Integration of medical services and public health in China: theoretical connotation and practical exploration

AbstractIntegrating medical services and public health is a key to shifting from a treatment-centered to a health-centered approach. It is also a strategic lever for building a Healthy China. Based on field research and an analysis of policy documents from 2020 onwards, this paper systematically examines the theoretical implications, policy evolution, and practical models of this integration. The paper also reveals the deep-seated institutional challenges that this integration faces. Key findings include: (1) China's integration of medical services and public health has undergone a four-stage policy evolution: "emergency collaboration → grassroots integration → systemic reform → system leapfrogging." Regional practices have developed three models: embedded responsibility lists, organizational restructuring, and digitally enabled integration. (2) Current reforms face five major challenges: misaligned value perceptions, fragmented management systems, imbalanced economic incentives, talent shortages, and disjointed policy implementation. These challenges stem from systemic conflicts between traditional "treatment-centered" approaches and the goals of health governance. (3) To advance high-quality development, China must adopt a five-dimensional approach: 1) reforming health performance-based compensation mechanisms, 2) building collaborative governance systems, 3) innovating financing models, 4) reshaping talent development pathways, and 5) strengthening dynamic supervision.