Evolution and interaction mechanisms of China’s high-performing national healthcare system

Abstract Objectives This study aims to identify the dimensions and evolutionary pathways of China’s high-performing national healthcare system, as well as the interaction mechanisms between the digital and traditional healthcare dimensions. Methods This study first constructs a high-performing healt...

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Main Authors: Chong Feng, Feiyang Chen, Ziwei Ye, Fenling Zhang
Format: Article
Language:English
Published: BMC 2025-05-01
Series:BMC Health Services Research
Subjects:
Online Access:https://doi.org/10.1186/s12913-025-12749-y
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author Chong Feng
Feiyang Chen
Ziwei Ye
Fenling Zhang
author_facet Chong Feng
Feiyang Chen
Ziwei Ye
Fenling Zhang
author_sort Chong Feng
collection DOAJ
description Abstract Objectives This study aims to identify the dimensions and evolutionary pathways of China’s high-performing national healthcare system, as well as the interaction mechanisms between the digital and traditional healthcare dimensions. Methods This study first constructs a high-performing healthcare evaluation index comprising four dimensions: digital healthcare, healthcare resource allocation, healthcare output, and healthcare effectiveness. It next presents a multilevel structural dynamic factor model to examine the evolutionary pathway of China’s national healthcare system. It then analyses the interaction mechanism of each healthcare dimension based on the impulse response function. Results First, the upward trend in the overall performance of China’s high-performing national healthcare system demonstrates that it is significantly improving. Second, the overall performance of China’s high-performing national healthcare system has been most impacted by healthcare effectiveness and least impacted by healthcare output. The performance is trending upward for digital healthcare and healthcare resource allocation but downward for healthcare output and effectiveness. Third, increasing healthcare resource allocation and output promotes digital healthcare. The improvement in digital healthcare performance significantly and positively impacts healthcare effectiveness, while having weaker effects on healthcare resource allocation and healthcare output. Conclusions The performance of China’s high-performing national healthcare system is improving. However, healthcare resource allocation and health outcomes require further optimisation, and the integration capacity of traditional healthcare with digital healthcare must be strengthened.
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spelling doaj-art-e54076b402e140e990b43130e1bf09c12025-08-20T03:10:13ZengBMCBMC Health Services Research1472-69632025-05-0125111710.1186/s12913-025-12749-yEvolution and interaction mechanisms of China’s high-performing national healthcare systemChong Feng0Feiyang Chen1Ziwei Ye2Fenling Zhang3School of Mathematics and Statistics, Xiamen University of TechnologySchool of Mathematics and Statistics, Xiamen University of TechnologySchool of Mathematics and Statistics, Xiamen University of TechnologySchool of Mathematics and Statistics, Xiamen University of TechnologyAbstract Objectives This study aims to identify the dimensions and evolutionary pathways of China’s high-performing national healthcare system, as well as the interaction mechanisms between the digital and traditional healthcare dimensions. Methods This study first constructs a high-performing healthcare evaluation index comprising four dimensions: digital healthcare, healthcare resource allocation, healthcare output, and healthcare effectiveness. It next presents a multilevel structural dynamic factor model to examine the evolutionary pathway of China’s national healthcare system. It then analyses the interaction mechanism of each healthcare dimension based on the impulse response function. Results First, the upward trend in the overall performance of China’s high-performing national healthcare system demonstrates that it is significantly improving. Second, the overall performance of China’s high-performing national healthcare system has been most impacted by healthcare effectiveness and least impacted by healthcare output. The performance is trending upward for digital healthcare and healthcare resource allocation but downward for healthcare output and effectiveness. Third, increasing healthcare resource allocation and output promotes digital healthcare. The improvement in digital healthcare performance significantly and positively impacts healthcare effectiveness, while having weaker effects on healthcare resource allocation and healthcare output. Conclusions The performance of China’s high-performing national healthcare system is improving. However, healthcare resource allocation and health outcomes require further optimisation, and the integration capacity of traditional healthcare with digital healthcare must be strengthened.https://doi.org/10.1186/s12913-025-12749-yHigh-performing healthcareIndicator systemMultilevel structural dynamic factor modelEvolutionInteraction mechanism
spellingShingle Chong Feng
Feiyang Chen
Ziwei Ye
Fenling Zhang
Evolution and interaction mechanisms of China’s high-performing national healthcare system
BMC Health Services Research
High-performing healthcare
Indicator system
Multilevel structural dynamic factor model
Evolution
Interaction mechanism
title Evolution and interaction mechanisms of China’s high-performing national healthcare system
title_full Evolution and interaction mechanisms of China’s high-performing national healthcare system
title_fullStr Evolution and interaction mechanisms of China’s high-performing national healthcare system
title_full_unstemmed Evolution and interaction mechanisms of China’s high-performing national healthcare system
title_short Evolution and interaction mechanisms of China’s high-performing national healthcare system
title_sort evolution and interaction mechanisms of china s high performing national healthcare system
topic High-performing healthcare
Indicator system
Multilevel structural dynamic factor model
Evolution
Interaction mechanism
url https://doi.org/10.1186/s12913-025-12749-y
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AT feiyangchen evolutionandinteractionmechanismsofchinashighperformingnationalhealthcaresystem
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AT fenlingzhang evolutionandinteractionmechanismsofchinashighperformingnationalhealthcaresystem