A Bibliometric Analysis of Performance Measurement and Management in Child and Adolescent Healthcare Services

Background/Objectives: Performance measurement and management is a key administrative function; however, its application to child and adolescent healthcare services remains poorly mapped in the international literature. This study attempts a systematic bibliometric mapping of the field. To the best of our knowledge, previous bibliometric studies in pediatric and related healthcare fields have primarily focused on specific clinical or service domains, whereas the intersection of performance measurement and management with child and adolescent healthcare services has not been specifically mapped. The novelty of the present study lies in addressing this intersection through an integrated bibliometric assessment of its thematic, temporal, and geographical structure. Methods: A bibliometric analysis was performed on the Scopus database, with a query that combined a proximity operator (W/10) and Boolean logic, yielding 643 documents (1990-2026). After metadata cleaning and application of an occurrence threshold (≥15), 111 keywords were analyzed with VOSviewer (network, overlay, density, targeted analysis, bibliographic coupling of countries). Results: Research production increased strongly since 2010, peaking in 2025. Four thematic clusters emerged-quality of care, clinical outcomes, administrative framework, emergency/operational care-with the term "quality of health care" as the central hub-bridge. The administrative cluster was linked to older publications relative to the clinical/operational clusters. Country-level bibliographic coupling identified distinct geographical patterns in cited-reference similarity, including a predominantly European cluster, a transcontinental cluster dominated by the United States and Canada, and a separate Australian cluster. The term "performance measurement" itself did not meet the inclusion threshold, reflecting the methodological effect of the selected occurrence threshold rather than the absence of the concept from the literature. Conclusions: The retrieved literature was strongly concentrated in clinical and health-related subject areas, while explicitly administrative and managerial perspectives appeared comparatively limited. This pattern indicates a potential research gap that warrants further investigation rather than confirming the absence of managerial performance frameworks in the broader field.