Abstract: Based on the development goals of the 14th Five Year Plan, a high-quality development model for the basic medical security is constructed. Taking 31 provinces as cases and combining a qualitative comparative analysis (QCA), this paper explores the path to achieve high-quality development of basic medical security. Finally, two implementation paths are obtained, namely the 5-dimensional linkage type and the 4-dimensional linkage type. The findings show that the high-quality development of basic medical security is influenced by the synergistic effects of multiple dimensions and variables. Moderate security, strengthened legislation, online services, and collaborative security are necessary conditions for promoting high-quality development. At present, there are relatively fewer provinces that have reached a high-quality development level, and there is a lack of policy settings and practices related to security dimensions. It is recommended to refer to the two linkage paths and draw on the successful experiences of the provinces with high-quality development, formulate flexible policy combinations according to local conditions, take moderate security, strengthened legislation, network services, and ensured coordination as the top priority, improve security dimensions, and attach importance to fund security and data security.

Key words: basic medical security, high-quality development, qualitative comparative analysis, perspective of configuration