Publication on health policy worldwide from 1898 to 2013: identifying position of iran.

BACKGROUND: As the field of health policy continues to evolve and grow, it is important to examine the trend of scientific output generated in this domain. Scientific outputs can also be used to evaluate academic progress of the field in each country or over a given period of time.
OBJECTIVE: Aim of this study is to depict trend of publication on topics of health policy world-wide and to highlight contribution of Iran in this field.
METHODS: The web of science database was used to identify all relevant published papers worldwide The search was conducted on documents published from January 1898 to December 2013. The criteria for retrieval were set to be "health policy" in topics. Then the retrieved papers were filtered in terms of distinct years, countries, source titles, and languages.
RESULTS: Findings revealed an increasing trend of publication on health policy over past decades. English was the first most dominant language of publication. USA had the highest number of publication with 5347 papers; however Switzerland ranked first after considering publication number in terms of countries' population. BMJ was the source title with highest number of publication on topics of health policy. Number of publication by Iranian authors was 87 from January 1898 to December 2013.
CONCLUSION: It seems discipline of health policy has started its evolution worldwide long time ago while Iran is in its initial phases.

1. INTRODUCTION

Health policies are defined as “decisions, plans and actions that are undertaken to achieve specific health goals within a society”[1].

Evidence shows the influence of historical milestones, political and economical changes on health policy[2, 3]. For instance, after the Second World War, rapid advances happened in medicine influencing development of health care in industrialized countries[4]. In essence, construction of health is not restricted to the health sector and as a matter of fact it goes beyond this domain[5]. Health policy has been the subject of political debates in many countries. As the field of health policy continues to evolve and grow, it is important to examine the trend of scientific output generated in this domain. Scientific outputs also can be used to evaluate academic progress of the field in each country or each academic centre. Scientific products published on health policy can provide evidence on different health policies and their impacts [6, 7]. Moreover scientific progress and evolution is critical for every discipline and it can be reflected in its publication trend. This trend has been explored in different domain of sciences; however the evolutionary pattern of publication on health policy has not been explored to date. This paper aims to depict the trend of publications on health policy topics worldwide from 1898 to 2013.

2. MATERIAL AND METHODS

The web of science database was used to identify all relevant published papers worldwide. Articles on topics of health policy originating from different countries across the world were used for examining their scientific production in this field. The search was conducted on documents published from January 1898 to December 2013. Data collection was conducted in April 2014.

The criteria for retrieval were set to be “health policy” in topics. Then the retrieved papers were filtered in terms of distinct years, countries, source titles, and languages.

3. RESULTS

3.1. Trend of publication by time

Figure 1 shows overall number of publication on topics of health policy worldwide by year. As it is evident there has been an increasing trend of publication on health policy over past decades.

Figure 1

Trend of publications on Health Policy indexed in Web of Sciences by year (from 1898 to 2013)

3.2. Top ten leading language

Top ten leading languages used for publications on topics of health policy are English(63465), French(1306), German(934),Spanish(860), Portuguese(828), Swedish(701), Norwegian(447), Danish(262), Dutch(180), and Italian(161). As it can be seen English is the most dominant language among the top ten leading languages. Number of documents published in English language (as the one holding the first place) is about 49 times higher than in French (placing in second place).

3.3. Top ten productive countries

As the statistics in table 1 indicates the US is the most productive country in publication of documents on topics of health policy. United Kingdom ranked the second followed by Canada. However when it comes to the number of publication per number of country’s population, Switzerland holds the first rank followed by Australia and UK.

Table 1

Top ten leading country in publication on health policy indexed in web of sciences (from 1898 to 2013)

3.4. Top ten productive journals

As it can be seen in table 2, highest number of publication belongs to the BMJ and Lancet.

Table 2

Top ten leading Journal in publication on topics of health policy indexed in web of sciences (from 1898 to 2013)

3 out of 10 leading journals in publication on health policy are very prestigious journals. One of the journals appears to have no impact factor and one has very low impact factor.

Surprisingly most of the leading journals on topics of health policy are among those with long history of publication.

3.5. Trend of publication by Iranian authors by year

Overall 87 papers were published by Iranian authors on topics of Health Policy. As the figure 5 shows the relatively dramatic increase in the publication has happened in 2010 reaching its highest number in 2012.

Majority of papers authored by Iranians have been published in journals originated from Iran. The highest number of these papers has been published in Iranian Journal of Public Health(10), Hepatitis Monthly(5), Archives of Iranian Medicine(4), Iranian Red Crescent Medical Journal(4), and Journal of Research in Medical Sciences(4).

Some of these journals have no impact factor and the highest impact factor among them is for Archives of Iranian Medicine with impact factor of is 1.44.

4. DISCUSSION

Trend of publication over time reflects the ascending growth of research in domain of Health Policy. As results show the number of publication has reached from 1 in 1919 to more than three thousands worldwide. This implies a great deal of progress happened in the field of health policy and its related publications.

There has been a considerable increase in number of publication in 1993. It can be as a result of some developments happened in health systems and health policy of countries with high contribution in the publication. In UK, legislation on the NHS community care was passed in 1990. Based on this act, health authorities got power to manage their own budgets and buy health care from hospitals and other health organization. This was followed by establishing the first 57 NHS trusts in 1991[8]. In the US, Medicare used a new scale namely the resource-based relative value scale (RBRVS) as a new method of payment for physicians[9]. In Canada, the economic recession pushed the health system to cut down health budgets and to implement some structural reforms[10]. In Australia, General Practice Strategy initiated as the major primary care initiative in 1991 [11].

As results reveals English is the dominant language of publication on topics of health policy as it is in many other topics [12-15]. This is in accordance with the fact that English is the dominant language of the scientific world[16]. French and German place in the second and third place respectively. These results are in line with that fact that English, French and German are the most dominant languages of sciences[17].

Nine out of 10 leading countries in publication of health policy papers belong to high income countries. Top 4 leading countries are USA, UK, Canada, and Australia that are among dominantly English speaking countries. This finding is consistent with results on dominant language of the publication in the studied field. Considering population size of countries, Switzerland has produced the highest number of papers while Australia and UK place in the second and third position in terms of papers per population size.

The highest number of documents on health topics across the world has been published in highly prestigious journals. This can reflect the high quality of papers published in health policy. Two most leading journal in publishing health policy papers have impact factors of 39 and 17 respectively. However most of the papers of Iranian authors have been published in journals with relatively low impact factors (journals originating from Iran rather than other countries).

Health policy as discipline has been started in developed and high income countries very long time ago and has evolved during this long period. However in Iran, it is in infancy period as an academic discipline and research. This might explain the great gap observed among research contribution of Iran and other countries in terms of quantity and quality of publication in this domain.

Trend of publications on Health Policy indexed in Web of Sciences by Iranians from 1898 to 2013