Background Systematic and quantitative evaluation of China's hospice and palliative care (HPC) policy corpus remains limited. This study addresses this gap through an integrated three-dimensional analytical framework examining policy themes, instruments, and design effectiveness.Methods A corpus of 85 national and provincial HPC policy documents (2016–2025) was analyzed using a Theme–Instrument–Effectiveness (TIE) framework integrating: (1) Latent Dirichlet Allocation (LDA) topic modeling optimized by coherence score and perplexity; (2) NVivo-assisted content coding with inter-rater reliability assessed via Cohen's Kappa; and (3) a Policy Modeling Consistency (PMC) Index Model applied to 24 representative policies across nine dimensions using binary coding and weighted aggregation.Results Eight latent topics were identified spanning health governance, elderly care services, technology application, and community nursing care, reflecting the mainstreaming of HPC within national aging agendas; equity-oriented themes addressing rural services and vulnerable populations were absent as standalone topics. Content coding of 4,510 text segments revealed a supply-dominant instrument structure (supply-side: 51.4%; demand-side: 31.7%; environment-side: 16.9%), with legal protection (2.3%) and public awareness (0.5%) the least utilized. PMC evaluation yielded a mean score of 6.15 (Excellent); Policy Instruments (X4 = 0.93) and Policy Objectives (X5 = 0.76) performed strongest, while Policy Timeliness (X2 = 0.33), Incentive Constraints (X9 = 0.58), and Policy Perspective (X3 = 0.60) exhibited systematic weaknesses.Conclusions China's HPC policy system has established a broad institutional foundation yet exhibits persistent structural gaps in equity coverage, instrument balance, and incentive design. Future policies should strengthen legal safeguards, rebalance instruments toward demand- and environment-side mechanisms, expand coverage of underserved populations, and embed performance evaluation provisions to improve implementation effectiveness.