The Impact of the “Healthy China 2030” planning outline strategy on the development of China’s medical and health resources—based on interrupted time series analysis from 1990 to 2023

To quantify the impact of the implementation of the “Healthy China 2030” Planning Outline on the scale expansion of medical and health resources in China, and to assess the dynamic changes of such resources before and after the policy intervention. Data for this study were obtained from the China Health Statistics Yearbook covering the period from 1990 to 2023. In October 2016, the Chinese government officially issued the Healthy China 2030 Planning Outline. A total of 13 indicators across 3 dimensions (human resources, physical resources, and financial resources) were selected for this study, specifically: number of hospitals, number of hospital beds, number of health personnel, number of health technicians, number of licensed (assistant) physicians, number of registered nurses, as well as the per 1,000 population counterparts of the above human resource indicators; additional financial indicators included total health expenditure, per capita health expenditure, and government health expenditure. Segmented regression analysis under the interrupted time series (ITS) analysis framework was applied to evaluate the changing trends of medical and health resources in China from 1990 to 2023, with a focus on the characteristics of scale changes in such resources before and after the implementation of the Outline. Autocorrelation of the outcome indicators was first assessed via residual plots, the reliability of the results was further verified using the Durbin-Watson test, and the Newey-West method was subsequently applied to correct the standard errors. To ensure the robustness of the study findings, sensitivity analyses were performed respectively by setting 2017 as the alternative intervention start point and excluding data from the COVID-19 pandemic period (2020–2023). Interrupted time series analysis showed that after the implementation of the “Healthy China 2030” Planning Outline, the scale of China’s medical and health resources continued to expand and showed a significant growth trend (all P < 0.05): the number of hospitals increased steadily from 1990 to 2023, with a growth coefficient of 0.082 (95% CI: 0.060–0.103) after the policy implementation; the number of hospital beds showed a significant upward trend (coefficient = 20.687, 95% CI: 16.001–25.373); the growth coefficients of human resource indicators all increased significantly, among which the growth coefficient of health personnel was 0.429 (95% CI: 0.363–0.495), health technical personnel was 0.429 (95% CI: 0.375–0.484), licensed (assistant) physicians was 0.181 (95% CI: 0.164–0.198), and registered nurses was 0.223 (95% CI: 0.195–0.251), while the growth coefficients of indicators related to per 1,000 population ranged from 0.133 to 0.309; When the financial resource indicators were analyzed in absolute terms, all indicators of financial resources showed a rapid increasing trend: total health expenditure increased by an average of 495.552 (95% CI: 450.222-540.882) billion yuan annually, per capita health expenditure increased by an average of 342.651 (95% CI: 310.002-375.301) yuan annually, and government health expenditure increased by an average of 116.142 (95% CI: 95.688-136.596) billion yuan annually. After log-transformation of the financial resource indicators, the results showed that the annual relative growth rate of total health expenditure decreased by 0.060 (95% CI: -0.072 to -0.047), the annual relative growth rate of per capita health expenditure decreased by 0.054 (95% CI: -0.065 to -0.043), and the annual relative growth rate of government health expenditure decreased by 0.090 (95% CI: -0.104 to -0.076) after the intervention. These findings indicate that although the absolute scale of health investment continued to expand, its relative growth rate slowed down, reflecting that China’s health investment has become more rational, efficient and sustainable, which is consistent with the policy goal of pursuing high-quality development and curbing unreasonable growth. Sensitivity analyses further verified the robustness of the main findings. The implementation of the Healthy China 2030 Planning Outline is positively associated with the significant growth in the total scale of medical and health resources and the level of per capita accessibility in China, with multiple indicators having reached the 2030 targets set out in the Outline ahead of schedule. This study, based on a quasi-experimental analysis of long-term national-level data, provides robust empirical evidence for the evaluation of the policy effects of national health strategies. Looking ahead, it is necessary to dynamically adjust the policy focus, maintain sustained attention to the fiscal sustainability of health investment and the long-term mechanism for health workforce training, so as to promote the high-quality development of medical and health resources.