通讯作者: 孟开, mengkai@ccmu.edu.cn

DOI：10.12201/bmr.202608.00030

Analysis of the Coupling Coordination Degree and Spatial Characteristics of Collaboration between Medical Care and Public Health in China

• 摘要：【摘要】目的：分析我国医防协同的耦合协调水平，揭示其时空演化规律与空间特征，为优化医防协同政策提供参考。方法：基于文献研究法构建评价指标体系，运用熵值法和耦合协调度模型测算医防协同的耦合协调度，并借助全局莫兰指数和局部莫兰指数分析其空间特征。结果：2013—2023年全国医防耦合协调度均值在0.4879至0.5073间微幅波动，整体处于濒临失调向勉强协调过渡的平台期。空间格局呈现“东部高值集聚、中部稳健、西部极化、东北退化”的非均衡特征。各省份耦合协调度呈现空间正相关性与空间异质性，HH集聚区与LL集聚区长期稳定共存。结论：我国医防协同水平整体偏低且提升缓慢，区域分化显著，空间集聚效应明显。建议从组织管理、筹资支付、信息共享等方面构建常态化协同机制，实施分区分类的差异化政策，推动医防协同从“政策驱动”转向“制度驱动”。

  关键词： 医防协同；耦合协调；空间自相关；区域差异

   

  Abstract: 【Abstract】Objective: To analyze the coupling coordination level of medical and preventive care integration in China, reveal the patterns of its spatio-temporal evolution and spatial characteristics, and provide a reference for optimizing policies related to the integration of medical and preventive care. Methods: Based on the literature research method, an evaluation index system was constructed. The entropy weight method and the coupling coordination degree (CCD) model were applied to calculate the CCD of medical and preventive care integration. Furthermore, Global and Local Moran’s I indices were employed to analyze its spatial characteristics. Results: From 2013 to 2023, the average CCD of medical and preventive care in China fluctuated slightly between 0.4879 and 0.5073, remaining in a plateau phase transitioning from “borderline dysregulation” to “barely coordinated”. The spatial pattern exhibited unbalanced characteristics described as “high-value agglomeration in the East, stability in the Central region, polarization in the West ,and degradation in the Northeast”. The CCD among provinces exhibited a positive spatial correlation and spatial heterogeneity, characterized by the long-term stable coexistence of High-High (HH) and Low-Low (LL) clusters. Conclusion: The overall level of medical and preventive care integration in China is relatively low with slow progress, significant regional differentiation, and prominent spatial agglomeration effects. It is recommended to establish normalized synergistic mechanisms in areas such as organizational management, financing and payment, and information sharing. Implementing differentiated policies based on regional classifications is essential to drive the transition of medical and preventive care integration from being “policy-driven” to “institution-driven.”

  Key words: Collaboration between medical care and public health；Coupling and coordination；Spatial autocorrelation；Regional differences

  提交时间：2026-08-16

  版权声明：作者本人独立拥有该论文的版权，预印本系统仅拥有论文的永久保存权利。任何人未经允许不得重复使用。
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• 序号	提交日期	编号	操作
  1	2026-04-24	10.12201/bmr.202608.00030V1	下载

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