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Medical Facilities in China


China's medical facilities are the core vehicle for supporting the medical and healthcare system. After years of construction,

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China's medical facilities are the core vehicle for supporting the medical and healthcare system. After years of construction, a complete network covering urban and rural areas, with distinct levels and complementary functions, has been formed, encompassing both grassroots institutions to meet basic medical needs and tertiary hospitals to provide high-end diagnostic and treatment services. It includes both primary institutions that meet basic medical needs and tertiary hospitals that provide high-end care, while taking into account special needs such as public health emergencies and Chinese medicine specialty services. The following is a comprehensive analysis of the network in terms of general overview, major types, core strengths, regional differences, existing challenges, and other dimensions:

Medical Facilities in China

General Overview of China's Healthcare Facilities

By 2023, the total number of healthcare facilities in China will be approximately 1.08 million (data from the National Healthcare Commission), forming a hierarchical system of “tertiary hospitals, secondary hospitals, and grassroots institutions”, covering preventive, curative, and treatment services. A hierarchical system has been formed, covering the whole chain of services, including prevention, treatment, rehabilitation and public health.

1. Types and number of institutions

. Hospitals (about 38,000): including general hospitals (accounting for more than 60% of the total), specialized hospitals (such as oncology, cardiovascular, and children's hospitals), Chinese medicine hospitals (about 4,500), and hospitals combining traditional Chinese and Western medicine.

. Primary health care institutions (about 980,000): community health service centers (stations), township health centers, village health offices, is the resident “health gatekeeper”; .

. Professional public health institutions (about 12,000): Centers for Disease Control and Prevention (CDC), Maternal and Child Health Centers, Emergency Centers, Blood Stations, etc., are responsible for disease prevention and control and public health services.

2. Total number of beds and resources

. Total beds : about 9.7 million (2023), 7.1 beds per 1,000 population (higher than the global average of 5.7) .

. Tertiary hospitals: about 1,600 (2023), concentrating the highest quality medical resources in the country (e.g. Peking Union Medical College, Shanghai Ruijin, West China Hospital, etc.); .

. Equipment Configuration : High-end equipment (e.g. 3.0T MRI, PET-CT, da Vinci Surgical Robot) is popularized in tertiary hospitals, and some primary institutions are equipped with basic imaging equipment (e.g. DR, color ultrasound).

the main types of medical facilities and functions

1. Tertiary hospitals: difficult and serious diagnosis and treatment of the “national team”

. Positioning: the national medical technology “high ground”, focusing on difficult and serious illnesses, acute and critical care and medical research.

. Representative institutions: Peking Union Medical College Hospital (difficult diseases), Shanghai Ruijin Hospital (hematology), Sun Yat-sen University Cancer Hospital (cancer), West China Hospital (emergency and critical care).

. Core Competencies :

Performing difficult surgeries (e.g. organ transplantation, brain surgery); .

Provide multi-disciplinary treatment (MDT).

Leading national clinical research (e.g. new anti-cancer drugs, gene therapy).

2. Level II hospitals: regional healthcare “hubs”

Positioning: connecting tertiary hospitals with primary care organizations. Positioning: the key link between tertiary hospitals and primary care institutions, undertaking the diagnosis and treatment of common and frequent diseases in the region, and the referral of acute and critical illnesses.

. Typical representatives: county-level people's hospitals, municipal hospitals; .

. Core functions :

Provide general medical services such as internal medicine, surgery, obstetrics and gynecology; .

Conducting regional tele-consultation (connecting to tertiary hospitals); .

Training of primary care doctors (such as rural doctors for further training).

3. Primary health care organizations: “health gatekeepers” of the population

. Types: community health centers (urban), township health centers (rural), village health offices (the most basic level); .

. Scope of services :

Basic medical care: diagnosis and treatment of common diseases such as colds and high blood pressure; .

Public health: vaccination, maternal health, chronic disease management (e.g. hypertension follow-up); .

Health promotion: health lectures, family doctor contracting (covering more than 500 million people).

. Advantages: Convenient proximity (within 15 minutes in urban areas and 30 minutes in rural areas), low cost (high reimbursement rate by health insurance). 4. Specialized hospitals: Specialized disease management (e.g., hypertension follow-up).

4. Specialized hospitals: precise diagnosis and treatment of specialized diseases

. Types: tumor hospitals, children's hospitals, stomatological hospitals, psychiatric hospitals, eye hospitals, etc.; .

. Characteristic services :

Tumor hospitals: providing radiotherapy, targeted therapy, immunotherapy; .

Children's Hospital: neonatology, pediatric surgery, pediatric intensive care; .

Dental Hospital: dental implants, orthodontics, pediatric dentistry; .

Psychiatric hospital: standardized treatment for depression and schizophrenia.

5. Chinese medicine facilities: “home base” of traditional medicine

. Types of institutions: Chinese medicine hospitals, combined Chinese and Western medicine hospitals, Chinese medicine departments of general hospitals, Chinese medicine halls of community health centers.

. Service Characteristics :

Specialized TCM therapies: Acupuncture, Tuina, Moxibustion, Traditional Chinese Medicine; .

Chronic disease management: diabetes, hypertension, arthritis rehabilitation; .

Cure for future diseases: body quality identification, guidance on medicinal diets, summer treatment for winter diseases (San Fu Paste).

6. Public health facilities: “outposts” for disease prevention and control

. Center for Disease Control and Prevention (CDC): a four-tier network of national, provincial, municipal, and county level, responsible for infectious disease surveillance, vaccination, and outbreak disposal; .

. Emergency Center: 120 emergency network covering the whole country, providing pre-hospital emergency treatment and transfer; .

. Maternal and Child Health Centers: Maternal system management, child nutrition improvement, birth defect prevention and control.

Core strengths of China's medical facilities

1. A grassroots network covering the entire population

. The number of grass-roots organizations accounts for more than 90% of the country's healthcare facilities, ensuring that “minor illnesses are treated at the grass-roots level”.

. Contracted family doctor services cover over 500 million people, providing personalized health management.

. The three-tier network of “county-village-village” in rural areas is basically sound, and the coverage rate of village health centers exceeds 98%.

2. International Competitiveness of Tertiary Hospitals

. Some of the top tertiary hospitals have entered the authoritative global rankings; .

. The hospitals have reached the international advanced level in the fields of precision tumor treatment, organ transplantation (the annual number of liver transplantation surgeries exceeds 6,000, the highest in the world), and cardiovascular and cerebrovascular interventional surgeries.

3. Unique value of TCM facilities

. The number of TCM hospitals accounts for 12% of the total number of hospitals nationwide, and the coverage rate of grassroots TCM centers exceeds 90%; .

. Chinese medicinal preparations play an important role in the management of chronic diseases and the prevention and control of epidemics; .

. The concept of “treating the future disease” of Chinese medicine is combined with modern preventive medicine to promote the development of “medical care integration”.

4. Intelligent medical care and facility upgrading

. Popularization of digital equipment: 90% of hospitals above the second level nationwide have realized electronic medical records above the fifth level, and 5G remote surgery (e.g., Beijing-Hainan remote brain surgery) is widely used; .

. Internet hospitals: more than 2,000 internet hospitals nationwide in 2023, providing online consultation, drug delivery and other services; .

AI-assisted diagnosis: AI systems such as lung nodule screening and fundus lesion identification are promoted in grassroots organizations to improve diagnostic efficiency.

Regional differences: imbalance between east and west, urban and rural areas

Although China is a global leader in the number of medical facilities, uneven regional distribution is still a prominent problem:

1. East-Middle-West gap

. Density of facilities: In the east (e.g., Jiangsu, Guangdong), there are about 120 medical facilities per 10,000 people, while in the west (e.g., Tibet, Qinghai), there are only about 60; .

. Resource quality: quality hospitals (Triple A) are concentrated in the east (e.g., Beijing, Shanghai, Guangzhou), and less than 20% of the quality resources in the west; .

. Technological level: the number of difficult surgeries (e.g. organ transplant, da Vinci surgery) performed by tertiary hospitals in the east is 3-5 times higher than that in the west.

2. Urban and rural disparities

. Equipment Configuration: The coverage rate of high-end equipment (e.g. MRI, CT) is over 80% in urban hospitals above the second level, while it is only 30% in rural areas; .

. Talent pool: about 4.2 practicing physicians per 1,000 population in urban areas, only 1.8 in rural areas (2023 data); .

. Service capacity: primary care organizations in rural areas can only provide treatment for less than 50 common diseases, while primary care organizations in urban areas can provide treatment for more than 200 diseases.

Existing Challenges and Directions for Improvement

1. Main Challenges

Main Challenges Concentration of high-quality resources: patients “pile up” in the three-armed hospitals, leading to overcrowding in large hospitals (e.g., the average daily outpatient capacity of the Peking Union Medical College Hospital exceeds 15,000) and idling of resources in grass-roots institutions. .

. Aging facilities: some grassroots institutions (especially rural village health centers) have outdated equipment, which is difficult to meet the demand.

. Differences in informationization levels: medical institutions in the east are highly intelligent, while those in the west still rely on traditional paper records.

2. Directions for improvement

. Sinking of resources: through the construction of “national medical centers” and “regional medical centers” (e.g., the layout of national hospitals in the central and western parts of the country), to promote the pairing of tertiary hospitals with grass-roots institutions to provide support.

. County Medical Community: Integrate county, township and village institutions within the county to achieve resource sharing (e.g., mutual recognition of test results, unified drug list); .

. Popularization of intelligent medical care: increase investment in medical informatization in western China, and promote remote diagnosis and AI-assisted decision-making systems; .

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