Under what conditions do cross-regional emergency coordinate for public health? A study on configuration effect based on fuzzy-set qualitative comparative analysis

Due to the contagiousness, mobility, and complexity of public health incidents, emergency management must cross geographical and policy boundaries, bringing huge challenges to global governance. Cross-regional emergency coordination is considered the key practice to deal with major public health incidents. In this paper, 31 provinces in China were selected as samples. The fuzzy-set qualitative comparative analysis (fsQCA) method was used to explore the configuration effect of the technical conditions, organizational conditions, and environmental conditions on the realization of cross-regional emergency coordination for public health. It is found that the interactive coupling of technical conditions, organizational conditions, and environmental conditions can effectively explain the realization of cross-regional emergency coordination for public health. The consistency of individual conditions necessity shows that there is no single necessary condition for cross-regional emergency coordination implementation in public health. The sufficient condition combination analysis shows that a high attention allocation combined with high coordination foundation can replace a low attention allocation combined with low coordination foundation under certain conditions. Additionally, a high attention allocation combined with a low-risk index can substitute a low attention allocation combined with a high-risk index under certain conditions. Cross-regional emergency coordination for public health has 3 kinds of implementation paths that can be generated and can be further summarized as "organizational" model, "environment" model, and "organization-environmental" model. Among them, "organization-environment" model is the main model to promote cross-regional emergency coordination realization for public health. This paper explores the realization paths of cross-regional emergency coordination for public health from a configuration perspective, and it promotes the joint response of various regions to public health challenges through the effective coupling of technical conditions, organizational conditions and environmental conditions. It will help to form a community with a shared future and facilitate global health safety and sustainable development.