Introduction:

An alternative approach to health systems research is discourse analysis.

Objective:

To describe the scientific production that investigates health systems using discourse analysis as a theoretical-methodological perspective.

Methodology:

Systematic review. The search was conducted in five databases (SciELO, MEDLINE, PubMed, EBSCO and Science Direct), in both Spanish and English. The descriptors used were "sistema OR salud" AND "análisis OR discurso", and their English equivalents. Qualitative studies, scoping reviews, essays and PhD theses, published between January 1994 and December 2019, were included; in all cases their subject was described clearly as discourse analysis of health systems, their functions or organizative structure.

Results:

A total of 27 texts were included in the revision; four categories describe how discourse analysis can be used in the study of health systems as well, the concept of the health-disease process, subject autonomy, management discourses, and health systems as public policy.

Discussion:

Health systems are fields for the exercise of power relations that construct subjects, configure the autonomy of the subject, and determine the interventions of the health-disease process.

Conclusions:

This review identifies that discourse is used as a device of power that configures subjects and the way in which the health-disease process is intervened.