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To ensure data security and realize sharing and access control, combining blockchain technology, attribute-based encryption and ciphertext policy (CP-ABE) and AES symmetric encryption algorithm, this paper proposes a hierarchical attribute-based encryption algorithm based on master-sidechain (MSC-CP-ABE) and a collaborative access control and sharing model with on-chain and off-chain (AC-CSS). The algorithm encrypts hierarchically based on data sensitivity, the ciphertext is stored in the interplanetary file system (IPFS), and the encrypted address and key are stored in the side chain, which is convenient for indexing in the main chain. The vectorized access policy implements policy hiding, combines on-chain and off-chain, saves blockchain space, achieves hierarchical access control, and improves security and efficiency. Simulation experiments show that the main sidechain model proposed in this paper has better performance in terms of transaction delay and throughput. Compared with existing models, the algorithm proposed in this paper has certain advantages in data encryption and decryption time and key generation time.<\/jats:p>","DOI":"10.3233\/jifs-238935","type":"journal-article","created":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T10:16:43Z","timestamp":1744885003000},"page":"215-231","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["A hierarchical access control and sharing model for healthcare data with on-chain-off-chain collaboration"],"prefix":"10.1177","volume":"48","author":[{"given":"Jianhang","family":"Dong","sequence":"first","affiliation":[{"name":"Faculty of Information Engineering and Automation, Kunming University of Science and Technology, Kunming, China"},{"name":"Yunnan Key Laboratory of Service Computing, Yunnan University of Finance and Economics, Kunming, China"}]},{"given":"Rong","family":"Jiang","sequence":"additional","affiliation":[{"name":"Yunnan Key Laboratory of Service Computing, Yunnan University of Finance and Economics, Kunming, China"},{"name":"Institute of Intelligence Applications, Yunnan University of Finance and Economics, Kunming, China"}]},{"given":"Yi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Yunnan Key Laboratory of Service Computing, Yunnan University of Finance and Economics, Kunming, China"}]},{"given":"Shenghu","family":"Tian","sequence":"additional","affiliation":[{"name":"Yunnan Key Laboratory of Service Computing, Yunnan University of Finance and Economics, Kunming, China"}]},{"given":"Bin","family":"Wu","sequence":"additional","affiliation":[{"name":"Yunnan Academy of Scientific and Technical Information, Kunming, China"}]}],"member":"179","published-online":{"date-parts":[[2025,1,17]]},"reference":[{"issue":"09","key":"e_1_3_2_2_2","article-title":"A study on the current status of open sharing of domestic healthcare data","volume":"15","author":"Ting X.U.","year":"2020","unstructured":"TingX.U. and GuangjunY.U., A study on the current status of open sharing of domestic healthcare data, China Digital Medicine 15(09) (2020), pp. 64-66+103 (In Chinese).","journal-title":"China Digital Medicine"},{"issue":"02","key":"e_1_3_2_3_2","article-title":"A study on the current status of healthcare data sharing in the maternal and child specialty alliance in the Yangtze River Delta region","volume":"18","author":"Jingjin S.","year":"2023","unstructured":"JingjinS., et al., A study on the current status of healthcare data sharing in the maternal and child specialty alliance in the Yangtze River Delta region, China Digital Medicine 18(02) (2023), pp. 93\u201398 (In Chinese).","journal-title":"China Digital Medicine"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1109\/35.312842"},{"key":"e_1_3_2_5_2","first-page":"11","article-title":"Commentary: Integrated blockchain-deep learning approach for analyzing the electronic health records recommender system","author":"Noh S.","year":"2023","unstructured":"NohS., FirdausM. and RheeK.H., Commentary: Integrated blockchain-deep learning approach for analyzing the electronic health records recommender system, Frontiers in Public Health (2023), 11.","journal-title":"Frontiers in Public Health"},{"key":"e_1_3_2_6_2","unstructured":"NakamotoS. 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