributors, and thematic clusters. Results: The analysis revealed a steady increase in publications from 2014 to 2021, peaking at 341 papers. A slight decline in subsequent years is likely due to indexing delays, not reduced research activity. Thematic clustering identified four main areas of focus: (1) hospital, (2) COVID-19, and (3) healthcare. In recent years, additional attention has been given to emerging themes such as health equity, access, and the application of artificial intelligence. These findings suggest a dynamic and evolving research landscape that reflects broader shifts in healthcare priorities. Conclusion: Research on hospital financial performance has expanded notably over the past decade. The COVID-19 pandemic exposed financial system vulnerabilities, shifting research priorities. The United States remains the leading contributor to global output in this field. The identified themes highlight both established and emerging priorities that are likely to shape future inquiry. These insights are essential for informing hospital administrators, policymakers, and healthcare professionals in developing more resilient and equitable financial strategies and health policies. Continued bibliometric monitoring will be valuable for tracking progress and guiding strategic interventions.