Division C Group No.

The Applications of Operations research in Resource

Allocation in Healthcare
Prof. Rajiv Wadh

A comprehensive analysis of how operations research is

utilized in healthcare resource allocation: a bibliometric
overview.

Abstract

Efficient allocation of resources in healthcare is imperative, considering healthcare's vital role in

society. Recent global health crises, such as the COVID-19 pandemic, have underscored the crucial
application of Operations Research (OR) in effectively managing available resources.

This bibliometric review examines a dataset comprising 64 academic journal articles published on
healthcare resource allocation between 2000 and 2023. The objective is to elucidate prevailing
publication trends, prominent methodologies, identified gaps, and the potential scope within this
domain. Graphical representations are utilized to illustrate aspects like annual scientific output,
citation averages, a three-field plot, notable sources, authors, affiliations, national scientific
contributions, temporal trends in national output, highly cited publications worldwide, and co-
occurrence networks of keywords. Additionally, a thematic map of keywords is employed to visually
represent the underlying thematic framework within the analyzed corpus. The analysis reveals a
burgeoning interest and enhanced expertise in this subject, particularly in the aftermath of the
COVID-19 pandemic, during which numerous healthcare systems grappled with resource
constraints. The importance of optimizing resource allocation within healthcare systems is
underscored, emphasizing the benefits of leveraging Operations Research methodologies.

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 1. Introduction

In the realm of healthcare, effective resource allocation is paramount, as it directly impacts the
well-being of individuals and communities. Recent global health crises, exemplified by the
COVID-19 pandemic, have underscored the essential role played by Operations Research (OR)
and decision science in optimizing resource usage. This paper serves as the gateway to an in-
depth exploration of the diverse applications of OR within the healthcare sector, drawing
insights from a range of relevant research publications.

Operations Research, often abbreviated as OR, encompasses a suite of quantitative techniques

and decision-making tools designed to improve the allocation of resources, boost efficiency, and
refine decision-making processes. In the healthcare landscape, OR is indispensable, addressing
a myriad of challenges, including resource allocation, capacity planning, response to epidemics
and emergencies, policy formulation, and cost-effective healthcare delivery. The research
papers selected for discussion provide concrete illustrations of how OR methodologies have
been successfully employed to address these complex healthcare challenges.

The selection of our topic, "Application of Operations Research in the Healthcare Sector," is
motivated by a multitude of compelling factors. Healthcare stands as a fundamental societal
need, and the judicious allocation of resources, informed decision-making, and effective
healthcare system management are imperative for the well-being of individuals and
communities alike. Recent global health crises, notably the COVID-19 pandemic, have
accentuated the pivotal role of OR in healthcare preparedness, response, and recovery.

The healthcare sector introduces unique challenges, encompassing the allocation of finite
resources, the demand for timely decision-making, and the optimization of healthcare services.
These challenges underscore the necessity to delve into and comprehend how OR
methodologies and decision science have made substantive contributions in resolving these
issues.

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Despite the substantial body of research on OR applications in healthcare, there are evident
gaps in the current literature. One such void is the absence of a comprehensive overview of
existing research, emerging trends, and areas where OR can bring about substantial
advancements. Additionally, there is a need for a critical assessment of the impact and efficacy
of various OR methodologies within the healthcare domain. Recognizing these gaps is of
utmost importance as it charts a course for researchers, policymakers, and healthcare
administrators to identify avenues where OR can offer innovative solutions and enhance
healthcare outcomes. This research paper aims to bridge these gaps by incorporating
bibliometric review techniques to assess the current state of OR in healthcare research.

Understanding the gaps in existing literature is pivotal, as it guides future research endeavors
and informs healthcare policy decisions. Bibliometric review techniques provide a systematic
and data-driven approach to analyze and consolidate the existing body of literature. Through
the utilization of bibliometrics, this paper seeks to offer insights into trends, influential
research works, prominent contributors, and emerging research domains within the field of
OR in healthcare.

Furthermore, this research paper aspires to shed light on the implications of OR in healthcare.
It examines how the applications of OR have led to improved healthcare resource allocation,
better decision support systems, enhanced emergency response capabilities, and more cost-
effective healthcare delivery. Additionally, it explores how these applications contribute to the
growth of academic knowledge and the advancement of healthcare systems.

2. Literature Review/ Understanding Application Area/ Evidence From

Extant Literature

2.1 Conceptual Background

Effective distribution of limited resources in the healthcare industry is a complex and critical
process, determining how finite essentials like personnel, finances, equipment, and facilities are

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dispensed to meet the diverse and growing healthcare demands of populations. The equitable
dispersion of these resources is fundamental to ensure fair and widespread access to healthcare
services, enhance the efficiency of healthcare delivery, and elevate overall patient outcomes. Making
decisions regarding resource allocation in healthcare involves striking a balance between various
competing demands, including the imperative of delivering high-quality care, managing costs, and
optimizing health outcomes. In advancing the understanding and improvement of resource allocation
in healthcare, two pivotal disciplines play a crucial role: Operations Research (OR) and Health
Economics. OR methodologies provide valuable mathematical and analytical tools to optimize the
allocation of resources, while Health Economics offers valuable insights into cost-effectiveness and
priority setting. Surprisingly, a comprehensive review encompassing this specific subject is lacking
in existing literature; thus, our research paper takes on the task of conducting an in-depth
bibliometric review.

Resource Allocation in Healthcare:

Efficient resource allocation stands as a pivotal component of healthcare management. Previous

research studies, like "Enhancing HIV Prevention Funds Distribution through Linear Programming:
A Preliminary Investigation" (Earnshaw et al., 2007) and "Optimizing Efficiencies in the UK Health
Service through Variable Returns to Scale Data Envelopment Analysis" (P.F. Tsai & Molinero,
2002), showcase how the application of Operations Research (OR) techniques effectively enhances
fund allocation and operational efficiency within healthcare systems."

Capacity Planning :

Efficient planning of healthcare facility capacity is crucial in meeting the demands of patients. The
research paper, "Modeling Capacity Allocation for Integrated Care and Access Management"
(Deglise‐Hawkinson et al., 2018), introduces a model aimed at strategically planning capacities
within integrated care systems, thus ensuring optimal resource usage.

Emergency Response:

Operations Research (OR) holds significant importance during emergencies and mass casualty
incidents. In the study by Rauner et al. (2016) titled "Simulating Policies for Effective Resource
Management in Mass Casualty Incidents," the use of OR in resource management during such

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incidents is thoroughly investigated. Additionally, during the COVID-19 pandemic, resource
allocation was effectively discussed in the research by Melman et al. (2021) titled "Optimizing
Hospital Resource Distribution Amidst the COVID-19 Crisis Using Discrete-Event Simulation.

Appointment Scheduling:

Optimal appointment scheduling is vital for delivering quality patient care. The study by Pham et al.
(2023), titled "Enhancing Appointment Scheduling Efficiency using Predictive Modeling: A Case
Study in Radiotherapy Treatment," showcases the application of predictive models to enhance and
streamline appointment schedules.

Pandemic Management:

"During pandemics, effective management of resources is essential. The study by Eriskin et al.
(2022), titled "An Effective Multi-Objective Model for Managing Healthcare Resources and
Planning Locations During Pandemics," presents a strong model for resource distribution during
pandemics. Additionally, in the research conducted by Arab Momeni et al. (2022), focused on
"Optimizing Operating Room Schedules, Specialty Team Schedules, and Emergency Patient
Assignments during the COVID-19 Outbreak using a Robust Optimization Approach," pandemic-
specific surgical scheduling takes precedence.

Together, these academic papers demonstrate the versatile applications of Operations Research
within the healthcare sector. Ranging from efficiently managing resources and planning capacities to
responding swiftly in emergencies and effectively handling pandemics, OR techniques substantially
contribute to enhancing the efficiency and efficacy of healthcare systems. It's worth noting, however,
that these papers are not reviews. Hence, our present endeavor aims to shine a light on the review
aspect of resource allocation within the healthcare sector."

3. Research Objective

The following research questions outline the scope of this review. RQ1: What are the current trends
regarding publication growth in the Resource allocation in healthcare RQ2: What are the major
methods discussed in the past literature on Resource allocation in healthcare? RQ3: What are the gap
areas and scope of future research in Resource allocation in healthcare?

4. Research Methodology

Data Collection (Article selection, inclusion, and exclusion criteria)

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The process of selecting articles for review can be broken down into several stages. Initially, a
keyword search was conducted on EBSCOhost using the terms 'Operations Research,' 'Healthcare,'
and 'Resource Allocation.' These keywords were carefully chosen to maximize the relevance of the
search results. This initial search yielded a total of 85 articles spanning from the year 1970 to 2023,
encompassing Academic Journals (73), Books (3), and Magazines (9) in two languages,
predominantly English (84) and one in Polish (1).

Subsequently, a further refinement of the search was undertaken by applying specific criteria, which
included limiting the publication year range to 2000 to 2023, ensuring the language was English, and
exclusively including Academic Journals. This refined search resulted in a final selection of 64
articles, which constituted the sample size for the review. This search was conducted on September
4, 2023. For subsequent analysis, various tools were employed, including Microsoft Excel,
Biblioshiny, Tableau, Vos Viewer, and RStudio.

Bibliometric analysis
Bibliometric analysis is a widely recognized and rigorous method for investigating and examining
extensive scientific data sets. It allows for the exploration of the evolutionary intricacies within a
specific field and provides insights into emerging areas of research (Donthu et al., 2021). The chosen
articles were exported in RIS format and imported into the reference management tool, Mendeley. A
bibliometric file in .bibtex format was created and then transferred to the Biblioshiny package within
RStudio. This step was taken to convert the data into an Excel format suitable for analysis using
Microsoft Excel and Tableau. All missing information, including author details, corresponding
author affiliations or institutes, document types, the country of the corresponding author, journal
names, total citations, and publication years, was manually added to the Excel file for comprehensive
analysis.

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 Keyword Search –
‘operations research AND Filter Applied: Years-2000 Filter Applied: Source Type-
healthcare AND resource to 2023 Academic Journals
allocation’ Number of Search Results= Number of Search Results=
Number of Search Results= 77 65
85
Filter Applied: Language-
English
Direct Export of 64 files in
Number of Search Results=
RIS format. This was
64
uploaded to Mendeley
This is the Final Sample Filled in missing
Size Information in Excel file-
Export (.bibtex) and upload Authors, Corresponding
it to Biblioshiny Package of Author Affiliation/Institute,
Create Relevant Graphs and
RStudio. This creates an Document Type,Country of
Thematic Map
Excel database of selected Corresponding Author,
Academic Journals. Name of Journal, Total
Citation and Publication
Year.
Analysis of Graphs and
Conclusion

5. Data Analysis and results

5.1 Annual Scientific Production

Figure 1: Year-wise growth in publication (extracted from Tableau – author’s work).

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Based on the data presented in Figure 1, it can be observed that 14% of the articles related to
healthcare resource allocation were published during the period of 2021 to 2022. Figure 1 also
illustrates that the overall increase in the number of publications follows an exponential pattern, with
an R-squared value of 0.4936 and a p-value of 0.0005515. While there isn't a specific discernible
trend, a notable surge in publications is evident after 2019, possibly attributed to the impact of the
COVID-19 pandemic. This exponential growth may be attributed to the cyclical nature of research or
the substantial government funding directed towards the healthcare sector.

5.2 Average Citations

Figure 2: Average number of citations (extracted from Tableau – author’s work).

Figure 2 illustrates the annual citation frequency of our papers over a span of 22 years. During the
period from 2000 to 2011, there was a noticeable fluctuating increase in the average number of
citations. Several factors may contribute to this phenomenon, including the growing significance of
our research over time and an expanding awareness of our work within the research community. As
more individuals become acquainted with our research, it becomes increasingly likely that they will
reference it in their own scholarly work.

Conversely, from 2012 to 2022, a decline is evident in the average citation count, returning to levels
similar to those observed in the year 2000. This decline could be attributed to several factors. It is
possible that the objectives established in earlier periods or research endeavors have been achieved,
leading to a reduced need for continued citations. Additionally, the decline might be influenced by
the emergence of new studies by other authors or in related fields that could serve as corollaries to
our work.

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5.3 Three Field Plot

Figure 3: Three field plot (extracted from Tableau – author’s work).

The nodes' size in each category of the three-field plot is directly proportional to the frequency of the
associated keyword. In essence, this implies that the most frequently used keywords within the realm
of healthcare resource allocation are represented by the largest nodes.

The most prevalent keywords in the context of resource allocation in healthcare, listed in descending
order, include:
• Resource allocation
• Bioterrorism
• Simulation
• Anthrax
• Operations research
• Medical care
• Optimization
• Decision making
• Health care
• Emergency medical services

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Keyword Relationships:
The thickness of the connections between nodes in the three-field plot mirrors the strength of the
relationships among these keywords. Consequently, the keywords that exhibit the closest
associations are denoted by thicker edges.

The three-field plot vividly demonstrates that resource allocation in healthcare is closely intertwined
with other critical areas within Operations Research (OR), such as healthcare management science,
operations research, and decision-making. This underscores the imperative for a multidisciplinary
approach to effectively address the intricate challenges of resource allocation in healthcare.

In summary, the three-field plot, which depicts keywords in the context of resource allocation in
healthcare, furnishes a valuable overview of the most pivotal subjects in this domain. It underscores
that resource allocation within healthcare is a multifaceted and demanding endeavor, requiring a
careful equilibrium among competing priorities, including the delivery of high-quality care, cost
management, and the attainment of optimal health outcomes.

5.4 Most relevant sources

Figure 4: Most relevant sources (extracted from biblioshiny).

This study is based on 64 documents on Operations Research in Resource allocation in the healthcare
sector. The graph shows that the preference for different sources varies depending on the subfield of
OR.

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 SR.NO SOURCE NUMBER OF DOCUMENTS

1 Annals of Operations Research 12

2 European Journal of Operations 8

3 Healthcare Management Science 8

4 Operations Research 9

5 Interfaces 4

6 Central European Journal of 3

Operations Research

7 Flexible Services and 2

Manufacturing Journals

8 IISE transactions 2

9 Manufacturing and Service 2

Operations Management

10 Computers and Industrial 1

Engineering

5.5 Most Relevant Authors

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Figure 5: Most relevant authors (extracted from biblioshiny).

Figure 5 presents a compilation of the foremost influential authors in the context of resource
allocation within the healthcare industry, particularly from an Operations Research (OR) perspective.
This ranking is based on the number of times their research papers have been cited in other scholarly
works. Prominent figures in this field include Lee Ek, a researcher affiliated with Universiti Tunku
Abdul Rahman, who has received citations in six different papers. Additionally, Benecke B, a
biochemist from Ruhr University Buchem, Mason J, a researcher at Stanford University, and Truong
Va, an Assistant Professor of Orthopaedic Surgery at UT Southwestern, each have three of their
papers cited most frequently.

It's worth noting that this list encompasses a mix of academic and commercial authors, underscoring
the substantial interdisciplinary nature of this subject. Given the intricacy and significance of the
topic, it is imperative for experts in this field to possess knowledge spanning across various
biological and scientific domains.

5.6 Most Relevant Affiliation

Figure 6: Most relevant affiliations (extracted from biblioshiny).

The primary affiliations of the corresponding authors predominantly originate from the Georgia
Institute of Technology in Atlanta, Georgia, which boasts the highest number of publications. As a
publicly funded research-focused institution in the United States, it is unsurprising that their research
predominantly centers around topics related to technology and science. Following closely are the
University of Vienna and the University of Twente, both located in Europe, as well as Columbia
University in the United States.

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This chart solely provides a ranking of leading universities based on the quantity of publications and
does not take into account other critical dimensions of scientific achievement, such as the quality of
research or its societal impact.

5.7 Countries Scientific Production

Figure 7: Countries scientific producation (extracted from Tableu).

The analysis of corresponding authors' countries, as depicted in Figure 7, demonstrates that the
highest number of publications originates from the United States, followed by China, Canada,
Sweden, France, and Turkey. The United States takes the lead with 26 publications, which could be
seen as a direct reflection of the government's support for increased research and development in the
healthcare sector. Additionally, collaborative publications involving authors from the United States
and Japanese authors, Tu San Pham and Antoine Legrain, have contributed to the diversity of
publications from the USA.

It's essential to highlight that the map exclusively showcases scientific output, quantified by the
number of research papers published. It does not consider other significant indicators of scientific
accomplishment, such as the quality of research or its broader societal impact.

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5.8 Countries Production Over Time

The chart depicts the publication counts in healthcare resource allocation for a chosen set of
countries from 2000 to 2023. In 2022, the leading nations with the highest publication figures were
the USA, China, and the UK. Notably, these countries have consistently ranked among the top
contributors in this field throughout the years, indicating a robust and sustained commitment to
research in this domain.

Additionally, France, Germany, and the Netherlands are noteworthy for their substantial publication
numbers. These nations have also experienced a consistent growth in the volume of publications
related to healthcare resource allocation over the past decade.

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5.9 Most global citied document

Figure 9: Most Global cited document (extracted from biblioshiny.)

The most frequently cited publications in this field garnered the following citation counts: 490 (RAIS
A, 2011), 305 (BRAILSFORD S, 2011), 288 (GUPTA D, 2008), 283 (BOSELIE P, 2003), and 177
(ZHANG Y, 2009). While these papers may be relatively dated, they offer valuable insights into the
fundamental principles of resource allocation within the healthcare sector.

It's worth noting that the top five most cited publications originated from Portugal, the UK, the USA,
the Netherlands, and Canada. Notably, all five of these countries rank within the top 25 when it
comes to the Healthcare Innovation Index.

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5.10 Co-occurrence Network of keywords

Figure 10: Co-occurrence of keywords (extracted from Vosviewer.)

A keyword co-occurrence network is a graphical representation that illustrates the semantic

relationships between keywords within a given body of text. In this network structure, individual
keywords are represented as distinct nodes, and connections, or edges, are established between pairs
of nodes when these keywords appear together within a document contained in the corpus. Using the
powerful scientometric analysis tool, VOS Viewer, we conducted a keyword investigation to identify
the most relevant keywords used across the 64 publications. This analysis not only reinforces the
foundational principles guiding our literature retrieval strategy, which is specifically tailored to the
realm of operations research in healthcare resource allocation, but also provides substantial insights
into the intellectual landscape that underpins this research field. It is important to note that the choice
of keywords assumes that the resulting keywords accurately reflect the content of the articles and
ultimately define the primary cluster of topics discussed within the related literature (Khan et al.,
2020; Paltrinieri et al., 2019).

The visual representation presented in Figure 10 offers a graphical summary of our findings,
prominently showcasing keywords that recurrently appear throughout the corpus, extending beyond
the core theme of 'Resource Allocation.' Noteworthy among these frequently occurring keywords are
'decision making,' 'operations research,' 'public health,' 'healthcare,' 'emergency medical services,'
'decision support system,' 'pandemic,' and 'OR in health services.' The prevalence of terms like
"decision making," "public health," "facility location," and "emergency service" underscores the
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essential and pivotal role that operations research methodologies play within the complex landscape
of the healthcare sector. Indeed, the multifaceted challenges confronting the healthcare industry,
which range from the prevalence of chronic diseases to the imperatives of providing equitable
healthcare and the emerging threat of antibiotic resistance, have spurred the widespread and
profound integration of operations research methodologies, solidifying their status as an
indispensable tool in the contemporary healthcare research landscape.

5.11 Thematic Map

Figure 11: Thematic map (extracted from Vosviewer.)

Figure 11 serves as an informative thematic map, encompassing a selection of 50 keywords

thoughtfully utilized by the authors to visually represent the underlying thematic structure within the
studied corpus. To distill these thematic groupings, a graph-based approach was employed, resulting
in the depiction of clusters resembling 'bubbles.' These visually distinct clusters were organized and
ranked based on their significance, utilizing Callon's centrality and density metrics, as expounded by
Callon et al. in 1991. In this graphical representation, the size of each bubble is inversely
proportional to the frequency with which the constituent keywords appear within the respective
cluster.

The X-axis in the graph reflects the level of interaction between clusters, signifying the significance
of a theme. On the other hand, the Y-axis gauges the density, indicating the strength and growth of a
theme. This graph enables us to identify four types of themes:
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(a) "Motor themes" occupy the top-right quadrant with high centrality and density, denoting their
significance and well-developed nature.
(b) "Niche themes," such as algorithms, are situated in the top-left quadrant with high density but
low centrality, indicating their specialized and relatively less critical nature.
(c) "Emerging or declining themes" are positioned in the bottom-left quadrant with low centrality
and density, signifying themes that are in their nascent stages or not particularly significant. Four
clusters are identified here, with the first focused on "reinforcement learning, dynamic resource
allocation, sars-cov-29," the second centered on "covid-19, healthcare operations, medical
personnel," and the third addressing "personnel management, queuing theory, medical care, queuing
networks."
(d) "Basic themes" are located in the bottom-right quadrant with high centrality but low density,
emphasizing their significance for cross-disciplinary research. This quadrant encompasses a single
cluster featuring "resource allocation, operations research, decision making." These are crucial
themes that have yet to gain substantial prominence.

The authors also examined how these themes evolved over time by segmenting them. If a theme's
trajectory moved up and to the right, it signified an increasing significance, whereas a path down and
to the left indicated diminishing importance.

The upper right quadrant primarily contains "motor themes" with stronger internal cohesion and
extensive connections with other themes. Notably, this quadrant does not contain any specific
clusters. In conclusion, the co-occurrence network provides a valuable overview of the fundamental
ideas and methodologies within the healthcare field.

6. Discussion and implications

6.1 Findings

The research has revealed a strong emphasis on operations research, healthcare, and allocation. The
frequency of particular terms, academic institutions, and writers suggests a rise in interest and
knowledge in the field, particularly after the Covid-19 pandemic, which left many healthcare systems
with insufficient funding. "This problem in the healthcare sector is even more complex due to
inherent complexities that arise from resource allocation and budget limitations in general facility
location problems" (Aslani et al., 2023). The subject of healthcare system reforms is becoming more

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influential and important due to increased understanding and discussion of the topic. The research
report uses a thematic map to identify emerging themes and trends, which is a novel finding that can
help identify locations that will become more relevant in the future.22The pandemic highlighted the
significance of statistics in decision-making and allowed to “evaluate their resource allocation
strategies and identify the effect of redefining the prioritization of patients”(Melman et al., 2021).
The emphasis on data analysis and mathematical modeling in this study can help to improve data-
driven decision-making in healthcare.

6.3 Implications

The importance of healthcare systems—which usually deal with staffing, equipment, and budgetary
constraints—is established in this article. The distribution of these resources can be optimised
through the application of operations research approaches to better serve patient requirements and
improve overall system performance. OR aids in making the best use of all healthcare facilities and
optimising the distribution of equipment resources. This article will be helpful to managers and
administrators of healthcare organisations that supervise resource allocation choices. Physicians,
nurses, and other healthcare workers may find it helpful to understand how operations research may
impact resource allocation. New research themes and methodologies can be explored by scholars and
students studying healthcare economics, operations research, and management. AI-powered
algorithms can solve complex resource allocation problems in real-time. These algorithms can
consider factors like patient acuity, resource availability, and cost-effectiveness to recommend
optimal resource assignments, such as patient scheduling, staff allocation, and equipment utilization.

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6.4 Future Research Agenda

Inputs Processes Outcomes Research Agenda

Healthcare resource Operations Efficient Investigate advanced data collection methods to

data research methods resource improve resource data accuracy and timeliness.
allocation

Patient demographic Resource Cost reduction Develop novel optimization algorithms to enhance
information allocation and financial resource allocation modeling for complex
modeling sustainability healthcare systems.

Funding sources and Allocation Improved Examine the impact of resource allocation
constraints decision-making patient care and strategies on patient outcomes, including health
processes outcomes disparities and quality of care.

Technological and Allocation policy Enhanced Investigate the integration of emerging

medical development and public health technologies (like AI, telemedicine) into resource
advancements evaluation preparedness allocation frameworks.
and resilience

Healthcare Equity and Equitable Assess the ethical and social implications of
regulations and fairness access to resource allocation decisions, addressing issues of
guidelines considerations healthcare equity, transparency, and fairness.
services

Community and Data-driven Improved Explore strategies for involving communities and
public health decision-making healthcare the public in resource allocation decisions to align
priorities system with local health needs.
performance
and efficiency

7. Conclusion and Limitations

To sum up, this study explores the field of Operations Research (OR) and its significant uses in the
medical field. Investigating how OR methods and decision science support effective resource
management and decision-making in healthcare systems is done. This article highlights important

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figures in the subject, presents a thorough summary of the body of research, and spots trends.
Additionally, it highlights how OR may enhance emergency response, decision support systems,
resource allocation, and the provision of affordable healthcare.

Extensive data analysis yields important findings, including the exponential growth in publications
about healthcare resource allocation, the identification of the most relevant sources and authors, and
the critical role that operations research and decision making play in the healthcare industry.

The fact that the research paper's data was only acquired from Ebsco is its main limitation. Future
research is advised to use additional databases, including Google Scholar or Scopus. Due to the fact
that this study is limited to bibliometric reviews, it also has a broad research scope. Since there aren't
many publications available on the subject, this evaluation is even more important in order to support
the need for in-depth investigation into this field.

Contributions

Shivansh Garg: Research Objective, Findings and analysis (Annual Scientific Production, most
relevant sources, most relevant authors, Countries scientific production, Co-occurrence network of
keywords, Thematic map)

Ishita Jadhav: Findings and analysis (Three field plot, Countries production over time, Average
citations, most global cited documents)

Aditya Singh: Findings and analysis (Most Relevant Affiliations), Discussions and Implications,
Conclusion and Limitations

Nainika Vig: Introduction , Literature review

Riya Rathi: Abstract, Research Methodology, References

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