Evolution of China’s industry–university–research–hospital collaboration in AI medical devices and implications for medical institutions and public health governance

Against the backdrop of China's rapid expansion of artificial intelligence (AI), and intelligent healthcare policies, the integration of AI into medical devices is reshaping healthcare delivery and innovation systems. Based on patent data on industry-university-research cooperation in the China AI medical device industry from 2019 to 2025, this study adopts social network analysis and geographical detector methods to systematically examine the spatiotemporal evolution and influencing factors of the innovation network across three dimensions. The findings reveal that at the microagent level, the early dominant pattern of enterprises has been gradually reconstructed by the participation of universities, research institutes, and medical institutions, with medical institutions rising from marginal participants to core intermediaries. At the provincial level, the network exhibits prominent unbalanced agglomeration characteristics. Beijing's status as a national hub has been continuously strengthened, and a multipolar spatial pattern has taken initial shape. At the level of the cooperation type, intraprovincial cooperation is dominated by industry-industry collaboration, while interprovincial cooperation has formed a cross-regional synergy framework with Beijing as the core, radiating to the Yangtze River Delta and the Pearl River Delta. The value added of the financial industry, the volume of import and export trade, and the transaction volume of the technology market are revealed as the core factors explaining the network status of provinces, whereas the explanatory power of the proportion of education expenditure remains weak. This study contributes to a deeper understanding of China's AI medical device industry and offers practical insights regarding public health governance.