Applications and Consequences of Transparency in the Health Systems: A Systematic Scoping Review



H Bouzarjomehri HOSSEIN ; Mr Maleki Mohammad REZA ; J Sajjadikhasraghi JAVAD ; Y Herandi YASAMAN
Source: Health Technology Assessment in Action Published:2025

Abstract

Context: Transparency is a crucial factor in addressing information asymmetry and inefficiencies within health systems. However, its outcomes can vary significantly. Objectives: This study aims to explore the applications and consequences of transparency in health systems. Methods: A scoping review was conducted, searching databases including PubMed, MEDLINE (Ovid), Scopus, Web of Science, ProQuest, and Google Scholar up to 2023. The six-step protocol by O’Malley and Arksey for scoping reviews was employed, adhering to the PRISMA-ScR reporting checklist. Data were extracted and summarized using a data collection form, then entered into MaxQDA software for coding, categorization, and synthesis. Results: The review included 97 documents published between 1994 and 2022, predominantly from the United States. The studies identified various applications of transparency, such as quality and safety, pricing and costs, personal health records (PHR), prescriptions, payments, insurance, waiting times, staffing, and statistical data. A total of 137 positive outcomes were reported, including improved quality, efficiency, empowerment, satisfaction, and competition. Conversely, there were 37 instances of no effect and 34 instances of negative outcomes, such as risk aversion, reduced quality, increased costs, and misinterpretation. Conclusions: The variability in the outcomes of public reporting can be attributed to the type and level of reporting, the structure of the health system, and the economic and cultural contexts. To enhance transparency effectively, it is essential to consider its outcomes and implement it in a principled and precise manner to maximize benefits and minimize potential harms. © 2025 Elsevier B.V., All rights reserved.