A Comparative Study on the Transformation Pathways of Public Health Systems in China, the United States, and South Korea from an International Perspective

Abstract

Objective

This study aims to systematically analyze the pathway differences in the transformation of public health systems from crisis response-oriented to health governance-oriented models in China, the United States, and South Korea through an international comparative perspective. It focuses on revealing the impact mechanism of institutional adaptability on public health governance effectiveness, providing theoretical references and practical insights for the global transformation of public health systems.

Subjects and Methods

(1) Institutional Design: China’s restructuring of the "central-local" governance framework, the U.S.’s community health governance innovation under federalism, and South Korea’s revision of the National Health Insurance Act; (2) Practical Pathways: China’s integration of the Patriotic Health Campaign with grassroots service upgrades, the U.S.’s risk prediction models developed through collaboration between the Centers for Disease Control and Prevention (CDC) and commercial insurers, and South Korea’s digital upgrading of the "Epidemic Control Tower"; (3) Common Logic: Extraction of institutional adaptability characteristics in the transformations of all three countries through policy text analysis and governance effectiveness evaluation.

Results

(1) China integrates vertical management with regularized health promotion to upgrade grassroots public health capabilities, transitioning from "passive epidemic response" to "proactive health management"; (2) the U.S. optimizes resource allocation through market-driven mechanisms and community governance innovation, leveraging social capital to bridge healthcare gaps; (3) South Korea establishes a legislation-driven "digital-prevention" ecosystem, integrating epidemic data with chronic disease management to achieve lifelong health coverage.

Conclusions

Institutional adaptability—enhancing administrative efficiency, activating market mechanisms, and breakthroughs in technological innovation—has effectively resolved challenges in public health systems.