Objective To define the conceptual connotation and characteristics of medical surges,and to construct a theoretical analysis framework for responding to medical surges based on complex networks.Methods By systematically reviewing relevant domestic and international research and practices,and from the perspective of complex networks and interdisciplinary integration,it analyzed the concept connotation,characteristics and comprehensive analytical framework of medical surges.Results The concept and connotation of medical surges were defined,and six major characteristics were summarized:sudden and surging congestion,overload spillover,stage recurrence,complex network and multi-dimensional collaboration,dynamic nonlinear multi-path evolution,and cascading amplification.A theoretical analysis framework was developed,encompassing four dimensions("risk and vulnerability coupling-complex surge scenario characterization-complex risk network chain drive-network dynamic collaboration capacity assessment and construction"),multiple hierarchical levels("macro-level healthcare system-meso-level hospital department functional systems-micro-level resource elements system"),and multiple scales("Wuli-Shili-Renli").Conclusion The proposed conceptual connotation,characteristics,and multi-dimensional,multi-level,and multi-scale theoretical analysis framework provide new perspectives and theoretical support for advancing the theoretical system of medical surges,guiding healthcare institutions to respond scientifically to surge impacts,and enhancing system resilience and network dynamic collaboration capacity.

Objective To systematically identify the scenario elements of unconventional hospital infection outbreaks and provide a theoretical framework for preventing and resolving unconventional hospital infection outbreaks.Methods The literature related to unconventional hospital infection outbreaks was searched,and the text was preprocessed by Chinese word segmentation technology,and the element categories were condensed layer by layer based on the three-level coding of grounded theory.Results A total of 122 initial concepts,52 initial categories,13 sub-categories and 4 main categories were extracted disaster causing factors,disaster bearers,disaster environment,and emergency activities,and the action types:disaster factors driving the causal chain,disaster bearers bearing the mediating conduction,disaster environment exerting moderating effects,and emergency activities had two-way feedback.Conclusion The four-dimensional scenario factor action type model constructed breaks through the traditional one-way causal framework and provides a qualitative theoretical framework for factor association for the prevention and control of hospital infection outbreaks.

Objective To identify the key factors affecting the risk of medical surges and their coupling relation5 ships,providing strategic support for medical institutions to optimize risk management and emergency governance.Methods 17 influencing factors were determined based on WSR theory,and an expert scoring method was employed to assess the impact strength among the factors.The DEMATEL method was applied to calculate the centrality,cau5 sality,influence,and being influenced degrees of the influencing factors.The ISM method was used to construct a hierarchical structure of the influencing factors related to medical surge risks,thereby revealing the connections and interaction mechanisms among these factors.Results Seven critical influencing factors were identified,including the crisis decision-making capacity and leadership effectiveness of emergency managers,the completeness of the emer5 gency system and dynamic execution capabilities,and the cross-departmental coordination mechanism and com5 mand collaboration efficiency.Deep driving factors and coupling pathways were also revealed.Conclusion The risk of medical surges exhibits multi-factorial coupling cascade effects;attention should be directed towards the construc5 tion of mid-to-deep level mechanisms such as information systems,institutional frameworks,and organizational management,to enhance targeted capabilities and systemic resilience in risk governance.

Objective Exploring the components of complex scenarios of healthcare surges triggered by major epidemics to provide a theorical basis for building resilience in healthcare organizations.Methods A hybrid analysis method is used to summarize macro-meso-micro multi-level and multi-source heterogeneous information,extract the elements of complex scenarios of medical surge and evaluate the rationality.Fault Tree Analysis method is used to clarify the logical relationship between various scenario elements and construct scenario reasoning paths.Results 10 scenario states,11 disaster-bearing,24 emergency management and 23 scenario results are summarized and extracted to form the key elements of complex surge scenarios.Among them,M4 expansion and coordinated scheduling of key positions,B2 conventional drug inventory emergency/insufficient core treatment drugs,B emergency medical material transportation breakage,S3 disease symptom spectrum shift to severe disease,R13 prevention and control awareness laxity,and M5 media information dissemination management are the key driving factors that promote a major turning point in the scenario.The most positive scenario result is the orderly operation of the medical service system,and the most negative scenario result is the paralysis of the medical service system.Conclusion Medical institutions need to improve emergency plans based on the complex evolution scenarios of medical surges and agile governance capabilities targeting key turning points,focus on dynamically expanding and scheduling personnel in key positions,strengthen material rotation and reserve mechanisms,maintain smooth emergency logistics channels,and improve efficient management of media and public opinion,so as to comprehensively improve overall resilience.

Objective To explore the coupling mechanism between medical surge response resources and the spread of secondary risks during public health emergencies,as well as the effectiveness of relevant interventions.Methods Based on complex network theory,a dual-layer network model of medical resources and secondary events was constructed.The interactive feedback between medical resource status and secondary event risk,as well as the effects of network structure,were analyzed through MATLAB simulations,REPAST agent-based modeling,and mean-field analysis.Results Simulation and prediction results show that an increase in first-layer resource-deficient nodes significantly raises the activation rate and transmission speed of secondary events,while the clustering and spread of secondary events in the second layer,in turn,intensify resource depletion,creating a negative feedback loop.Mean-field analysis indicates a nonlinear positive correlation between the adequacy of medical resources and the likelihood of secondary events.Network structure analysis reveals that when the average node degree exceeds 8,resource allocation efficiency improves markedly.Conclusion There exists a dynamic coupling and bidirectional feedback relationship between medical resource status and secondary event risks.Enhancing the flexible allocation and responsiveness of medical resources,improving multi-sectoral collaborative monitoring and coordinated regulation,optimizing network connectivity and coordination mechanisms for resource distribution,and establishing dynamic monitoring and tiered early warning systems are key strategies for strengthening the resilience of healthcare systems and effectively containing the spread of secondary events.

Objective To define the conceptual connotation of network dynamic collaboration capacity in medical surge response and construct its theoretical model.Methods A mixed concept analysis method was employed,integrating multidisciplinary literature and collecting empirical evidence through semi-structured expert interviews to extract the concept of network dynamic collaboration capacity in medical surge response.By integrating complex systems,network science,synergetics,and dynamic capability theory,and combining the interview results,the study used the analogy of flood control in hydraulic engineering to develop a"network-dynamic-collaboration"triangular capacity theoretical model.Results It reveals one antecedents(sudden external shocks have led to an abnormal and continuous surge in medical demand),six core attributes(information interconnection accessibility,dynamic resource adaptability,risk perception responsiveness,multi-party collaborative interactivity,service process adaptability elasticity,and learning iterative evolution),and four consequences(mitigation of crowding risk,protection of service continuity,minimization of crisis spillover,and enhancement of system resilience)for the network dynamic collaboration capacity in medical surge response.The theoretical model elucidates the coupling mechanisms among network structural resilience,dynamic regulation processes,and collaborative co-evolution in resisting medical surge.Conclusion The new concept and theoretical model proposed in this study deepen the understanding of medical surge response system mechanisms and offer a theoretical framework and practical guidance for strengthening the full-chain resilience of health emergency systems.

Objective To empirically analyze multiple pathways for enhancing medical surge response capacity and provide useful references for improving the resilience of health systems.Methods A comprehensive theoretical analysis framework for improving medical surge response capacity was constructed based on the 4S theory and collaborative governance theory.68 interview texts on medical surge response capacity conducted in July 2024 were selected as analysis samples.Using fuzzy-set Qualitative Comparative Analysis(fsQCA),7 conditional variables were selected from four dimensions:management system,information system,materials,and personnel to analyze their impact on medical surge response capacity.Results(1)A single conditional variable does not constitute a necessary condition for improving medical surge response capacity;(2)After the combination of conditions,8 specific configuration paths for capacity improvement were identified.Through systematic and comprehensive refinement,they were summarized into three modes of comprehensive configuration capacity improvement paths,namely:rapid response and collaborative operation mode,information empowerment and precise response mode,and resource conditions and resilience construction mode.Conclusion It is necessary to explore and construct systematic,combined,modularized and path-oriented capacity building strategies,refine the operational implementation paths for improving China's medical surge response capacity,target the linkage and configuration modes of different conditional variables,promote the formulation and implementation of modular construction schemes oriented by key capacity,and make efforts from multiple aspects to enhance the resilience of the health system.

Objective:Based on value orientation,it aimed to scientifically define the concept and connotation of accessibility to novel anticancer drugs,in order to deeply understand the nature and current status of the accessibility issues of novel anticancer drugs,and to provide a reference for the formulation and optimization of policies related to novel anticancer drugs.Methods:Data was collected through literature review and expert interviews,and the concept of drug accessibility was defined using the atomic diagram method.Results:The core images include"affordability","availability","high quality"and"patients".The concept of accessibility to novel anticancer drugs is defined as"the process of ensuring the sustainable supply,equitable access,affordability,and rational use of high-quality anticancer drugs to safeguard the realization of patient benefit goals."The connotation of the value orientation in policies on the accessibility of novel anticancer drugs is profoundly reflected in the multi-dimensional value-driven approach to ensure the ultimate benefit of patients,which includes quality,sustainability,equity,affordability,and rational use.Conclusion:The proposal of the concept and connotation of accessibility provides a theoretical basis for a deep understanding of the accessibility of novel anticancer drugs and offers valuable references for subsequent policy-making and practical operations.

Objective:To define the concept of public value on digital supervision of medical insurance funds and to interpret its basic characteristics.Methods:Based on defining the concept of"public value"using the atomic atlas method,the formal logic definition method is used to define the"public value on digital supervision of medical insurance funds".Results:Among 47 concepts related to"public value",public,citizen,collective,and preference are the core elements;negotiation,utility,and expectation are the quasi-core elements;government,outcome,and common are the important elements;and integration,construction,and appeal are the non-important elements.The"public value on digital supervision of medical insurance fund"can be defined as"in the practice of digital supervision of the health insurance fund,citizens' value demands and expectations,and the degree of satisfaction of these demands and expectations,based on their knowledge and basic value judgments of the health insurance system and digital technology,and formed through a wide range of value-constructing mechanisms,such as social communication and political consultation."Conclusion:The public value on digital supervision of medical insurance funds has the characteristics of people-centeredness,the construction of multi-subject negotiation,and the integration of multiple value dimensions.These features together constitute the rich connotation of the public value of digital supervision of medical insurance funds,which provides a certain reference for promoting the modernization and governance of healthcare insurance and the construction of digital government.

Objective To define the conceptual connotation and characteristics of medical surges,and to construct a theoretical analysis framework for responding to medical surges based on complex networks.Methods By systematically reviewing relevant domestic and international research and practices,and from the perspective of complex networks and interdisciplinary integration,it analyzed the concept connotation,characteristics and comprehensive analytical framework of medical surges.Results The concept and connotation of medical surges were defined,and six major characteristics were summarized:sudden and surging congestion,overload spillover,stage recurrence,complex network and multi-dimensional collaboration,dynamic nonlinear multi-path evolution,and cascading amplification.A theoretical analysis framework was developed,encompassing four dimensions("risk and vulnerability coupling-complex surge scenario characterization-complex risk network chain drive-network dynamic collaboration capacity assessment and construction"),multiple hierarchical levels("macro-level healthcare system-meso-level hospital department functional systems-micro-level resource elements system"),and multiple scales("Wuli-Shili-Renli").Conclusion The proposed conceptual connotation,characteristics,and multi-dimensional,multi-level,and multi-scale theoretical analysis framework provide new perspectives and theoretical support for advancing the theoretical system of medical surges,guiding healthcare institutions to respond scientifically to surge impacts,and enhancing system resilience and network dynamic collaboration capacity.