Objective  To clarity conceptual connotation of health system resilience (HSR) in the context of catastrophic surge in medical demand and to provide references for improving disaster risk management in China.

  Methods  Through searching PubMed, China National Knowledge Infrastructure (CNKI) and other databases, totally 33 Chinese and English literatures published from January 2014 through January 2021 were retrieved using the key words including “health system resilience, “health system”, and “resilience”. An Delphi consultation was then conducted among 31 domestic experts and scholars engaged in health emergency management and disaster medicine using a self-designed questionnaire based on analyses on subject words relevant to conceptual connotation of HSR.

  Results  The coefficients were 81.6%, 0.84, and 0.383 for the consultation′s positivity, authority, and coordination. Towards to the connotation of resilience of a complex system, the experts′ grading scores were 4.84 ± 0.37 for the recognition on the resilience as a capability trait, 4.39 ± 0.76 for as a tacit capability trait, and 4.71 ± 0.46 for as a capability of interference absorption, adaptation, and transformation. The experts′ grading score was 4.77 ± 0.50 for the recognition on a health system as a dynamically changing complex system; towards to the connotation of a health system′s resilience, the experts′ grading scores were 4.29 ± 0.69, 4.39 ± 0.80, and 3.97 ± 0.95 for the recognition on the resilience as a capability of interference absorption, adaptation, and transformation, respectively.

  Conclusion  The health system resilience in the context of a catastrophic surge in medical demand could be defined as a health system′s capability of interference absorption, adaptation, and transformation against internal and external adverse impact considering the system′s dissipative structure with its main subjects such as medical and health institutions in dynamic changes.