Mapping geographic variation in metadata completeness, article processing charges and journal impact across MEDLINE journals and the influence of publisher clustering

Objective To examine geographic distribution across metadata completeness, pricing, and journal impact for MEDLINE-indexed journals, and the associations among these dimensions. Methods Cross-sectional analysis of currently MEDLINE-indexed journals, conducted April 1st, 2026. Data were extracted via API queries from Crossref for metadata completeness, PubMed/MEDLINE for journal identification, SCImago for journal impact, and the Directory of Open Access Journals for pricing and APC availability. Metadata were assessed using 8 indicators (abstracts, affiliations, ORCID, funder information, licenses, references, update policies, resource links); impact was assessed using the SJR, and pricing using APCs. Geographic classification was based on journals’ publisher headquarters location mapped to eight geographic regions. Results There were statistically significant regional differences in metadata scores (χ² = 231.42, p < 0.001), APCs (χ² = 123.98, p < 0.001), and SJR (χ² = 477.46, p < 0.001). Western Europe and Northern America had the highest SJR values, while Africa and Eastern Europe had the lowest across all three dimensions. Metadata completeness followed a related pattern, but the Middle East showed the highest median composite score. Funder information was the most consistently deficient metadata element across all regions (0%-40%). Median APCs varied around a median of €2,470. Much of the regional pattern in metadata completeness, and somewhat in SJR scores, was attributable to publisher-level clustering rather than region per se. Conclusions MEDLINE-indexed journals show substantial regional heterogeneity in metadata completeness, APCs, and journal impact. These gaps may impede discoverability and research accountability. Geographic stratification in metadata completeness, impact, and pricing suggests persistent systemic inequities in the biomedical publishing infrastructure.