A scoping review of Chinese national policies to promote the three-medicals linkage reform since 2014

Abstract In 2014, for the first time, the Chinese government included the “three-medicals linkage” as a key task of medical reform, aiming to integrate medical care, medical insurance, and medicine into a cohesive health governance and service delivery model. This study reviews national policies on the “three-medicals linkage” issued from 2014 to 2023 to analyze its framework, evolution, strengths, and challenges. A thematic synthesis of 121 policy documents, selected from an initial 4392 records from State Council and its affiliated ministries, revealed 12 major strategies, including “reform of medical insurance payment methods” and “universal medical insurance and informatization of medical insurance”. But areas such as health information and workforce development remain underemphasized. Although the “three-medicals linkage” has strengthened the health system, gaps remain, particularly in multi-sectoral coordination and information integration. We recommend enhancing multi-sectoral cooperation, addressing deficiencies in health information and workforce, and establishing robust monitoring, evaluation, and incentive mechanisms.