目的: 医用耗材集采中集中带量采购与带量价格联动两种模式并存,其内在逻辑与协同机制缺乏系统研究。本文旨在揭示二者的“源—流”层级关系,为采购策略优化提供参考。方法: 选取2021—2025年广东省指导、深圳市牵头的6个集采案例,从九个维度系统比较两种模式。结果: 集中带量采购通过竞争形成突破性新基准价（定基准）;带量价格联动依托外省中选价实现区域协同（推基准）。二者呈“源—流”层级关系：集中带量采购是“以量换价”体系的“源”,带量价格联动是其成果的延伸放大。结论: 深圳“精准匹配+协同联动”机制,以外省集采为前置条件建立两级决策体系,从定基准到推基准,兼顾费用管理、执行效率与供应稳定,或可为其他地区提供参考。

Objective: In centralized procurement of medical consumables, two models coexist: centralized volume-based procurement and volume-based price linkage, yet their intrinsic logic and synergistic mechanisms lack systematic research. This paper aims to reveal the “source-flow” hierarchical relationship between the two models and to provide a reference for optimizing procurement strategies. Methods: Six procurement cases guided by Guangdong Province and led by Shenzhen City from 2021 to 2025 were selected, and the two models were systematically compared across nine dimensions. Results: Centralized volume-based procurement generates groundbreaking new benchmark prices through competition (setting the benchmark); volume-price linkage relies on selected prices from other provinces to achieve regional coordination (promoting the benchmark). The two models present a clear “source-flow” hierarchical relationship: centralized volume-based procurement is the “source” of the “volume-for-price” system, while volume-price linkage serves as the extension and amplification of this outcome. Conclusion: The “precision matching plus synergistic linkage” mechanism explored in Shenzhen establishes a two-level decision-making system using out-of-province centralized procurement as a pre-condition, moving from setting the benchmark to promoting the benchmark, while balancing cost control, implementation efficiency, and supply stability, which can provide a reference for other regions.