The ongoing impact of policy documents on the pandemic based on the framework of the “4Rs” theory and policy tools: in China

Chinese local governments primarily applied authority tools to drive institutional improvements, complemented by incentive tools and capacity-building tools to enhance policy effectiveness and public engagement. Optimizing PHE management requires dynamic adjustments to policy tools based on crisis stage characteristics, balancing rigidity with flexibility and immediate responses with long-term system development. The findings may provide valuable references for governments worldwide in formulating follow-up PHE policies and offer a replicable framework for future analyses in this field.