Open AccessA Systematic Review of Research Trends and Collaborations on Corporate Governance in Healthcare
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A comprehensive bibliometric analysis was conducted to systematically examine the development, thematic evolution, and collaborative networks of scholarly research on corporate governance within healthcare systems. Data were extracted from articles indexed in both the Scopus and Web of Science databases. Following an initial retrieval of 315 records, a rigorous screening process was implemented to identify studies with direct relevance to the research focus, yielding a refined dataset of 168 articles. The Biblioshiny interface, an advanced module of the Bibliometrix package, was employed for analytical processing. Key findings included the identification of the most influential publications, authors, and contributing countries in the field. Moreover, a country-level collaboration map was generated, revealing the geographical distribution and intensity of international research partnerships. Through a detailed analysis of author keywords, conceptual structures and prevailing research themes were visualised via word clouds and trend topic plots. Thematic mapping and evolutionary trajectories highlighted the dynamic nature of corporate governance discourse in healthcare, encompassing sub-themes such as hospital governance models, healthcare accountability, stakeholder engagement, and performance-based oversight. By elucidating the intellectual structure and collaborative landscape of this interdisciplinary domain, the study provides critical insights into its historical development and future directions. These findings are expected to inform both academic inquiry and policy implementation, offering a strategic foundation for advancing governance frameworks in health systems worldwide.1. Introduction
The health sector is in a comprehensive transformation process due to factors such as technological innovations, economic restrictions, increasing competition and changes in the role of service delivery. In this context, hospitals have turned to re-evaluating their managerial structures to maintain their sustainability. In the literature, it is emphasized that the relationship between hospital managers in particular plays a central role in this change process. Various researchers argue that boards of directors can be structured with a more professional and strategic approach and that institutional effectiveness can be increased in this way (Judge & Zeithaml, 1992).
Corporate governance is a tool that helps determine strategic direction, aims to maintain the effectiveness of the application and ensures accountability. Traditionally, management research focused on the private sector has now turned to non-profit organizations and especially healthcare institutions. The public trust and social accountability responsibilities of these institutions and the organizational change reflected in management styles in professional areas such as healthcare have been effective in this increasing interest (Barnett et al., 2001). Because placing health and welfare at the center of development strategies constitutes the basic principle of performance. This approach is valid for all methods, whether community-centered or state-focused. Considering the complex structure of the healthcare system, it can be said that the successful operation of the system depends largely on the quality of corporate governance practices and the effective management of relationships among many stakeholders within the system (Ostojic et al., 2013).
Today, the sustainable, transparent and accountable provision of health services is closely related not only to clinical quality but also to effective governance practices. In this context, corporate governance principles have gained increasing importance in the provision of health services. Corporate governance aims to increase the efficiency of health institutions, optimize resource use and strengthen the public's trust in the health system through basic principles such as accountability, transparency, participation, fairness and strategic direction. The aim of this study is to examine academic publications that address corporate governance and health services together using bibliometric analysis methods and to determine trends in the literature, key authors, collaboration networks and future research opportunities. Thus, it is aimed at providing a guiding framework for both decision-makers who develop health policies and academics.
2. Corporate Governance
The concept of corporate governance can be defined as a management style consisting of rules that all stakeholders must comply with, as well as the senior management that directs the business (Ataman et al., 2017). Corporate governance is a set of mechanisms, both market-oriented and institutional, that encourages the managers of the firm to make decisions that will maximize the value of the firm for the owners of the firm (Çengel et al., 2020).
Corporate governance is defined as the entire organizational structure and processes between shareholders, the board of directors and stakeholders. In this context, corporate governance aims to determine the roles in the management process, implement strategic leadership, ensure accountability and improve corporate performance (Ho, 2005). Therefore, at this point, instead of a one-sided relationship where only one party manages the other, a network of relationships is mentioned where mutual interactions are present between senior management, shareholders and stakeholder groups, where all stakeholder groups are included and where the interests of all parties are sought to be observed, even if they are not at the same level (Bursalı, 2018).
Corporate governance procedures aim to provide organizational balance by defining all roles in the management process of a company. These procedures develop various audit and control mechanisms to both protect the interests of shareholders and meet the expectations of other stakeholders. In other words, corporate governance aims to ensure that the company uses its resources effectively and efficiently, while adhering to the principles of transparency and accountability in the use of power and to establish harmony between economic and social goals, considering the responsibilities of the company towards its social environment (Aras & Crowther, 2008). It also defines corporate governance as “the processes and structure by which the company’s business and activities are managed and administered with the aim of increasing long-term shareholder value by enhancing corporate performance and accountability and taking into account the interests of other stakeholders”. Therefore, good corporate governance embodies both business (performance) and accountability (compliance)” (Khan, 2011).
Corporate governance is a system that defines how organizations are managed and controlled. The dominant model in this area is based on the management of organizations through a board of directors. The board model is based on the principle that board members participate in decision-making processes with shared responsibility and equal authority. The decisions taken are generally shaped and implemented in line with the information and suggestions provided by managers (Brown, 2019). In addition, a company needs to integrate strong corporate governance with corporate culture for its sustainability and development. This harmony increases transparency, encourages stakeholder trust, and creates an environment compatible with ethical norms. Corporate governance is shaped by leadership, culture, and employee behavior. If employees do not sufficiently understand the principles of management, their likelihood of complying with corporate principles decreases (Almashhadani & Almashhadani, 2023).
The most basic tool for reflecting the theoretical dimension of corporate governance at the application level is corporate governance principles. It is possible to describe these principles as the completed version of corporate governance. Within the framework of the discussions in the literature, it is possible to say that corporate governance is basically the principles of participation, transparency, accountability, and the rule of law/fairness/responsibility (Aytar, 2022; Orhan, 2011).
3. Corporate Governance Principles
Companies should define the corporate governance principles of transparency, accountability, responsibility and justice in detail and be able to apply these principles in their strategies in practice. Therefore, explaining the principles briefly will be effective in understanding the subject (Aras & Crowther, 2008).
Transparency practices, one of the principles of corporate governance, consist of two headings: Financial transparency and governance transparency. Financial transparency is related to the intensity and timing of financial disclosures and their interpretation by the media and analysts. Governance transparency is related to the practices used by investors to hold company managers accountable. While governance transparency is linked to a country's legal regime, financial transparency is linked to political economy (Ulaşkın, 2024).
Transparency in financial reporting will help investors and the market make better assessments and investors make better decisions, while increasing confidence in the markets. Therefore, for markets to be fair, efficient and transparent, it should be aimed to ensure that investors have fair access to market and corporate information (Fung, 2014). Transparency in corporate governance is defined by the accuracy and accessibility of information provided by the company to stakeholders. This information can be openly shared (active) or only available upon request (passive) and can be one-way or reciprocal. For effective transparency, information must be both reliable and accessible. Reliable information provides comprehensive and relevant data about the company's situation. Comprehensiveness should include all information related to ownership structure, performance, and management. Relevance and timeliness of data facilitate stakeholders in making correct decisions (Bandsuch et al., 2008).
Collaboration between all industry players will be harmonized considering the transparency principle of corporate governance and will be encouraged to implement best practices globally. Organizations that prioritize transparency will be able to establish long-term, strong, harmonious and sustainable relationships with all their stakeholders. In this way, they will be able to protect against risks, provide support for investments and build a path to the growth they desire.
Accountability refers to a company's strategic guidance and the board's accountability to the company and shareholders (Hindasah et al., 2021).
Within the scope of the accountability principle, the actors involved in the management of the business should be able to transparently explain why they made all the important decisions, their performance, the responsibilities they assumed in case of faulty or unsuccessful applications, and the administrative process and results to all stakeholders and assume responsibilities. The accountability principle also provides many benefits and conveniences to the business, like the transparency principle.
Corporate accountability, like transparency practices, is critical in explaining its effectiveness on risks (Raimo et al., 2022). As the level of accountability increases in a company, managers will be restricted from making questionable decisions, acting without forgetting their responsibilities, and looking out for the interests of a certain group, and ultimately, more effective decisions can be made because there is an obligation to account.
Within the framework of the principle of responsibility, the main purpose of good governance is to increase corporate value by fulfilling the company's obligations to all stakeholders. In this context, shareholders' capital contributions should be protected and rewarded. Employees should be employed and incentivized under equitable conditions in return for their labor and intellectual contributions. Customers should be provided with access to quality services and products as well as competitive prices. Suppliers should be paid on time, and trust should be ensured in business relations. Creditors should be protected with repayment assurance in return for the financing they provide; the institution should also fully comply with its tax obligations by fulfilling its social and legal responsibilities to society (Castrillón, 2021). The principle of responsibility, consistent with this broad definition, encompasses the objective of companies to maximize their contribution to the overall economy while ensuring that all stakeholders are considered. It also requires that organizations act in a socially, financially, and administratively responsible manner in all activities influenced by both the macro- and micro-environment (Claessens, 2006).
This principle states that the company management treats all rights holders and stakeholders equally, and the protection of shareholders' rights is realized within the scope of this principle. In this principle, which is an obligation brought by the understanding of fair management, the company management should be at an equal distance to everyone who is directly or indirectly affected while performing its activities (Çemberci, 2013). All partners, including minority and foreign shareholders, should be treated equally in the company. In this context, the same type of shareholders should be treated equally, and all shareholders of all types should have the same voting rights. On the other hand, members of the Board of Directors and managers should publicly disclose their transactions that create a material benefit or affect the company (Aktan, 2013).
Today, existing corporate governance theories are inadequate to fully reflect the complex and multifaceted structure of corporate structures. Management practices may vary significantly depending on the political, social and historical dynamics along with the unique cultural values of countries. In this context, management approaches in developed and developing countries differ in line with the unique cultural and economic conditions of each country. On the other hand, findings in the literature reveal that despite strict legal regulations, various violations are experienced in corporate governance practices. This situation necessitates the creation of new definitions that will provide a more comprehensive and alternative perspective on corporate governance (Yusoff & Alhaji, 2012).
4. Corporate Governance in the Health Sector
It is seen that corporate governance practices in the health sector are addressed less than corporate governance studies in the banking and finance sectors. However, it is seen that today's health service providers are trying to meet current needs, compete, provide services and develop under complex and difficult conditions.
Continuously increasing service costs, increased public awareness, criticisms of patient dissatisfaction, and media pressure are making the management processes of healthcare institutions even more complicated. Especially in public healthcare institutions, transparency and accountability issues regarding the use of public resources constitute a serious problem area. In this context, although it is not always possible to directly adapt corporate governance models developed in the private sector in terms of hospital management, these models can provide hospitals with a comprehensive reference framework on governance (Jamali et al., 2010).
The events in the literature reveal that many hospitals, which are health sector businesses, have one of the basic types of information of corporate governance, accountability, which is an important component of contemporary management approaches, and that corporate performance positively reveals the perception of people's future through the introduction of the concept. With another benefit, the hospital is supported, corporate performance is committed to the principle of accountability in terms of sustainability, and this principle is given great importance. The effective and systematic implementation of this principle will play an important role in increasing the general performance levels of hospitals (Çınar, 2015).
The perspective of corporate governance in healthcare services is associated with concepts such as quality control or accountability. The duties of corporate governance actors regarding healthcare quality are as follows: (Brown, 2019).
• Monitoring and developing quality performance,
• Determining and monitoring strategic quality targets,
• Supporting leadership and quality-focused corporate culture,
• Creating systems and processes that will make quality sustainable.
As a result, recommendations regarding corporate governance cannot be considered a single ideal model or fixed set of standards for hospitals. Even within the for-profit sector, management approaches and practices are quite diverse, and this diversity is almost limitless. Because the effectiveness of any corporate governance system may vary depending on both the geography and the conditions of the period it is in. However, it is possible to create a common "frame of reference" based on the different existing governance models. Although the proposed models may not be directly applicable in non-commercial healthcare environments, the basic problems and principles addressed by these models are nevertheless broadly universal (Eeckloo et al., 2004). It is corporate governance itself that seeks to answer these universal questions and helps organizations move toward a more transparent, fair, accountable, and responsible understanding.
Health sector practitioners should be open to internal and external audits on issues such as service quality, patient safety, health data and financial status from a transparency perspective. Patients, employees and the public should be informed openly, honestly and transparently about every issue that needs to be informed. Senior management and clinical managers should assume responsibility for practices that are erroneous, have delayed results or are made because of negative conditions or for responsibilities that are not fulfilled and should be accountable to all stakeholders, especially patients, for the decisions they make and the practices they carry out. The health sector, which is bound by legislation and principles regarding public health, employee rights, environmental sustainability and patient rights, is responsible for all its administrative activities in these areas. Health sector providers are responsible to all stakeholders, especially for social issues, within the ethical and legal framework in the activities of the institution. The principle of fairness, which is one of the basic principles that every sector should provide, means providing equal service to patients, providing equal opportunities to employees and treating stakeholders fairly for the health sector. There should be no discrimination between patients and employees, and their rights should be protected by observing them. Thanks to these principles, service quality will increase, resources will be used more efficiently, and the satisfaction of all stakeholders will be achieved for institutions providing health services. The health sector, which directly affects society due to environmental reasons, will reflect the outputs of every gain it makes for itself to the whole society. The corporate governance approach, which forms the cornerstones in this cycle where every segment makes a profit, should be further investigated and put into practice by health sector practitioners and academics. Therefore, in this study, it was aimed to profile the current literature, see its deficiencies and make suggestions for future studies by examining field studies on the subject.
5. Methodology
This study employs bibliometric analysis—a systematic research method—to identify and evaluate existing literature on corporate governance in healthcare services. The aim is to explore and answer the research questions outlined below by examining current studies in the field.
RQ1. How are the articles written about the concept distributed over the years?
RQ2. Which are the most influential authors, sources and countries regarding the concept?
RQ3. Which are the most used keywords regarding the concept, and how have usage trends changed over the years?
RQ4. How have country collaborations regarding the concept been formed?
Descriptive analysis, citation analysis, keyword analysis, thematic maps, evolution and collaboration network methods are used to answer the research questions (Shome et al., 2023). Descriptive analysis is necessary to provide important scientific statistics about bibliometric data to start bibliometric research (Kulkarni et al., 2025). Counting publications can be useful for making some comparisons, but citation analysis allows us to look at the impact of these articles on others by determining how often they are cited (McBurney & Novak, 2002). A word cloud was created using keywords representing the themes of the studies as input components (Schöggl et al., 2020). The larger the term appears in the generated graph, the more it is used in the examined dataset (Khayet et al., 2022). This gives an idea about the sub-themes that the concept focuses on. In addition, a trend topic view is presented that examines the evolution of the most frequently occurring keywords over the years in order to understand the current sub-themes that emerge in the studies related to the concept (Kumar & George, 2024). In addition to the level of scientific productivity and impact, an analysis of cross-country collaboration is also presented to reveal the global dimension of research networks. Such analyses help us understand how scientific collaboration is shaped by examining the frequency, direction and impact of studies conducted by researchers from different countries on scientific outputs (Glänzel, 2001).
The study was conducted using the Biblioshiny web interface for R software. Considering the targeted methods, Biblioshiny stands out for our study because it includes a wide range of different analyses (Moral-Muñoz et al., 2020). In addition to the variety of analyses it offers, Biblioshiny allows users to easily perform data integration and analysis processes (Ullah et al., 2022). It offers the ability to import and transform data from various bibliographic databases such as SCOPUS, Clarivate Analytics Web of Science, PubMed/MedLine, and Cochrane Database (Aria & Cuccurullo, 2017). This feature allows researchers to work with data sets from different sources.
Regarding the data, we turned to Scopus and Web of Science, the two most comprehensive databases for scientific literature (Keathley-Herring et al., 2016). This provides a more comprehensive view than using a single database and is especially important for identifying emerging research areas. Web of Science and Scopus have unique coverage across disciplines and geographic regions. Web of Science is particularly strong in the natural sciences, engineering, and humanities (Vieira & Gomes, 2009). Scopus, on the other hand, has broader coverage in the social sciences and biomedical fields (Martín-Martín et al., 2018). When used together, these complementary strengths provide researchers with a more balanced and comprehensive view of the academic literature. In addition, both databases provide standardized bibliographic data, supporting data consistency and comparability (Mongeon & Paul-Hus, 2016). These features strengthen the reliability and validity of bibliometric analyses.
The data was searched in the Web of Science and Scopus databases on August 30, 2024. The search string mainly focused on corporate governance in healthcare institutions. The first line of the search string included the expressions “corporate governance”, and the second line included the expressions “healthcare” OR “health care” or “health services” OR “hospital” or “hospitals”. The AND conjunction was used when adding two lines. While the search string was scanned in the Title/Abstract/Keywords fields in Scopus, it was scanned in the topic field of the Web of Science database. The searches were limited to publications between the years 2000 and 2023 as a time criterion. In addition, documents other than articles were excluded as a document type. Only English publications were included in the search as a publication language.
After all these limitations, 147 articles were found in the Web of Science database and 168 articles were found in the Scopus database, and the necessary metadata files for the analyses were exported. These two metadata files were combined with the Biblioshiny application, which is the interface of the Bibliometrix R package. During the merging of the files, 88 articles were found in both databases. Since counting the same publication more than once in bibliometric analyses may have a misleading effect on the number of publications, citation counts, and other metrics, duplicate publications were removed from the study. The new metadata file that emerged contained information about 227 articles. The researchers first examined the titles of all articles and removed 30 articles that were not related to the concept from the data set. Then, the keywords were examined, and 15 articles were removed from the study here. In the next step, the abstract sections of all the remaining articles were examined, and 14 articles were removed from the research file in this section. Finally, an analysis file containing the data of 168 articles was created. (see Figure 1).
6. Findings
Table 1 provides a detailed summary of bibliometric metadata. The bibliometric analysis covers the period from 2000 to 2023. It is seen that 168 articles were published on the concept during this period. It is understood that a total of 429 researchers worked on these articles. An average of 10.3 articles were published annually, and an average of 15.75 citations were made per article.
When the distribution of articles on corporate governance in healthcare institutions is examined by year, a fluctuating course is observed between 2000 and 2015. However, since the article production in the last 5 years constitutes 37.2% of the total production, it can be said that the interest in the subject has increased in recent years. In particular, the year 2023 saw a sharp increase in the number of publications on corporate governance in healthcare. This increase can be partly attributed to the ongoing effects of the COVID-19 pandemic, which has intensified global interest in health system resilience, corporate accountability, and effective governance structures. The crisis has likely accelerated academic interest in examining how governance mechanisms can support better preparedness and response in healthcare institutions (see Figure 2).
Description | Results |
Main Information about Data | |
Timespan | 2000:2024 |
Sources (Journals, Books, etc.) | 134 |
Documents | 168 |
Annual Growth Rate % | -0.93 |
Document Average Age | 10.3 |
Average Citations per Doc | 15.75 |
Document Contents | |
Keywords Plus (ID) | 536 |
Author's Keywords (DE) | 489 |
Authors | |
Authors | 429 |
Authors of single-authored docs | 38 |
Authors Collaboration | |
Single-authored Docs | 40 |
Co-Authors per Doc | 2.87 |
International Co-authorships % | 11.31 |
Document Types | |
Article | 163 |
Article; Book Chapter | 2 |
Article; Early Access | 1 |
Article; Proceedings Paper | 2 |
An analysis of the most prolific researchers in the field reveals that Brawn A. and Chambers N. stand out, each having published four articles on the subject. Additionally, it has been observed that Afriyie S., Bassett S., De S.J., Eeckloo K., Ellwood S., Felix E., Garcia-Lacalle J., and Kong Y. have each contributed three publications related to the concept (see Figure 3).
When the article production of the responsible authors researching corporate governance in healthcare institutions is examined by country, it is observed that the most influential countries are the United States (62 articles), the United Kingdom (49 articles), Australia (39 articles), Indonesia (21 articles), Italy and Brazil (17 articles). Figure 4 shows the production trends of these six countries over time.
When the effective sources about corporate governance in healthcare institutions are examined, it is observed that the journals published under the names of Health Policy, Health Services Management Research and International Journal of Health Planning and Management are the journals that publish the most publications (5) on the concept. In addition, BMC Health Services Research and Healthcare Management Review have contributed to the development of the literature by publishing 4 articles on the subject (see Figure 5).
According to the article citation analysis conducted using Biblioshiny, the article titled “Fraudulent Financial Reporting: Consideration of Industry Traits and Corporate Governance Mechanisms” published by Beasley et al. (2000) was cited 603 times by other studies. Another study on the subject, the article titled “When will Boards Influence Strategy? Inclination × Power = Strategic Change”, published by Golden & Zajac (2001), was cited 367 times by other studies. It can be said that these two studies were the most influential studies on the subject during the selected period (see Figure 6).
In publications on corporate governance in healthcare institutions, it is understood that the most frequently used keywords by the authors are corporate governance with 53 repetitions, governance with 28 repetitions, healthcare with 23 repetitions and hospital with 22 repetitions. These expressions are also like the search words that help us access the research data in the Web of Science and Scopus databases. In order to prevent the bias brought by this similarity and to reveal the sub-themes in the research that adopt corporate governance in healthcare institutions, the word cloud (see Figure 7) and trend topic (see Figure 8) visuals were created in the Biblioshiny program by excluding the keywords “Healthcare”, “Health Services”, “Hospital”, “Corporate Governance”, “Governance” and “Corporate”.
According to Figure 8, after 2007, the weight of the keywords risk management and management can be mentioned regarding the concept. Later, it is observed that the weight shifted to the keyword’s clinical governance, performance and leadership. Especially in the last period, it is understood that the emerging theme is related to the keyword corporate social responsibility.
A network density map was created to create a collaboration network map for the countries of the corresponding authors of the articles. According to the analysis conducted among the countries with the highest connections, 19 countries with collaboration networks were identified, which were combined into 6 clusters. The first cluster, which includes the most countries, includes the United States, Australia, Brazil, Belgium, Canada, France, and the Netherlands. The second cluster is composed of the United Arab Emirates, Egypt, and Lebanon. The third cluster is composed of the United Kingdom, Italy, and Spain. The fourth cluster is composed of China and Ghana, the fifth cluster is composed of India and Kuwait, and the sixth cluster is composed of Indonesia and Nigeria. According to Figure 9, the densest cluster in these collaboration clusters is in the first cluster, which is centered on the United States.
7. Results and Conclusions
The corporate governance approach in healthcare organizations stands out as a critical area for improving the quality of healthcare services, financial sustainability, and social trust. Existing literature emphasizes the importance of this topic and provides an important opportunity for future research. Studies in this area can contribute to the development of healthcare management policies at both academic and practical levels. This development particularly affects the responsibilities of policy makers. Policy makers should determine management standards based on accountability, transparency, participation, and ethical values, which are corporate governance principles in healthcare organizations, and these standards should be supported by legislation. Innovative practices in corporate governance that will increase service quality while reducing resource waste should be supported with special funds and grants. In addition to all these, digital decision support systems and audit processes should be supported by corporate governance practices. In this context, our study aims to determine the publication numbers and trends of academic studies produced in the field of corporate governance in healthcare services, the most influential authors and to provide a bibliometric analysis on the concept. Our study contributes to researchers who will work in this field by presenting a bibliometric summary and revealing the sub-themes of the concept.
To achieve this goal, the Biblioshiny interface, which is part of the Bibliometrix program, was used for analysis. Academic content indexed in Scopus and Web of Science databases was preferred as the data source of the research. The search string focused on corporate governance in healthcare institutions. The first line of the search string included the expression “corporate governance”, and the second line included the expressions “healthcare” or “Health Care” or “health services” or “hospital” or “hospitals”. The conjunction “and” was used when adding two lines. The time frame selected for the database search spanned from the year 2000 to 2023, inclusive. The search criteria were limited to only article document type and English documents. As a result of the scan performed with these criteria, data belonging to 168 articles in Scopus and 147 articles in Web of Science were exported in two different files. These two files were merged using Biblioshiny and the duplicates of 88 articles scanned in both databases were removed from the file. Then, the titles, keywords and abstracts were examined, and an analysis file consisting of 168 article data was prepared by excluding 59 data that were found not to be compatible with the concept.
As a result of the analysis, it is seen that articles published about corporate governance in healthcare institutions in the last five years constitute 37.2% of the total article production. This result can be said that corporate governance in healthcare institutions continues to be a current research area. Brawn A. and Chambers N., the authors who published the most articles on the concept, have 4 articles each. In addition, according to the countries of the responsible authors, the countries with the most publications are the United States (62 articles), the United Kingdom (49 articles) and Australia (39 articles). In addition, the central role of the United States in academic collaborations shows that this country is a key player in global research networks.
The subthemes (based on author keywords) that have emerged since 2000 in studies addressing corporate governance in healthcare services are performance, clinical management, leadership, corporate social responsibility, risk management, financial performance and quality. In addition, the prominence of themes such as corporate social responsibility, leadership and performance in recent years shows that healthcare institutions focus not only on medical service delivery but also on social and ethical responsibilities. This trend reflects the evolution of healthcare systems towards a more transparent, accountable and community-oriented management approach. While this study offers a systematic bibliometric overview of the literature on corporate governance in healthcare, it is important to note that bibliometric tools are inherently limited in their ability to capture the qualitative dimensions of governance practices. Thematic nuances, contextual factors, and institutional variations often require in-depth qualitative exploration. Future research could build on the findings of this study by employing complementary qualitative methods such as case studies, interviews, or document analysis to further contextualize and interpret emerging trends.
Institutional governance in healthcare institutions stands out as an indispensable area for improving the quality, financial sustainability and social trust of healthcare services. The results that can be achieved in this area can increase both theoretical and practical contributions in this field, allowing healthcare institutions to be managed more effectively, transparently and in a more community-oriented manner. Future research can focus on expanding international collaborations, exploring new thematic areas and transforming research findings into practical applications, thus improving the management capacity in healthcare services. Finally, one of the limitations of the study is that it is in the healthcare field. Future studies could also work in different fields such as finance or the education sector.
Conceptualization, F.G.; methodology, E.Y.; formal analysis, E.Y.; resources, F.G.; writing—original draft preparation, E.Y. All authors have read and agreed to the published version of the manuscript.
The data used to support the research findings are available from the corresponding author upon request.
The authors declare no conflict of interest.
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