家庭医生签约服务政策的变迁逻辑与高质量发展路径研究——基于政策整合的分析框架

To investigate the multi-level logic of change in China’s family doctor contract service policies and propose pathways for their high-quality development. Methods: An analytical framework grounded in policy integration theory was developed. Through content analysis and policy network analysis, 346 policy documents on family doctor contract services were analyzed using Nvivo and Gephi software, with cross-text and cross-stage thematic coding to identify patterns of policy change. Results: The policy change process can be categorized into three phases: pilot exploration, nationwide implementation, and high-quality development. Key trends include: Policy frameworks transitioned from instrumental issue to comprehensive agendas; Policy subsystem participation shifted from unilateral leadership by health departments to multi-stakeholder collaboration; Objectives expanded from healthcare capacity-building to systemic integration across domains; Policy instruments evolved from fragmented trials to structured systems. Conclusion and Recommendations: To advance high-quality development, policymakers should: Strengthen value integration through strategic governance frameworks;Facilitate process integration for Iterative innovation in service models; Accelerate technical integration via digital transformation; Implement feedback integration with multidimensional evaluation mechanisms.