REVIEW ARTICLE POWER STRUCTURES IN CONTEMPORARY MEDICAL SYSTEMS: A PUBLIC HEALTH–ORIENTED BIBLIOMETRIC ANALYSIS

This study examines the scholarly landscape of power structures in contemporary medical systems through a comprehensive bibliometric analysis from a public health perspective. A systematic bibliometric review was conducted using VOSviewer, Biblioshiny (R-package), and Harzing’s Publish or Perish, based on data retrieved from the Scopus database. A total of 279 journal articles published between 2003 and 2025 were analyzed, revealing a sharp and sustained increase in research output over the past decade. The findings demonstrate that issues related to health system governance, stewardship, institutional authority, and healthcare delivery structures dominate the literature, reflecting growing concern over how power is exercised and regulated within medical systems. The analysis further identifies emerging themes related to digital power, particularly the governance of artificial intelligence, health data, and algorithmic decision-making, signaling a shift in power dynamics from traditional institutional control toward technologically mediated authority. Research output is largely concentrated in high- and middle-income countries, with the United Kingdom, the United States, and Australia as leading contributors, and prominent public health and health policy institutions serving as key knowledge hubs. Major journals in health services research, public health, and health policy play a central role in shaping the field. Despite this growth, notable gaps remain, particularly regarding empirical evidence from low-resource and fragile health systems, as well as the implications of digital governance for health equity, accountability, and public trust. Overall, this study provides a structured overview of the evolution and thematic orientation of power-related research in medical systems and highlights critical directions for future inquiry aimed at strengthening equitable and resilient health system governance.