{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T14:14:04Z","timestamp":1782742444725,"version":"3.54.5"},"reference-count":30,"publisher":"Gobierno de Navarra","issue":"2","license":[{"start":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:00:00Z","timestamp":1756339200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/deed.es"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["An Sist Sanit Navar"],"abstract":"<jats:p>Background. Six Sigma is widely implemented in healthcare to enhance efficiency, minimize medical errors, and improve patient safety. However, the global distribution and impact of Six Sigma research in healthcare remain underexplored. This study conducts a scientometrics analysis of Six Sigma research in healthcare, examining its association with global health, research, and development indicators across income groups.\nMethodology. A mixed-methods scientometrics study was employed, utilizing data from Scopus, PubMed, and other databases. Regression models and meta-analyses were applied to evaluate associations between Six Sigma research productivity and global health, research and development indicators. Publications were categorized by World Bank income groups, and bibliometric parameters such as impact were analysed.\nResults. A total of 804 Six Sigma-related publications in healthcare were identified, with high-income countries contributing 70.8% of the total output. The number of publications was significantly associated with adult mortality reduction in high- and upper-middle income countries (p &lt;0.01). Research and development expenditure showed a strong positive correlation with Six Sigma research output across all income groups. However, low-income countries exhibited minimal research activity, with no significant associations detected.\nConclusions. Six Sigma research in healthcare is predominantly concentrated in high-income countries, with increasing but uneven growth in upper-middle and low-middle income countries. The limited engagement of low-income countries underscores a critical research gap.<\/jats:p>","DOI":"10.23938\/assn.1124","type":"journal-article","created":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T12:51:39Z","timestamp":1757076699000},"page":"e1124","source":"Crossref","is-referenced-by-count":5,"title":["Six Sigma research in healthcare is associated with global health, research and development indicators: A scientometrics study based on countries by income groups","La investigaci\u00f3n en Six Sigma sobre salud se asocia con indicadores de salud global, investigaci\u00f3n y desarrollo: Estudio cienciom\u00e9trico por pa\u00edses seg\u00fan grupos de ingresos"],"prefix":"10.23938","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-1965-0488","authenticated-orcid":false,"given":"Estefany","family":"Romero-Freile","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2742-3777","authenticated-orcid":false,"given":"Darwin","family":"Ortiz-Cerchar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6742-3185","authenticated-orcid":false,"given":"David A.","family":"Hern\u00e1ndez-P\u00e1ez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1539-7584","authenticated-orcid":false,"given":"Ornella","family":"Fiorillo-Moreno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7498-5346","authenticated-orcid":false,"given":"Yelson Alejandro","family":"Pic\u00f3n-Jaimes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8346-2336","authenticated-orcid":false,"given":"Tulia","family":"Beltr\u00e1n-Venegas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2445-3680","authenticated-orcid":false,"given":"Johana","family":"Galv\u00e1n-Barrios","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1960-7334","authenticated-orcid":false,"given":"Ivan David","family":"Lozada-Martinez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10024","published-online":{"date-parts":[[2025,8,28]]},"reference":[{"key":"ref0","unstructured":"1. 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Int J Environ Res Public Health 2022; 19(1): 587. https:\/\/doi.org\/10.3390\/ijerph19010587","DOI":"10.3390\/ijerph19010587"}],"container-title":["Anales del Sistema Sanitario de Navarra"],"original-title":[],"link":[{"URL":"https:\/\/recyt.fecyt.es\/index.php\/ASSN\/article\/download\/113791\/84613","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/recyt.fecyt.es\/index.php\/ASSN\/article\/download\/113791\/84613","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T05:52:33Z","timestamp":1759125153000},"score":1,"resource":{"primary":{"URL":"https:\/\/recyt.fecyt.es\/index.php\/ASSN\/article\/view\/113791"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,28]]},"references-count":30,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,6,30]]}},"URL":"https:\/\/doi.org\/10.23938\/assn.1124","relation":{},"ISSN":["2340-3527","1137-6627"],"issn-type":[{"value":"2340-3527","type":"electronic"},{"value":"1137-6627","type":"print"}],"subject":[],"published":{"date-parts":[[2025,8,28]]}}}