diff --git a/crates/erp-health/src/handler/action_inbox_handler.rs b/crates/erp-health/src/handler/action_inbox_handler.rs
new file mode 100644
index 0000000..0453f1f
--- /dev/null
+++ b/crates/erp-health/src/handler/action_inbox_handler.rs
@@ -0,0 +1,43 @@
+use axum::extract::{FromRef, Json, Path, Query, State};
+use axum::Extension;
+use erp_core::error::AppError;
+use erp_core::rbac::require_permission;
+use erp_core::types::{ApiResponse, PaginatedResponse, TenantContext};
+
+use crate::service::action_inbox_service::{
+    self, ActionInboxQuery, ActionItem, ThreadResponse,
+};
+use crate::state::HealthState;
+
+pub async fn list_action_inbox<S>(
+    State(state): State<HealthState>,
+    Extension(ctx): Extension<TenantContext>,
+    Query(query): Query<ActionInboxQuery>,
+) -> Result<Json<ApiResponse<PaginatedResponse<ActionItem>>>, AppError>
+where
+    HealthState: FromRef<S>,
+    S: Clone + Send + Sync + 'static,
+{
+    require_permission(&ctx, "health.action-inbox.list")?;
+    let result =
+        action_inbox_service::list_action_items(&state.db, ctx.tenant_id, &query).await?;
+    Ok(Json(ApiResponse::ok(result)))
+}
+
+pub async fn get_action_thread<S>(
+    State(state): State<HealthState>,
+    Extension(ctx): Extension<TenantContext>,
+    Path(source_ref): Path<String>,
+) -> Result<Json<ApiResponse<ThreadResponse>>, AppError>
+where
+    HealthState: FromRef<S>,
+    S: Clone + Send + Sync + 'static,
+{
+    require_permission(&ctx, "health.action-inbox.list")?;
+    let result =
+        action_inbox_service::get_action_thread(&state.db, ctx.tenant_id, &source_ref).await?;
+    match result {
+        Some(resp) => Ok(Json(ApiResponse::ok(resp))),
+        None => Err(crate::error::HealthError::Validation("行动项未找到".into()).into()),
+    }
+}
diff --git a/crates/erp-health/src/handler/mod.rs b/crates/erp-health/src/handler/mod.rs
index 47222ec..94dfc7a 100644
--- a/crates/erp-health/src/handler/mod.rs
+++ b/crates/erp-health/src/handler/mod.rs
@@ -1,3 +1,4 @@
+pub mod action_inbox_handler;
 pub mod alert_handler;
 pub mod alert_rule_handler;
 pub mod appointment_handler;
diff --git a/crates/erp-health/src/module.rs b/crates/erp-health/src/module.rs
index b6a403c..5ed5fcd 100644
--- a/crates/erp-health/src/module.rs
+++ b/crates/erp-health/src/module.rs
@@ -6,6 +6,7 @@ use erp_core::events::EventBus;
 use erp_core::module::{ErpModule, PermissionDescriptor};
 
 use crate::handler::{
+    action_inbox_handler,
     alert_handler, alert_rule_handler,
     appointment_handler, article_category_handler, article_handler, article_tag_handler, consultation_handler, consent_handler, critical_alert_handler, critical_value_threshold_handler, daily_monitoring_handler, device_handler, device_reading_handler, diagnosis_handler, doctor_handler, follow_up_handler, follow_up_template_handler,
     health_data_handler, medication_record_handler, medication_reminder_handler, patient_handler, points_handler, stats_handler,
@@ -685,6 +686,15 @@ impl HealthModule {
                 "/health/devices/{id}",
                 axum::routing::delete(device_handler::unbind_device),
             )
+            // 行动收件箱
+            .route(
+                "/health/action-inbox",
+                axum::routing::get(action_inbox_handler::list_action_inbox),
+            )
+            .route(
+                "/health/action-inbox/{source_ref}/thread",
+                axum::routing::get(action_inbox_handler::get_action_thread),
+            )
     }
 }
 
@@ -1051,6 +1061,19 @@ impl ErpModule for HealthModule {
                 description: "创建/编辑/删除药物提醒".into(),
                 module: "health".into(),
             },
+            // 行动收件箱
+            PermissionDescriptor {
+                code: "health.action-inbox.list".into(),
+                name: "查看行动收件箱".into(),
+                description: "查看统一行动收件箱中的待办事项".into(),
+                module: "health".into(),
+            },
+            PermissionDescriptor {
+                code: "health.action-inbox.manage".into(),
+                name: "管理行动项".into(),
+                description: "审批/拒绝/标记行动收件箱中的事项".into(),
+                module: "health".into(),
+            },
         ]
     }
 
diff --git a/crates/erp-health/src/service/action_inbox_service.rs b/crates/erp-health/src/service/action_inbox_service.rs
new file mode 100644
index 0000000..ede6984
--- /dev/null
+++ b/crates/erp-health/src/service/action_inbox_service.rs
@@ -0,0 +1,434 @@
+use chrono::{DateTime, Utc};
+use erp_core::types::PaginatedResponse;
+use sea_orm::{DatabaseBackend, DatabaseConnection, FromQueryResult, Statement};
+use serde::{Deserialize, Serialize};
+use uuid::Uuid;
+
+use crate::error::HealthError;
+
+// ── DTO ──────────────────────────────────────────────────────────────
+
+#[derive(Debug, Clone, Serialize, Deserialize, PartialEq, Eq)]
+#[serde(rename_all = "snake_case")]
+pub enum ActionType {
+    AiSuggestion,
+}
+
+#[derive(Debug, Clone, Serialize, Deserialize, PartialEq, Eq)]
+#[serde(rename_all = "snake_case")]
+pub enum ActionPriority {
+    Urgent,
+    High,
+    Medium,
+    Low,
+}
+
+#[derive(Debug, Clone, Serialize, Deserialize, PartialEq, Eq)]
+#[serde(rename_all = "snake_case")]
+pub enum ActionStatus {
+    Pending,
+    InProgress,
+    Completed,
+    Dismissed,
+}
+
+#[derive(Debug, Clone, Serialize)]
+pub struct ActionItem {
+    pub id: String,
+    pub action_type: ActionType,
+    pub priority: ActionPriority,
+    pub status: ActionStatus,
+    pub title: String,
+    pub summary: String,
+    pub patient_id: Uuid,
+    pub patient_name: String,
+    pub source_ref: String,
+    pub created_at: DateTime<Utc>,
+    pub updated_at: DateTime<Utc>,
+}
+
+#[derive(Debug, Clone, Serialize)]
+pub struct ThreadEvent {
+    pub step: String,
+    pub label: String,
+    pub status: ActionStatus,
+    #[serde(skip_serializing_if = "Option::is_none")]
+    pub detail: Option<String>,
+    #[serde(skip_serializing_if = "Option::is_none")]
+    pub timestamp: Option<DateTime<Utc>>,
+    #[serde(skip_serializing_if = "Option::is_none")]
+    pub operator: Option<String>,
+    #[serde(skip_serializing_if = "Option::is_none")]
+    pub link_to: Option<String>,
+}
+
+#[derive(Debug, Clone, Serialize)]
+pub struct ActionDefinition {
+    pub key: String,
+    pub label: String,
+    pub variant: String,
+    #[serde(skip_serializing_if = "Option::is_none")]
+    pub api_endpoint: Option<String>,
+}
+
+#[derive(Debug, Clone, Serialize)]
+pub struct ThreadResponse {
+    pub action_item: ActionItem,
+    pub thread: Vec<ThreadEvent>,
+    pub available_actions: Vec<ActionDefinition>,
+}
+
+#[derive(Debug, Deserialize)]
+pub struct ActionInboxQuery {
+    pub status: Option<String>,
+    #[serde(rename = "type")]
+    pub action_type: Option<String>,
+    pub page: Option<u64>,
+    pub page_size: Option<u64>,
+}
+
+// ── 内部查询结构体 ──────────────────────────────────────────────────
+
+#[derive(Debug, FromQueryResult)]
+struct ActionItemRow {
+    id: Uuid,
+    suggestion_type: String,
+    risk_level: String,
+    status: String,
+    params: Option<serde_json::Value>,
+    created_at: DateTime<Utc>,
+    updated_at: DateTime<Utc>,
+    patient_id: Uuid,
+    patient_name: String,
+    result_content: Option<String>,
+    _analysis_id: Uuid,
+}
+
+#[derive(Debug, FromQueryResult)]
+struct CountRow {
+    cnt: i64,
+}
+
+#[derive(Debug, FromQueryResult)]
+struct SuggestionDetail {
+    id: Uuid,
+    suggestion_type: String,
+    risk_level: String,
+    status: String,
+    params: Option<serde_json::Value>,
+    workflow_instance_id: Option<Uuid>,
+    reanalysis_id: Option<Uuid>,
+    created_at: DateTime<Utc>,
+    updated_at: DateTime<Utc>,
+    _analysis_id: Uuid,
+    patient_id: Uuid,
+    patient_name: String,
+    result_content: Option<String>,
+    analysis_created_at: DateTime<Utc>,
+}
+
+// ── 辅助函数 ────────────────────────────────────────────────────────
+
+fn risk_to_priority(risk: &str) -> ActionPriority {
+    match risk {
+        "high" => ActionPriority::Urgent,
+        "medium" => ActionPriority::High,
+        "low" => ActionPriority::Medium,
+        _ => ActionPriority::Low,
+    }
+}
+
+fn suggestion_status_to_action(status: &str) -> ActionStatus {
+    match status {
+        "pending" => ActionStatus::Pending,
+        "approved" => ActionStatus::InProgress,
+        "executed" => ActionStatus::Completed,
+        _ => ActionStatus::Dismissed, // rejected, expired, parse_failed
+    }
+}
+
+fn suggestion_type_to_title(suggestion_type: &str) -> String {
+    match suggestion_type {
+        "followup" => "建议安排随访".into(),
+        "appointment" => "建议预约复查".into(),
+        "alert" => "建议关注指标异常".into(),
+        _ => "AI 健康建议".into(),
+    }
+}
+
+fn extract_title(params: &Option<serde_json::Value>, suggestion_type: &str) -> String {
+    params
+        .as_ref()
+        .and_then(|p| p.get("reason"))
+        .and_then(|v| v.as_str())
+        .map(|s| s.to_string())
+        .unwrap_or_else(|| suggestion_type_to_title(suggestion_type))
+}
+
+// ── 公开 API ────────────────────────────────────────────────────────
+
+pub async fn list_action_items(
+    db: &DatabaseConnection,
+    tenant_id: Uuid,
+    query: &ActionInboxQuery,
+) -> Result<PaginatedResponse<ActionItem>, HealthError> {
+    let page = query.page.unwrap_or(1).max(1);
+    let page_size = query.page_size.unwrap_or(20).min(100);
+    let offset = (page - 1) * page_size;
+
+    let status_filter = match query.status.as_deref() {
+        Some("pending") => "AND s.status = 'pending'",
+        Some("in_progress") => "AND s.status = 'approved'",
+        Some("completed") => "AND s.status = 'executed'",
+        Some("dismissed") => "AND s.status IN ('rejected', 'expired', 'parse_failed')",
+        _ => "",
+    };
+
+    let data_sql = format!(
+        r#"
+        SELECT s.id, s.suggestion_type, s.risk_level, s.status, s.params,
+               s.created_at, s.updated_at,
+               a.patient_id, p.name AS patient_name,
+               a.result_content, a.id AS analysis_id
+        FROM ai_suggestion s
+        JOIN ai_analysis a ON s.analysis_id = a.id
+        JOIN patient p ON a.patient_id = p.id
+        WHERE s.tenant_id = $1
+          AND s.deleted_at IS NULL
+          {status_filter}
+        ORDER BY
+          CASE s.risk_level WHEN 'high' THEN 1 WHEN 'medium' THEN 2 ELSE 3 END,
+          s.created_at DESC
+        LIMIT $2 OFFSET $3
+        "#
+    );
+
+    let rows: Vec<ActionItemRow> = FromQueryResult::find_by_statement(
+        Statement::from_sql_and_values(
+            DatabaseBackend::Postgres,
+            data_sql,
+            [
+                tenant_id.into(),
+                (page_size as i64).into(),
+                (offset as i64).into(),
+            ],
+        ),
+    )
+    .all(db)
+    .await
+    .map_err(|e| HealthError::DbError(e.to_string()))?;
+
+    let count_sql = format!(
+        r#"
+        SELECT COUNT(*) AS cnt
+        FROM ai_suggestion s
+        JOIN ai_analysis a ON s.analysis_id = a.id
+        WHERE s.tenant_id = $1
+          AND s.deleted_at IS NULL
+          {status_filter}
+        "#
+    );
+
+    let count_row: Option<CountRow> = FromQueryResult::find_by_statement(
+        Statement::from_sql_and_values(DatabaseBackend::Postgres, count_sql, [tenant_id.into()]),
+    )
+    .one(db)
+    .await
+    .map_err(|e| HealthError::DbError(e.to_string()))?;
+
+    let total = count_row.map(|r| r.cnt).unwrap_or(0) as u64;
+
+    let items: Vec<ActionItem> = rows
+        .into_iter()
+        .map(|r| ActionItem {
+            id: format!("ai_suggestion:{}", r.id),
+            action_type: ActionType::AiSuggestion,
+            priority: risk_to_priority(&r.risk_level),
+            status: suggestion_status_to_action(&r.status),
+            title: extract_title(&r.params, &r.suggestion_type),
+            summary: r.result_content.unwrap_or_default().chars().take(100).collect(),
+            patient_id: r.patient_id,
+            patient_name: r.patient_name,
+            source_ref: r.id.to_string(),
+            created_at: r.created_at,
+            updated_at: r.updated_at,
+        })
+        .collect();
+
+    Ok(PaginatedResponse {
+        data: items,
+        total,
+        page,
+        page_size,
+        total_pages: if page_size > 0 { (total + page_size - 1) / page_size } else { 0 },
+    })
+}
+
+pub async fn get_action_thread(
+    db: &DatabaseConnection,
+    tenant_id: Uuid,
+    source_ref: &str,
+) -> Result<Option<ThreadResponse>, HealthError> {
+    let suggestion_id = source_ref
+        .strip_prefix("ai_suggestion:")
+        .ok_or_else(|| HealthError::Validation("无效的 source_ref 格式".into()))?;
+    let uuid = Uuid::parse_str(suggestion_id)
+        .map_err(|e| HealthError::Validation(format!("无效的 UUID: {e}")))?;
+
+    let detail: Option<SuggestionDetail> = FromQueryResult::find_by_statement(
+        Statement::from_sql_and_values(
+            DatabaseBackend::Postgres,
+            r#"
+            SELECT s.id, s.suggestion_type, s.risk_level, s.status, s.params,
+                   s.workflow_instance_id, s.reanalysis_id,
+                   s.created_at, s.updated_at,
+                   s.analysis_id, a.patient_id, p.name AS patient_name,
+                   a.result_content, a.created_at AS analysis_created_at
+            FROM ai_suggestion s
+            JOIN ai_analysis a ON s.analysis_id = a.id
+            JOIN patient p ON a.patient_id = p.id
+            WHERE s.id = $1 AND s.tenant_id = $2 AND s.deleted_at IS NULL
+            "#,
+            [uuid.into(), tenant_id.into()],
+        ),
+    )
+    .one(db)
+    .await
+    .map_err(|e| HealthError::DbError(e.to_string()))?;
+
+    let detail = match detail {
+        Some(d) => d,
+        None => return Ok(None),
+    };
+
+    let action_status = suggestion_status_to_action(&detail.status);
+
+    // ── 拼装线程时间线 ──
+    let mut thread = Vec::new();
+
+    // Step 1: AI 分析完成
+    thread.push(ThreadEvent {
+        step: "ai_analysis".into(),
+        label: "AI 分析完成".into(),
+        status: ActionStatus::Completed,
+        detail: None,
+        timestamp: Some(detail.analysis_created_at),
+        operator: None,
+        link_to: Some("/health/ai-analysis".into()),
+    });
+
+    // Step 2: 医生审批
+    let approval_status = match detail.status.as_str() {
+        "approved" | "executed" => ActionStatus::Completed,
+        "rejected" => ActionStatus::Dismissed,
+        _ => ActionStatus::InProgress,
+    };
+    let is_terminal = matches!(approval_status, ActionStatus::Completed | ActionStatus::Dismissed);
+    thread.push(ThreadEvent {
+        step: "doctor_approval".into(),
+        label: "医生审批".into(),
+        status: approval_status,
+        detail: None,
+        timestamp: if is_terminal {
+            Some(detail.updated_at)
+        } else {
+            None
+        },
+        operator: None,
+        link_to: None,
+    });
+
+    // Step 3: 执行安排
+    let has_workflow = detail.workflow_instance_id.is_some();
+    if has_workflow || detail.status == "approved" || detail.status == "executed" {
+        thread.push(ThreadEvent {
+            step: "action_dispatched".into(),
+            label: "执行安排".into(),
+            status: if has_workflow {
+                ActionStatus::Completed
+            } else {
+                ActionStatus::Pending
+            },
+            detail: None,
+            timestamp: None,
+            operator: None,
+            link_to: None,
+        });
+    }
+
+    // Step 4: 再分析对比
+    if detail.reanalysis_id.is_some() || detail.status == "executed" {
+        thread.push(ThreadEvent {
+            step: "reanalysis".into(),
+            label: "前后对比".into(),
+            status: if detail.reanalysis_id.is_some() {
+                ActionStatus::Completed
+            } else {
+                ActionStatus::Pending
+            },
+            detail: None,
+            timestamp: None,
+            operator: None,
+            link_to: detail.reanalysis_id.map(|id| format!("/health/ai-analysis/{id}")),
+        });
+    }
+
+    // ── 动态操作按钮 ──
+    let available_actions = match detail.status.as_str() {
+        "pending" => vec![
+            ActionDefinition {
+                key: "approve".into(),
+                label: "批准并执行".into(),
+                variant: "primary".into(),
+                api_endpoint: Some(format!("/api/v1/ai/suggestions/{}/approve", detail.id)),
+            },
+            ActionDefinition {
+                key: "reject".into(),
+                label: "拒绝".into(),
+                variant: "danger".into(),
+                api_endpoint: Some(format!("/api/v1/ai/suggestions/{}/approve", detail.id)),
+            },
+        ],
+        "approved" => vec![ActionDefinition {
+            key: "acknowledge".into(),
+            label: "标记已知悉".into(),
+            variant: "default".into(),
+            api_endpoint: None,
+        }],
+        "executed" => vec![ActionDefinition {
+            key: "view_comparison".into(),
+            label: "查看前后对比".into(),
+            variant: "primary".into(),
+            api_endpoint: Some(format!(
+                "/api/v1/ai/suggestions/{}/comparison",
+                detail.id
+            )),
+        }],
+        _ => vec![],
+    };
+
+    let action_item = ActionItem {
+        id: format!("ai_suggestion:{}", detail.id),
+        action_type: ActionType::AiSuggestion,
+        priority: risk_to_priority(&detail.risk_level),
+        status: action_status,
+        title: extract_title(&detail.params, &detail.suggestion_type),
+        summary: detail
+            .result_content
+            .unwrap_or_default()
+            .chars()
+            .take(100)
+            .collect(),
+        patient_id: detail.patient_id,
+        patient_name: detail.patient_name,
+        source_ref: detail.id.to_string(),
+        created_at: detail.created_at,
+        updated_at: detail.updated_at,
+    };
+
+    Ok(Some(ThreadResponse {
+        action_item,
+        thread,
+        available_actions,
+    }))
+}
diff --git a/crates/erp-health/src/service/mod.rs b/crates/erp-health/src/service/mod.rs
index 87db442..1b89bbd 100644
--- a/crates/erp-health/src/service/mod.rs
+++ b/crates/erp-health/src/service/mod.rs
@@ -1,3 +1,4 @@
+pub mod action_inbox_service;
 pub mod ai_action_dispatcher;
 pub mod ai_suggestion_loader;
 pub mod alert_engine;