Fang Wu

Background/Objectives: The global health landscape is currently confronted with dual challenges from both infectious diseases and chronic conditions. Medical–preventive integration has emerged as a pivotal strategy to address these issues, aiming to create a comprehensive, closed-loop framework that spans disease prevention, treatment, rehabilitation, and healthcare, ultimately improving population health outcomes. In the Chinese context, existing policies remain fragmented, scattered across various healthcare-related regulations, and lack systematic and comprehensive analysis. This policy fragmentation may impede the creation of synergistic effects essential for the effective implementation of integrated healthcare strategies. Methods: This study adopted a mixed-methods approach to analyze 85 national policies: a three-stage coding process identified 1088 policy nodes, and a three-dimensional framework (policy instruments (X) × full-cycle health service (Y) × integration stages (Z)) was applied to uncover systemic imbalances. Social network analysis and Latent Dirichlet Allocation (LDA) topic modeling were utilized to map interagency collaboration patterns and thematic shifts, which were visualized using Gephi and Sankey. Results: The analysis revealed that policy instruments are predominantly supply-side (45.04%) and environmental-side (40.35%), with demand-side instruments (14.61%) being notably underutilized, particularly in health financing. Rehabilitation services, representing just 8.27% of the policy focus, were identified as a significant gap in the comprehensive health service cycle. While 44.58% of the instruments facilitated collaboration of medical and preventive services, integration of medical–preventive management stagnated at 25.28%, reflecting institutional inertia that impedes the redistribution of cross-sector resources. Agency collaboration evolved from a siloed approach (2015–2018) to a networked structure (2019–2021) and transitioned to centralized governance post-2022. Thematic shifts in policy discourse moved from a “Healthy China” focus toward pandemic-driven disease surveillance, culminating in the recent development of smart health ecosystems. Conclusions: China’s policies for medical–preventive integration demonstrate notable structural imbalances, particularly in the economic instruments related to health financing and the private-sector participation in healthcare. These imbalances may impede the effective allocation of healthcare resources and hinder the seamless transition toward integrated care. Future policy efforts should focus on optimizing the structure of policy instruments, addressing gaps in the full lifecycle of health services, advancing integration reforms, and promoting the transformation of the healthcare system through enhanced collaborative governance among key stakeholders.

China has established a comprehensive primary medical health service system, but the development of primary medical health services in the central and western regions is still unbalanced and insufficient. Based on data from 2010 to 2019, this paper constructs a super efficiency Slack-Based Measure model to calculate the supply efficiency of primary medical health services in 20 provinces and cities in central and western China. Using Kernel density estimation and Markov chain analysis, this paper further analyzes the spatial-temporal evolution of the supply efficiency of primary medical health services in central and western China, and also predicts the future development distribution through the limiting distribution of Markov chain to provide a theoretical basis for promoting the sinking of high-quality medical resources to the primary level. The results show that firstly, during the observation period, the center of the Kernel density curve moves to the left, and the main peak value decreases continuously. The main diagonal elements of the traditional Markov transition probability matrix are 0.7872, 0.5172, 0.8353, and 0.7368 respectively, which are significantly larger than other elements. Secondly, when adjacent to low state and high state, it will develop into convergence distributions of 0.7251 and 0.8243. The supply efficiency of primary medical health services in central and western China has the characteristics of high (Ningxia) and low (Shaanxi) aggregation respectively, but the aggregation trend is weakened. Thirdly, the supply efficiency of health services has the stability of keeping its own state unchanged, but the transition of state can still occur. The long-term development of the current trend cannot break the distribution characteristics of the high and low clusters, the efficiency will show a downward trend in the next 10–20 years, and still the problem of uneven long-term development emerges.

The uneven distribution of medical and health resources leads to changes in the choice of patients for medical treatment, which is the key to restrict the reform of medical services in China currently. Taking service accessibility and residents' cognition as the starting point, this study utilized the data from the questionnaire and applied logistic regression and mediation test. By taking service accessibility as an explanatory variable and residents' cognition as an intermediary variable, the study examined the differences between residents' choice of medical treatment at the primary and non-primary levels. Thus, the influencing factors of residents' choice of medical treatment at the primary level were explored. The research statistics came from questionnaires of 1,589 residents in Nanjing, Jiangsu Province, China. The results showed that service accessibility and residents' cognition were significantly correlated with the residents' choice of primary medical treatment. Household registration, age, the signing situation with family doctors, hospital service fees, and distance to the hospital were positively related to residents' choice of primary medical treatment; while the reputation, scale, residents' income, and the reimbursement ratio of residents' medical insurance were negatively correlated with the choice. In addition, residents' cognition played an intermediary effect between service accessibility and the residents' choice of primary medical treatment. The signing situation with family doctors indirectly affected the choice of primary medical treatment through residents' cognition, and residents' cognition masked some negative influence of the reimbursement ratio of residents' medical insurance on the choice of primary medical treatment.

The balanced allocation of medical and health resources is an important basis for the sustainable development of health undertakings. In recent years, China has made remarkable achievements in the medical and health services, but there is still a phenomenon of unbalanced allocation of medical and health resources among different regions, which has become an urgent problem to be solved in deepening the reform of the medical and health system during the 14th Five-Year Plan period. From the perspective of people’s needs for health, this study analyzed the equity and efficiency of urban medical and health resources allocation in China by using the Theil index method and DEA method. Meanwhile, the authors used the coupling coordination degree model to construct a balanced development model with equity and efficiency as subsystems, taking the city of Nanjing as an example to analyze its balanced allocation of medical and health resources from 2008 to 2019. In general, taking Nanjing as an example, it shows that the balanced allocation of medical and health resources in Chinese cities is good, but in geographical dimension, the level of balanced allocation is low, and there are still significant differences in the equity and efficiency of allocation among regions. In the future, the government can strengthen the rationality of regional planning, appropriately increasing health investment and medical supply, considering both equity and efficiency to further realize the balanced allocation of medical and health resources and improve the sustainability of urban medical service system. The main contribution of this paper lies in that, from the perspective of sustainable development, the evaluation system is integrated to measure the equity and efficiency respectively, and the balanced development model is used to investigate the allocation of urban medical and health resources. The research results can provide reference for optimizing resources allocation and promoting the sustainable development of medical and health undertakings.

The improvement of the efficiency of medical and health services is of great significance for improving the high-quality and efficient medical and health services system and meeting the increasingly diverse health needs of residents. Based on the panel data of 13 cities in Jiangsu Province, this research analyzed the relative effectiveness of medical and health services from 2015 to 2019 using the super efficiency slack-based measure-data envelopment analysis model, and the Malmquist index method was used to explore the changes in the efficiency of medical and health services from a dynamic perspective. Furthermore, the spatial autocorrelation analysis method was used to verify the spatial correlation of medical and health services efficiency. In general, there is room for improvement in the efficiency of medical and health services in 13 cities in Jiangsu Province. There are obvious differences in regional efficiency, and there is a certain spatial correlation. In the future, the medical and health services efficiency of China’s cities should be improved by increasing the investment in high-quality medical and health resources, optimizing their layout and making full use of the spatial spillover effects between neighboring cities to strengthen inter-regional cooperation and exchanges.

The successful anti-COVID-19 pandemic model of BEST region (Beijing-Seoul-Tokyo) includes China, Japan and South Korea, which benefit from its well-functioning organizational ecosystem and specific anti-COVID-19 pandemic strategies. Under the premise of an efficient market, the capable organizations of China, Japan and South Korea will play the dynamic function of coordination and organic connection. They will also help improve the governance efficiency of facilitating state in different stages of fighting against the pandemic. This article follows the analytical logic of the new structural economics, taking the factor endowment and its structure as the starting point for the analysis, through the comparative advantage operation mode determined by the market, and based on the collaborative anti-COVID-19 pandemic perspective of the government, the market and various social organizations, to build a framework for the facilitating state-efficient market-capable organization. The key to the success of the anti-COVID-19 pandemic method in China, Japan and South Korea is organically coordinated between government, market and organizations. Based on the effective promotion of micro-organizations, governments organize resource integration and implement macro-control of the market. A dynamic balance between economic governance and pandemic prevention and control has been achieved by optimizing the endowment structure of resources, improving infrastructure and reducing system costs.