关键词: 慢性病, 多重慢病, 政策工具, 社会网络分析, 政策文本分析

Abstract: Background　China is increasingly emphasizing the prevention and control of chronic diseases，with the number and variety of related policies showing a growing trend. With the intensification of population aging，multimorbidity has become a critical challenge in the field of public health，necessitating the urgent optimization of relevant policies. Objective　This study aims to reveal the characteristics and priority areas of chronic disease policies and identify potential directions for policy improvement. Methods　Based on a three-dimensional framework of policy tools，policy evolution，and policy actors， content analysis was conducted using NVivo 20.0 software to encode and classify relevant policy documents issued between March 2009 and January 2024. Social network analysis was applied using Ucinet 6.0 software to examine the collaboration network among policy actors，and statistical analyses were performed using Excel 2021. Results　Analysis of the 68 included policy documents identified a total of 279 references to policy tool usage，comprising 135 instances of supply-side tools，27 instances of demandside tools，and 117 instances of environmental tools. The General Office of the State Council accounted for the highest proportion of policy tool references（35.48%，99/279），while the National People's Congress（NPC） and its Standing Committee accounted for the lowest（2.87%，8/279）. In the social network analysis，the collaboration network density among policy actors was 0.631，with the National Health Commission exhibiting the highest centrality. Further analysis of the 68 policies revealed an increasing trend in both the number and variety of policy tools as policies evolved，though supply-side tools remained predominant （35 policies）. The NPC and its Standing Committee were involved in relatively few policies（3 policies）. Moreover，only 10 out of the 68 policies addressed multimorbidity. Conclusion　The results indicate structural imbalances in the use of policy tools and insufficient collaboration among policy actors. The number of policies addressing multimorbidity is limited，and specialized policies in this area are lacking. To address the challenges of chronic disease prevention and control，it is recommended to optimize the allocation of policy tools，enhance coordination among policy actors，and promote the development of specialized policies for multimorbidity. Expanding policy coverage and transitioning from a single-disease management model to an integrated multimorbidity management approach are essential to comprehensively strengthen the capacity for chronic disease prevention and control.

Key words: Chronic diseases；Multimorbidity, Policy instruments, Social network analysis, Policy text analysis