目的 系统探讨中国新医改背景下三明医改模式的可持续发展路径，为全国推广提供理论参考与实践指引。方法 运用SWOT分析法，结合政策文献梳理与典型案例调研，分析三明医改的内在优势与劣势、外部机遇与威胁。结果 三明医改经历了“治混乱、堵浪费”“建章程、立制度”“治未病、大健康”3个阶段，形成了以“三医联动”为核心、以薪酬制度改革为抓手的系统改革路径。SWOT分析显示，其优势在于系统集成治理架构、颠覆性激励机制和显著改革成效，劣势在于高度依赖政府推动、薪酬体系复制性争议和技术创新激励不足，外部机遇在于国家政策加持、数字技术赋能和健康中国战略深化，面临的威胁为推广变形走样、改革动力衰减和既得利益阻力。结论三明医改可持续发展的关键在于“学习精神实质，而非照搬数字”，建议应用“通用原则+差异化路径”框架在不同规模城市进行推广。

Objective To systematically explore the sustainable development path of the Sanming healthcare reform model within the context of China's new healthcare reform,providing theoretical reference and practical guidance for its nationwide implementation. Methods A SWOT analysis was employed,combined with a review of policy documents and case studies,to assess the internal strengths and weaknesses,as well as the external opportunities and threats,of the Sanming healthcare reform. Results The Sanming healthcare reform has progressed through three stages: “rectifying disorder and curbing waste”,“establishing rules and institutions”,and “preventive care and comprehensive health”. It has developed into a systematic reform pathway centered on the “tripartite coordination of healthcare,insurance,and pharmaceuticals”,with compensation system reform as a key driver. The SWOT analysis reveals that its strengths include an integrated governance structure,a transformative incentive mechanism,and notable reform outcomes. Weaknesses include heavy reliance on government promotion,controversies over the replicability of its compensation system,and insufficient incentives for technological innovation. External opportunities arise from national policy support,digital technology empowerment,and the advancement of the Healthy China strategy. Threats include the risk of reform distortion during scaling,diminished reform momentum,and resistance from vested interests. Conclusions The key to the sustainable development of the Sanming healthcare reform is “learning from its underlying principles rather than copying numerical targets．” A framework of“general principles plus context-specific pathways” is recommended for implementation in cities of different scales.