The Current Situation and Existing Problems of the Impact of China's Digital Economy on the Allocation of Medical and Health Resources—Based on PEST-SWOT Analysis Framework

: The healthcare sector is currently an important target for accelerating the release of digital economy momentum. In order to study the current situation and existing problems of China's digital economy on the efficiency of healthcare resource allocation, this article constructs a PEST-SWOT model and systematically analyzes the current situation and problems of China's digital economy on healthcare resource allocation based on four aspects: advantages, disadvantages, opportunities, and threats, Clarify the practical basis for the research conclusions and policy recommendations, which is conducive to promoting the Digital transformation and upgrading of medical and health resource allocation, so that the people can obtain better and more convenient medical and health services.


Introduction
Digital economy is a kind of economy based on digital technology [1] , which is a brand-new economic form that is obviously different from the previous agricultural economy and industrial economy [ 2] . At present, the development momentum of the digital economy is accelerating its release, and healthcare is an important target for the release of the momentum of the digital economy. On March 2, 2023, China Internet Network Information Center (CNNIC) released the 51st Statistical Report on the Development of Internet in China, pointing out that by December 2022, the number of Internet medical users in China had reached 363 million, an increase of 64.66 million over December 2021, accounting for 34.0% of the total Internet users [3] . The new era has proposed new policies for the development of the healthcare sector, namely new infrastructure. With the support of emerging technologies such as the Internet, cloud computing, and 5G communication, China's healthcare sector will form a diverse and orderly healthcare smart service system in the future. This system will focus on the health of the people, meet the health needs of patients in various aspects such as preventive care, medical consultation, and health management, and use the advantages of the digital economy and digital technology to promote more efficient and convenient resource allocation in the healthcare sector. At present, the impact of China's digital economy on the allocation of healthcare resources is reflected in various aspects such as policies, technology, society, and economy. Specifically, in March 2022, the NHC and the State Administration of Traditional Chinese Medicine jointly issued the Detailed Rules and Regulations on the Internet Administration of Diagnosis and Treatment (Trial), which officially came into effect [4] . The regulatory rules take promoting the healthy development of Internet diagnosis and treatment as the overall goal, emphasizing the need to rely on physical medical institutions, integrate online and offline management, and prohibit the use of artificial intelligence and other automatic prescription generation, so as to ensure the service quality and safety of the whole process of Internet diagnosis and treatment. In view of the Internet medical safety problems, its safety attribute is strengthened to provide institutional guarantee for the quality and safety of medical and health services. In addition, the digital economy has expanded the online service coverage of internet healthcare, and digital healthcare and internet hospitals are important ways to further optimize resource allocation in the healthcare field through digital technology. With the development of the digital economy and its integration with the healthcare field, the digital economy will inevitably penetrate more comprehensively into the healthcare field, affecting various aspects such as the supply of healthcare services and the allocation of healthcare resources.
In order to comprehensively analyze and systematically grasp the current situation and existing problems of the impact of China's digital economy on the allocation of medical and health resources, this study constructs a PEST-SWOT model, and systematically analyzes the current situation and problems of the impact of China's digital economy on the allocation of medical and health resources based on four aspects: advantages, disadvantages, opportunities, and threats, in order to clarify the practical basis for proposing research conclusions and policy recommendations.

PEST-SWOT model construction
The SWOT analysis method, also known as the TOWS matrix method, was first proposed by Professor Kenneth R Andrews in his book "Corporate Strategic Management" in 1971 [ 5 ] . The SWOT analysis method, as a theoretical framework for enterprises to formulate and carry out development and management strategies, conducts specific analysis of enterprise development from four aspects: advantages, disadvantages, opportunities, and threats. With the widespread application of SWOT method in various fields of academia, this theoretical framework has been recognized by scholars. At present, the SWOT analysis method has been introduced into the field of healthcare and has played an important role in the management of healthcare. Jianding Ding (2017) [6] and Bo Wu (2016) [7] and other scholars have carried out research on related issues in the medical and health field in China based on the SWOT analysis framework. PEST analysis refers to the analysis of the macro environment, usually used when analyzing the environmental conditions of a company. P (politics) represents political and legal environment analysis, E (economy) represents economic environment analysis, S (society) represents social environment analysis, and T (technology) represents technical environment analysis. The PEST embedded SWOT analysis model is beneficial for subdividing the external factors of opportunities and threats in SWOT analysis methods through the PEST analysis framework. Xiaosen Li et al. (2017) [8] , Yuchen Li et al. (2019) [9] have set up the PEST-SWOT analysis framework for research.
This study combines SWOT analysis and PEST analysis to establish a PEST-SWOT analysis model, and based on this model, analyzes the current situation and existing problems of the impact of China's digital economy on the allocation of medical and health resources. The specific analysis framework is shown in Table 1. Internal S It is beneficial for reducing medical and health costs and improving the efficiency of medical and health resource allocation. It is conducive to optimizing the patient's medical treatment process and improving the level of medical and health services. It is conducive to promoting graded diagnosis and treatment, and improving the efficiency of high-quality resources sinking into the grassroots level. It is conducive to optimizing the entire lifecycle health management and promoting the development of digital healthcare.
W Data dispersion, information silo, no cross regional information sharing and interaction mechanism.

Advantage Analysis
The advantages of China's digital economy in promoting the allocation of healthcare resources lie in the following four aspects: Firstly, it is beneficial for reducing healthcare costs and improving the efficiency of healthcare resource allocation. The digital economy can promote the effective allocation and management of healthcare resources by improving information and data sharing capabilities, thereby improving overall efficiency. In terms of information sharing, the development of the digital economy effectively promotes the popularization of information technology and information sharing, making the allocation and management of medical and health resources more scientific and precise. Through digital information sharing, medical and health resources can be more efficiently allocated, thereby providing more accurate services to patients. For example, the establishment of medical and health information sharing platforms in various regions is conducive to achieving efficient circulation and sharing of medical and health resources. In terms of telemedicine, the development of the digital economy has promoted the application of telemedicine technology. Through network technology, remote transmission of medical and health resources can be achieved, enabling remote communication between doctors and patients, making the utilization of medical and health resources more flexible. In terms of internet healthcare, the development of the digital economy has given birth to the internet healthcare industry, which enables online communication and sharing of healthcare resources through internet technology, providing patients with more convenient and efficient healthcare services.
Secondly, it is conducive to optimizing the patient's medical treatment process and improving the level of medical and health services. Medical and health institutions empower multiple medical service links such as appointment, treatment, transportation, charging, follow-up, and emergency treatment through the use of artificial intelligence, big data, blockchain, and other technologies, covering the entire process of patient medical treatment before, during, and after diagnosis. Through digital technology, the entire process of patient medical treatment is optimized to enhance patients' sense of access and experience. For example, digital hospitals, online appointments launched by hospitals, APP for consultation, applets and official account, etc., save a lot of time for patients to queue for registration and waiting, and enhance the convenience of patients to see doctors.
Thirdly, it is conducive to promoting graded diagnosis and treatment, and improving the efficiency of high-quality resources sinking into the grassroots. Yali Liang, vice president of marketing group of Intel Corporation, said: "At present, China's high-quality medical and health resources are distributed in an" inverted triangle "shape, but the people's medical and health needs are widely scattered at the grass-roots level, and the overall distribution is in a" positive triangle "shape, and supply and demand cannot match. To match these two triangles, technology needs to play a crucial role Relying on innovative technologies such as big data, 5G, and AI, remote healthcare can not only break the limitations of healthcare space and provide high-quality healthcare services to grassroots patients, but also promote the rational allocation of healthcare resources and improve the diagnosis and treatment level of grassroots healthcare institutions. For example, the "Remote Intelligent Ultrasound System" jointly established by Intel and Guizhou is based on the Intel vPro platform, and with the assistance of 5G network and AI technology, it achieves synchronous real-time transmission of ultrasound images, video and voice, allowing people to enjoy high-quality medical and health services at their doorstep. The accelerated integration of digital technology and the healthcare sector has not only accelerated the sinking of high-quality healthcare resources to the grassroots level, allowing patients to enjoy high-quality healthcare resources from zero distance, but also a powerful attempt to promote the implementation of hierarchical diagnosis and treatment models through digital technology.
Fourthly, it is conducive to optimizing the entire lifecycle health management and promoting the development of digital healthcare. In the context of the digital economy, intelligent full lifecycle health management, as a more high-quality health management model, is committed to providing high-quality health management services for the public. Taking the "Smart Whole Life Cycle" health management project in the Sheshan District of Zhongshan Hospital in Shanghai as an example, the project specifically includes smart healthcare, full process health management, customized personal health records, precise and accurate appointment and referral, and is committed to creating a smart health management service system that covers the entire life cycle of prevention, screening, disease prediction, diagnosis, treatment, and rehabilitation for the entire population. As an efficient way to achieve full lifecycle health management, digital means are increasingly being widely used in public hospitals and other healthcare institutions, and continue to promote the development of digital healthcare in China.

Disadvantages Analysis
Due to the large population base in China, there is a huge amount of patient data and a lack of correlation, resulting in a high degree of dispersion in medical and health data, which is not conducive to the in-depth mining, research, and utilization of medical and health data. In addition, the data information between medical and health institutions in China is lack of interconnection mechanism, and cannot be shared. For example, basic data such as patient disease information, image inspection reports, patient diagnosis and treatment records, and drug use cannot be exchanged among provinces, cities, and even medical and health institutions, which leads to patient information data showing a "information silo", and it is difficult to form a joint force of interconnection. This not only causes various problems for patients, such as high medical costs, repetitive medical procedures, and low medical efficiency. For medical and health institutions, problems such as repeated examinations, difficulty in accessing patient history, and difficulty in understanding patient medical history are not conducive to doctors' work, and the workload of practicing physicians in large public hospitals is heavy. In terms of cross regional information sharing and interaction mechanisms, although the central government has begun to promote the exploration and promotion of cross departmental, cross industry, and cross level open sharing of healthcare big data in various regions, the exploration of cross regional aspects in various regions is still in the initial stage, lacking government leadership and institutional support, making it difficult to achieve cross regional healthcare information sharing and interaction. Currently, Chongqing has achieved cross regional The sharing of health records and electronic medical record data across medical and health institutions, but there is still a lack of specific institutional mechanisms and implementation rules to support the sharing of medical and health information across provinces and regions, making it difficult to start a larger scale of medical and health information interconnection and sharing in China. To sum up, data dispersion, information silo and lack of cross regional information sharing and interaction mechanism are the key problems that restrict the optimization of medical and health resource allocation in China's digital economy.

Analysis of Political and Legal Environment
The introduction of relevant policies is conducive to providing a favorable external policy environment for the digital economy to assist in the allocation of medical and health resources. In recent years, the central government has issued multiple policies to support, encourage, and regulate the digital healthcare industry in order to promote its development. In April 2021, the National Medical Insurance Administration issued the "Guiding Opinions on Strengthening Network Security and Data Protection Work", which proposed to ensure a clear process and sound mechanism for sharing and using medical and health data, and promote the digitalization and intelligence level of medical security. In July 2021, the Ministry of Industry and Information Technology issued the "Sailing Action Plan for 5G Applications (2021-2023)", which pointed out the creation of a batch of 5G+smart medical model projects and the creation of over 100 5G application benchmarks as one of the key industries. In December 2020, the National Development and Reform Commission mentioned in the "Catalogue of Industries Encouraging Foreign Investment (2020 Edition)" the encouragement of the development and application of digital medical systems, community care, and personal health maintenance related products. In addition, the national "14th Five Year Plan" also requires the construction of 5G based application scenarios and industrial ecology, and pilot demonstrations in key areas such as smart healthcare. The relevant policies introduced by the central government have increased policy support in top-level design for China's digital economy to support the development of the medical and health sector.
In response to the national call, various provinces and cities have also issued a series of policies to promote the development of digital healthcare. For example, in August 2021, Jiangsu Province issued the "14th Five Year Plan for the Development of Jiangbei New Area in Nanjing", which pointed out the need to vigorously develop new formats such as digital healthcare. In November 2021, the General Office of Tianjin Municipal People's Government pointed out in its implementation opinion on promoting the development of "Internet+medical health" that it should comply with the innovative development trend of Industrial Internet, improve the digital and intelligent manufacturing level of medical and health equipment, and promote industrial upgrading. In March 2022, several opinions on promoting the high-quality development of medical and health services in the new area near the port of China (Shanghai) Pilot Free Trade Zone pointed out that we should focus on supporting the research and development of regenerative medicine, precision medicine, biotherapy, digital medicine, biomaterials, etc. Support the construction of health consortia in the Lingang New Area and the improvement of public health emergency response capabilities by medical institutions.
The central government and some provinces and cities in China have issued relevant policies for the development of digital healthcare, which plays an important policy support role in enhancing the digital economy and optimizing the allocation of healthcare resources in China.

Economic Environment Analysis
The overall level of health funding in China has increased, with residents' income increasing and their investment in healthcare increasing. At present, China's economy is developing steadily and rapidly, and the overall operating situation is good. According to relevant data from the National Bureau of Statistics, from 2011 to 2020, China's per capita GDP has increased from 36277 yuan to 71828 yuan, indicating a rapid development trend in the past decade. Among them, residents' expenditure on healthcare is also gradually increasing, and the national per capita subsidy standards for residents' medical insurance and basic public health services are also continuously increasing, with an increase of 30 yuan and 5 yuan respectively in 2022. Both government health funding and residents' expenditure on healthcare are on the rise, and the economic environment is conducive to promoting the development of digital healthcare. In addition, the scale of information technology investment in China's healthcare sector has also shown a rapid growth trend [10] . The government's increase in total health expenses and investment in health informatization is conducive to promoting the upgrading of digital medical infrastructure in China's medical and health institutions, and providing software and hardware support for improving the efficiency of medical and health services.

Social Environment Analysis
Social environment analysis mainly includes the following two aspects: Firstly, the population has increased and the population structure has changed. The population is the service target of medical and health resources, and the continuous growth of the population and the demographic changes brought about by the comprehensive two child policy have further released the demand for medical and health resources. In addition, the decline in China's birth rate and mortality rate has led to an accelerated process of population aging. Related studies have shown that the per capita health expenditure of the elderly population aged 65 and above is 2.4 to 4.8 times that of the population below [11] . Therefore, as China's population aging process accelerates, there will be higher requirements for the allocation of medical and health resources. Compared to other population groups, the elderly population has higher demands and demands for long-term care and health management. The functional characteristics of large medical and health institutions such as public hospitals determine that they cannot meet the needs of these groups, which also indicates the need to accelerate the development of grassroots medical and health centers, elderly care and rehabilitation centers, and other related medical and health institutions. In this social environment, the intervention of digital medical and health resources is conducive to efficiently promoting online collaborative medical and health services provided by hospitals and community clinics, meeting the efficient and high-quality medical and health needs of patients.
Secondly, the population's awareness of health has increased. According to relevant data, over 75% of Chinese residents aged ≥ 60 suffer from ≥ 1 chronic disease, which has become a serious public health problem that poses a threat to public health [12] . The health awareness of residents is gradually increasing, and the demand for medical and health services is increasing. Residents are no longer satisfied with basic disease treatment, and the demand for disease prevention and health care continues to grow. The integration of digital economy and healthcare can meet the needs of residents. For example, hospitals can regularly publicize health knowledge and promote regular physical examination to residents through official account, APP and other Internet channels; Due to the continuous expansion of wearable device market share, the use of digital technology to achieve real-time monitoring of patient health index facilitates patients to understand their own conditions in real time. The idea of seeking medical attention in a timely manner when physical conditions arise will also become possible with the development and improvement of the digital economy, digital technology, and digital infrastructure.

Technical Environment Analysis
Technical environment analysis mainly includes the following two aspects: Firstly, the internet penetration rate has been increasing year by year. The rapid development of internet technology in China has had a huge impact on residents' lives. According to the latest 51st "Statistical Report on the Development of China's Internet Network" released by the China Internet Information Center (CNNIC), as of December 2022, the number of internet users in China reached 1.067 billion, an increase of 35.49 million compared to December 2021, and the internet penetration rate reached 75.6% [13] . The report shows that the standardization level of internet healthcare in China continues to improve, becoming the application with the fastest growth in user scale in 2022. As of December, the number of internet medical users in China reached 363 million, an increase of 64.66 million compared to December 2021, accounting for 34.0% of the total number of netizens. From this, it can be seen that China's digital economy has brought opportunities for the development of the healthcare sector and the efficient allocation of healthcare resources.
Second, medical institutions "Internet plus" have been established and promoted. With the continuous upgrading of the information system of medical and health institutions in China and the rise of the medical online service industry, medical and health services have begun to shift from PC end to intelligent mobile end. What follows is the expansion of the "Internet plus+medical health" development model. The combination of the Internet and various subjects in the medical and health field reflects the continuous establishment and promotion of the "Internet plus" medical and health institutions, which provides a high-quality technical environment for China's digital economy in optimizing the allocation of medical and health resources. For example, the establishment of a smart hospital is conducive to multidimensional construction of patient data based on diagnosis and treatment cases and continuous monitoring, and data mining through intelligent algorithms, ultimately forming efficient and high-quality diagnosis and treatment empirical evidence, providing data support for innovation in diagnosis and treatment methodology, and ultimately guiding practical development.

Analysis of Political and Legal Environment
At present, there is a lack of specific implementation rules for optimizing the allocation of medical and health resources in China's digital economy. Although the central government has provided policy support for the development of digital healthcare in terms of top-level design, the lack of specific implementation rules remains the bottleneck in integrating China's digital economy into the healthcare field. First, the unification of data interconnection standards in the medical and health field is lagging behind, and the government lacks a unified standard for medical and health data interconnection, which is not conducive to cross institutional and cross regional patient diagnosis and treatment data information sharing, and is prone to the "information silo" problem. Second, although China's Digital transformation policy in the medical and health field is constantly developing and improving, medical data outflows, personal privacy leaks and other related issues are still common. The reason is that there is a lack of unified construction standards, the supervision of relevant government departments is insufficient, and poor supervision will lead to low medical efficiency, which is not conducive to the overall optimal allocation of digital resources in the medical and health field.

Economic Environment Analysis
At present, the competition in China's healthcare market is fierce. According to the latest analysis report on market competition in China's digital healthcare industry released in 2023, it can be seen that the internal competition in China's digital healthcare industry is currently fierce, due to slow industry growth, leading to fierce competition among competitors for market share; A large number of competitors with comparable competitive strength; The products and services provided by competitors are showing a serious homogenization trend. It can be seen that the competition within the industry is still at the low-end stage, and continuous evolution will only lead to adverse consequences such as vicious competition, waste of products and services, which is not conducive to the optimal allocation of medical and health resources. In addition, the continuous entry of potential competitors and alternative products into the digital healthcare industry will also lead to the accumulation of digital healthcare resources, ultimately resulting in redundancy. This low-end competition will lead to cost reduction, resource waste, and a decrease in industry profits. Ultimately, the development of digital healthcare will be severely limited by the competition in the low-end market, which is not conducive to the development of the healthcare industry and the optimal allocation of healthcare resources.

Social Environment Analysis
At present, the public still has conceptual barriers and difficult to change their medical habits. The application of digital economy technology, products, and services in the field of healthcare is still emerging for the public. The rise and development of emerging things will inevitably be constrained by traditional concepts. The group with traditional concepts is not limited to patients, but the acceptance of digital healthcare by traditional physical hospital management departments led by public hospitals, as well as the participation of physicians in digital healthcare during the diagnosis and treatment process, all constrain the integration of the digital economy and the field of healthcare, which is not conducive to accelerating the development of healthcare resources with the help of digital technology. From the perspective of patients, the implementation forms of the digital economy in the field of healthcare, such as smart hospitals, cloud hospitals, internet hospitals, remote healthcare, and online consultation, are all emerging things. Questions such as whether these new forms can meet their own medical needs and how effective they are are are all the reasons why patients have low acceptance of digital healthcare. This will also lead to the blocking of the Digital transformation process in the medical and health field. In addition, entity public hospitals and top three hospitals are still the first choice for most patients to seek medical treatment. Although the national policy calls for hierarchical diagnosis and treatment and primary care, the change of public medical habits cannot be achieved overnight. Digital transformation in the medical and health field still has a long way to go, and there is still serious conceptual resistance to the digital economy to help optimize the allocation of medical and health resources.

Social Environment Analysis
At present, the number of digital infrastructure in China is insufficient and unevenly distributed. The overall distribution of digital infrastructure in the eastern, central, and western regions shows a trend of eastern, central, and western regions, with significant regional differences. Due to the lack of digital infrastructure and incomplete construction of internet hardware facilities in some provinces and cities (districts) in the central and western regions, the digitalization process in the medical and health field in the central and western regions of China lags far behind that in the eastern regions. The more remote the areas are, the more areas are often lacking in high-quality medical and health resources. However, due to the common lack of digital infrastructure and highquality medical and health resources. This has led to a serious shortage of supply for remote and online medical services in the central and western regions of China, which contradicts the demand for remote and online consultations among patients in the central and western regions. This contradiction is difficult to reconcile within the medical and health field, and requires comprehensive support from government policies, funds, and other means to gradually alleviate this technological and environmental threat problem.

Conclusions
At present, opportunities and crises coexist in the Digital transformation of China's medical and health field. In terms of policy, although the country has given policy support to digital medicine and "Internet plus health care" in the top-level design dimension, the lack of specific implementation rules, lack of regulatory regulations, unclear management departments and other issues are still restricting the development of digital economy in the medical and health field from the policy and law aspects. In terms of economy and society, there is a contradiction between the huge population demand and the homogenization and low-quality supply of digital healthcare resources. At the technical level, there is a serious regional imbalance in the allocation of digital infrastructure resources in the medical and health field. The eastern region is far ahead, the remote areas in the central and western regions have serious problems such as the slow development of digital technology, the old and backward digital infrastructure and insufficient number, and the serious loss of digital talents. The development differences between regions have seriously restricted the rational and optimal allocation of medical and health resources in China's digital economy.
Based on this, in terms of policies, the government should establish a sound system of policies and regulations. In order to enhance the promoting role of the digital economy in the development of healthcare, the government should introduce specific implementation rules, clearly define relevant management departments, promote the unification of powers and responsibilities, and issue regulatory regulations to promote the standardized development of China's healthcare sector in the context of the digital economy. At the technical level, the fundamental and leading role of digital infrastructure in promoting the construction of rural medical and health systems should be fully utilized. Make up for the shortcomings of rural information infrastructure, promote the digital and intelligent transformation of rural traditional medical and health infrastructure, and accelerate the transformation and upgrading of rural digital medical infrastructure. In terms of economy and society, we will promote the expansion and sinking of high-quality medical and health resources, as well as balanced regional layout. The government should fully leverage the advantages of the digital economy in technology, equipment, and other aspects, build a high-quality and efficient medical and health service system with Chinese characteristics, continuously enhance the people's sense of happiness and security in medical consultation, healthcare, and health management, break the "last mile" for more urban and rural residents, and for residents in remote areas, so that the people can obtain better quality More convenient medical and health services.