The integration of medical care and preventive services is a key strategy in advancing the Healthy China Initiative. However, substantial divergence among stakeholders in terms of its concept, connotation, standards, and mechanisms hampers policy transformation and calls for integrated evidence.

This study aims to conduct a systematic review of the concept, connotation, pathways, content and characteristics of the integration of medical care and preventive services in China, providing evidence to inform policy design and research.

A systematic review approach was adopted. Literature published between 2018 and 2024 was retrieved from China National Knowledge Infrastructure, Wanfang Data, and the Chinese Medical Journal Network using the keywords"integration of medical care and preventive services""integration"and"connotation"from December 31, 2024. A revised analytical framework—grounded in the theories of social determinants of health and integrated care—was applied for data extraction. Data were further integrated, analyzed, and interpreted through the lens of transaction cost theory from new institutional economics.

A total of 27 studies published since 2020 were included. No universal consensus was found regarding the concept and connotation of the integration of medical care and preventive services, leading to elevated ex-ante transaction costs such as negotiation complexity. Regarding integration pathways, studies demonstrated analytical diversity but showed imbalance, with greater emphasis on clinical, normative, and system dimensions, while organizational, functional, professional, and individual dimensions were underexplored, thereby contributing to higher ex-post transaction costs during implementation. In terms of service content, discussions were comprehensive yet limited in scope, focusing mainly on preventive and medical services and their marginal extension, with insufficient attention to health management and patient empowerment services, which may result in multiple layers of transaction costs. As for integration characteristics, although various key features such as continuity, life-course orientation, comprehensiveness, and systematization were proposed, detailed analyses and interpretations were lacking, which may lead to increased transaction costs at different stages.

This study suggests that future research should strengthen the theoretical conceptualization and demand-side perspective; enhance analysis of organizational, functional, professional, and individual pathways; broaden the scope of integration to encompass preventive, medical, health management, and patient empowerment services; and provide more detailed discussions on key integration characteristics. The conceptual and connotative discussions of the integration of medical care and preventive services should strike a balance between policy design and policy implementation, between reality responsiveness and theoretical insight, and between supply-side perspectives and demand-side concerns. These insights may contribute to reducing ex-ante and ex-post transaction costs in both the design and implementation of institutional arrangements.