Abstract: Background　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. Objective　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. Methods　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. Results　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. Conclusion　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.

Key words: Integration of medical care and preventive services, Integrated care, Systematic review, Transaction cost

摘要： 背景　医防融合是实施和推进健康中国战略的关键策略，但利益相关者对其概念、内涵、标准和机制等的理解存在较大争议，因而难以推动政策变革和提供实践指南，亟待相关研究证据的整合。目的　系统梳理我国医防融合的概念内涵、实现路径、服务内容和融合特征，为完善医防融合政策设计和科学研究提供证据。方法　采用系统综述方法，于2024-12-31，以“医防融合”“整合”和“内涵”等为主题词检索中国知网、万方数据知识服务平台及中华医学期刊网3个数据库，纳入发表时间为2018—2024年的文献。以基于健康决定因素理论和整合医疗理论修订的框架进行数据提取，以新制度经济学的交易费用理论为基础进行整合、分析和阐释。结果　本研究共纳入27篇文献，发表时间均为2020年及之后。纳入文献对医防融合概念及内涵未达成共识，易引致较高的谈判成本等事前交易成本。在医防融合的实现路径方面，纳入文献的分析多元但侧重失衡，对服务、规范和系统维度融合研究较多，对组织、功能、专业和个人维度融合研究较少，易造成较高的执行成本等事后交易成本。在医防融合的服务内容方面，纳入文献的讨论全面但范畴有限，聚焦于预防性服务和医疗性服务范畴及其边际拓展，对健康管理服务和患者赋能服务等范畴的关注较少，或将面临多重交易成本。在医防融合的特征方面，纳入文献的论述多样但阐释不足，提出连续性、全周期、全方位和系统化等的关键特征，但对其具体分析阐释较少，或将导致多重交易成本。结论　本研究认为相关研究应加强对需方视角的关注和对概念学理性的阐述；增加对组织、功能、专业和个体融合维度的思考和分析；拓展医防融合服务内容至预防、医疗、健康管理和患者赋能服务等的更广范畴；增加对医防融合各特征的具体论述。本研究建议医防融合的概念及内涵讨论应当兼顾顶层设计和具体执行，兼备现实回应和理论探究，兼具供方视角和需方关切。以上研究建议和政策建议将有助于降低医防融合制度设计和制度执行时的事前交易成本和事后交易成本。

关键词: 医防融合, 整合医疗, 系统综述, 交易费用