MH integrate surgical, X-ray, and laboratory equipment, enabling it to provide hospital-equivalent EM capabilities directly at on-site (15). This includes the management of event-related acute conditions such as shock resuscitation, cardiac arrest, debridement and suturing, and fracture immobilisation. MH’s modular diagnostic units, comprising X-ray, B-mode ultrasound, and laboratory testing systems, greatly reduce on-site diagnostic times. This forward-deployed capability allows for immediate management of injuries and illnesses at the event, thereby minimising unnecessary referrals and effectively alleviating pressure on EM departments.

International practices demonstrated that the medical model of MH is cost-effective. Examples include Hospital in the Nursing Home (HiNH) in Australia (6), HAH (Hospital at Home) in France (16), and Pathfinder in Ireland (17), which have consistently shown that integrating MH services into aged care facilities can substantially reduce EM visit and hospital admissions. For example, the HiNH programme savde a AU$8,659,788 per year by reducing EM utilisation, substantially exceeding its operational costs of AU$488,116, resulting in a net annual saving of AU$8,171,671 (18). The triage mechanisms and demand management strategies employed by these programmes are directly applicable to event medical support, reducing reliance on visits and hospitalizations of EM.

MH enhance urban resilience by supporting seamless cross-regional EM information transfer (15), ensuring patients receive continuous care regardless of their location within the event’s scope. Its characteristics of “peacetime-wartime combination” and dual function in both event support and disaster relief highlights its strategic value. During the events, they can be rapidly deployed to the venue, and in the event of a disaster, they can be immediately redirected to the affected area. This dual-use infrastructure model significantly reduces equipment idleness and optimises long-term operational and maintenance costs.

Despite differences in health characteristics between event participants and nursing home residents, the underlying principles of healthcare delivery—namely, the effectiveness of on-site treatment, the necessity of referral, and the continuity of care—are highly similar. The application of MH in sporting events is essentially a contextual extension of the “Hospital at Hand” concept (19). MH not only address the fluctuating demand for medical resources during events but also provide reusable infrastructure for EM systems. This innovative EM approach not only redefines the paradigm of medical support for large-scale events but also offers a robust solution for building resilient healthcare systems. Its strategic value extends beyond event medical care, becoming a crucial pillar for the modernisation of public health governance.

The Tour of Shanghai New City Cycling Race, held in September 2024, spanned approximately 300 kilometres across five administrative districts: Jiading, Qingpu, Songjiang, Fengxian, and Nanhui (20). During the event, the MH of Huashan Hospital deployed a command vehicle, outpatient vehicles, an X-ray vehicle, a surgical vehicle, a power supply vehicle, and an ambulance with monitoring capabilities. A professional medical team accompanied the whole race and were deployed at key points along the route to ensure the smooth progression of the competition. The event was challenged by typhoon weather, which led to slippery roads and a significant increase in accident risk. Under these conditions, the MH treated dozens of injured individuals, with only five requiring transfer to designated hospitals for further treatment (21).

The 2024 Shanghai Marathon, held on 1 December, attracted approximately 38,000 runners (22). At the finish line area, the MH of Huashan Hospital deployed a command vehicle, an X-ray vehicle, a surgical vehicle, and medical team. For common runner injuries such as muscle strains, abrasions, dehydration, and fractures, the MH provided on-site treatment to nearly a hundred patients, with only two requiring transfer to designated hospitals.

The practical application of MH in both the Tour of Shanghai New City Cycling Race and the Shanghai Marathon verified its advantages of rapid deployment and on-site first aid. Under the complex geographical environments and high-density event scenarios, MH established a EM support network, enabling precise allocation and efficient utilisation of EM resources. This demonstrates a replicable and scalable solution for large-scale event EM support.

Although MH is self-sufficient, the diversity of deployment scenarios—such as remote mountainous regions or dense urban centres—imposes stringent demands on logistical support. Prior to deployment, it is crucial to precisely identify flat, open sites and ensure a continuous supply of water and electricity. At the same time, robust plans for medical waste disposal and the transportation of heavy equipment must be established to suit varying environmental conditions. Furthermore, the entry and exit of large medical vehicles in traffic-dense areas can lead to congestion or safety hazards (15). This necessitates collaborative development of dynamic traffic management strategies with event organisers and traffic authorities to balance event security and public safety requirements.

The efficient operation of MH relies on versatile personnel and inter-agency collaboration. Operating staff must not only be proficient in medical techniques but also familiar with the specialised equipment inherent to mobile units, including portable imaging devices and emergency communication systems. Experience from the Chongqing MH indicates that insufficient operational training directly compromises rescue efficiency (15). Moreover, it is essential to establish standardised collaboration protocols with local hospitals, emergency services (police, fire), and event organisers. This is vital to prevent conflicts of responsibility between city-level emergencies (e.g., natural disasters) and event-specific medical plans, ensuring a clear chain of command. Future development should focus on integrating multidisciplinary teams, including sports medicine specialists, emergency physicians, nursing staff, and logistics engineers, to form a cohesive “medical-technical-management” response system. This integrated approach aims to optimise the entire chain, from casualty identification to resource allocation.

Technological advancements for MH must prioritise lightweight design, intelligent systems, and comprehensive integration. Future development should focus on more portable and rapidly deployable medical units, incorporating automated setup procedures (e.g., one-button tent deployment) to significantly reduce response times. Simultaneously, establishing real-time data collection and analysis systems is crucial for intelligent management of patient tracking, resource allocation, and risk early warning, thereby enhancing operational efficiency (5, 6). Epidemiological research specifically targeting sports-related injuries, such as cranial trauma in cycling races or heatstroke in marathons, can provide precise data to inform and refine future event medical support strategies. Furthermore, the evolution of MH should extend beyond individual medical units to encompass a holistic system design that integrates logistics, communication, and event management, ensuring seamless connectivity across all operational phases. By regularly participating in urban emergency drills and community medical services, MH can transition into routine medical resources. This approach addresses the challenge of traditional emergency assets being “heavy on acquisition but light on maintenance”, fostering sustainable “peacetime-wartime integration”.