Overview of descriptive and analytical themes.

BackgroundReputation is a critical factor in the health insurance industry, impacting business performance and public health outcomes. However, despite its acknowledged importance, the reputation of health insurers has received limited attention in both academic research and industry practice. Gaining a comprehensive understanding of health insurers’ reputation could help insurers strategically manage their public image while providing policymakers with valuable insights to develop policies that improve health outcomes.ObjectiveThis study aims to identify the factors shaping the reputation of health insurers and to assess the broader impacts of reputation within the industry and the health care system.DesignA scoping review was conducted to map the existing literature on the reputation of health insurers. Using the PRISMA-ScR framework, it identified key determinants and outcomes of health insurer reputation, clarified concepts of reputation and trust, and highlighted gaps in the current body of literature.ResultsA total of 3385 records were identified, of which 397 were fully screened for eligibility, resulting in the inclusion of 45 studies. The majority of the included studies conducted surveys (n = 40), while the minority employed qualitative interviews (n = 6) and focus group discussions (n = 7). The total number of participants involved in the included studies is 31’344. The analysis identified 23 descriptives themes, which were organised into two main analytical categories: determinants and outcomes. The determinants included 17 descriptive themes which have been further classified into three groups based on whether they pertain to policyholders, insurers or providers. The outcomes consist of six key descriptive themes.ConclusionThis review provides a thorough analysis of research that have investigated different aspects of health insurance reputation and identify significant gaps in the literature. It maps key determinants of reputation – such as corporate culture, product structure, and service quality – that insurers can directly influence. Additionally, factors like the quality of healthcare providers and targeted communication efforts may also be linked to reputation. The analysis underscores the importance of reputation for core business activities (e.g., client acquisition and retention) and its role in preventive healthcare. Notably, there is a lack of research on the regulatory implications of insurers’ reputation, suggesting a need for further studies to enhance preventive strategies and integrate insurers into a broader public health framework.研究背景：信誉是健康保险行业的关键影响因素，既会对企业经营绩效产生作用，也会影响公共卫生健康结局。尽管学界与业界均认可其重要性，但目前针对健康保险公司信誉的相关学术研究与行业实践均较为匮乏。全面厘清健康保险公司的信誉构成，能够助力保险机构战略性地管理其公众形象，同时也可为政策制定者提供宝贵的决策参考，助力其出台能够改善卫生健康结局的相关政策。 研究目标：本研究旨在明确影响健康保险公司信誉的核心因素，并评估信誉在健康保险行业及医疗保健系统中产生的广泛影响。 研究设计：本研究采用范围综述（scoping review）方法，对现有健康保险公司信誉相关文献进行系统梳理。本研究遵循PRISMA-ScR框架，明确了健康保险公司信誉的关键决定因素与影响结局，厘清了信誉与信任的概念内涵，并指出了当前文献体系中存在的研究空白。 研究结果：本次检索共识别出3385条文献记录，其中397条经过完整资格筛查，最终纳入45项研究。纳入的研究中，绝大多数采用问卷调查法（n=40），少数采用质性访谈法（n=6）与焦点小组讨论法（n=7）。纳入研究的总参与人数为31344人。经分析共提炼出23个描述性主题，可归纳为两大分析类别：信誉决定因素与信誉影响结局。其中，决定因素包含17个描述性主题，依据其关联对象进一步划分为三类：保单持有人、保险公司自身以及医疗服务提供者。信誉影响结局则涵盖6个核心描述性主题。 研究结论：本综述对现有健康保险信誉相关的多维度研究进行了全面梳理，并明确了当前文献中存在的显著研究空白。研究识别出保险公司可直接干预的信誉关键决定因素，如企业文化、产品结构与服务质量等。此外，医疗服务提供者的服务质量、针对性沟通策略等因素，同样可能与保险公司信誉存在关联。本研究强调了信誉对于保险公司核心业务活动（如客户获取与留存）的重要性，以及其在预防性医疗保健领域的作用。值得注意的是，目前学界针对保险公司信誉的监管层面影响研究仍存在空白，这提示未来需开展更多相关研究，以完善预防性健康策略，并将保险公司纳入更广泛的公共卫生框架之中。