【醫在中國Q＆A·開欄語】

Healthcare in China Q&A: Opening words

過去5年，中國醫療體系迎來深刻變革：中國每人平均預期壽命達到79歲，基本醫保覆蓋超13億人，藥品價格顯著下降，遠端醫療幾乎實現縣域全覆蓋。即日起，中國網開設《醫在中國Q＆A》系列問答欄目，聚焦醫療變革背後的制度創新，解讀中國在分級診療、中醫藥發展、公共衛生應急等領域的實踐，為全球公共衛生治理提供中國方案。

Over the past five years, China's healthcare system has undergone profound transformations: the average life expectancy of Chinese people has reached 79 years, basic medical insurance now covers more than 1.3 billion people, drug prices have significantly decreased, and telemedicine services have reached almost all areas at the county level.

Today, China.com.cn launches the “Healthcare in China Q&A” series, which focuses on the institutional innovations behind these changes. The series will interpret China’s practices in areas such as the hierarchical medical system, the development of traditional Chinese medicine (TCM), and public health emergency, to offer Chinese solutions for global public health governance. 

醫在中國Q&A | 中國醫療衛生服務體系的獨特性是什麼？

Healthcare in China Q&A| What makes China's healthcare system unique?

全國醫療衛生機構遍佈城鄉，九成以上居民在15分鐘內能夠到達最近的醫療服務點；全國基本醫保參保13.27億人，基本醫療保險參保率穩定在95％以上；長期護理保險制度參保1.9億人……織起覆蓋14億人口的龐大“醫療健康網”，中國為什麼能做到？“全民健康全覆蓋”背後的運作機制是怎樣的？

China has woven a massive health net that covers its entire population of 1.4 billion. The evidence is striking: over 90% of the population has access to medical services within 15 minutes; basic insurance covers 1.327 billion people (a coverage rate of over 95%); and long-term care insurance benefits 190 million.

The driving force behind this achievement? A System Unlike Any Other—a model of centralized planning and a tiered healthcare system that turns the vision of universal health coverage into a tangible reality.

Q1：中國醫療衛生服務體系的突出特點有哪些？

Q1: What are the prominent features of China's healthcare service system?

A：堅持中國醫療衛生事業的公益性方向，將人民健康置於優先發展的戰略地位。基本醫療保險參保率穩定在95％以上。2024年，全國基本醫保參保13.27億人，長期護理保險制度參保1.9億人，職工和居民住院費用目錄內基金支付比例分別穩定在80％和70％。

China’s healthcare system is built on the principle of public welfare, placing people’s health at the center of national development. The system now covers over 95% of the population, with basic medical insurance protecting 1.327 billion people as of 2024. Long-term care insurance also covers 190 million people. The reimbursement rate for inpatient costs remains stable at 80% for urban employees and 70% for rural and urban residents under their respective basic medical insurance plans.

以政府辦醫療機構為主導，醫療、醫保、醫藥協同發展，國家組織藥品耗材集中帶量採購，心臟支架等高值醫用耗材價格大幅下降；創新藥械上市審批和納入醫保，讓患者用得上、用得起好藥。

China is building a coordinated system that links medical services, insurance coverage, and drug supply. To ensure patients have access to affordable, innovative medicines, China's centralized volume-based procurement program has significantly reduced prices for high-value medical devices like cardiac stents. Meanwhile, accelerated approval and rapid inclusion of innovative drugs and devices in insurance coverage allow patients to benefit from cutting-edge treatments sooner.

堅持中西醫並重，將中醫藥深度融入醫療衛生服務體系建設的各個方面。

The system also embraces both traditional Chinese and Western medicine, fully integrating TCM into prevention, treatment, and health management. This inclusive approach provides diverse pathways to better health for all.

Q2：“全民健康覆蓋”如何實現？

Q2: How did China achieve universal health coverage?

A：中國建成了世界上規模最大的疾病預防控制體系、醫療服務體系和醫療保障體系，建立健全覆蓋中央、省、地市、縣四級疾病預防控制體系。

China has established the world's largest systems for disease prevention and control, medical services, and health insurance, with a comprehensive four-tier (national, provincial, municipal, county) disease prevention network.

高水準醫療服務“網狀式”全覆蓋。中國以國家醫學中心、區域醫療中心為引領，以省級區域醫療中心為支撐，以地市級醫院提質擴能、縣級醫院提質達標為銜接，以緊密型城市醫療集團、縣域醫共體和基層醫療衛生機構為基座，以巡迴醫療、遠端醫療為輔助，形成縱向貫通、區域均衡的高水準醫療服務擴容下沉路徑。目前，已設置國家醫學中心、國家區域醫療中心和省級醫療中心。2025年底，縣域醫共體將覆蓋90％以上縣域，優質醫療資源總量持續增加、佈局更為均衡。

China has built a high-performance "network-style" healthcare structure: national and regional medical centers lead the way, provincial medical centers provide strong support, upgraded city/county hospitals serve as critical hubs, and grassroots medical groups/alliances form the foundation - all enhanced by mobile clinics and telemedicine. Currently, there are 26 national medical centers (across 13 specialties), 125 national regional medical centers, and 114 provincial medical centers. By the end of 2025, county-level medical consortia will cover over 90% of counties.

就近就便服務明顯提升。縣域內常見病、多發病就診率達到90％以上。87％的二級以上公立醫院開展了預約診療服務，83％的三級公立醫院開展了日間手術服務。2024年跨省異地就醫醫保直接結算突破1億人次。網際網路醫院達3756所，全國70％以上的衛生院與上級醫院建立了遠端醫療協作關係，藥品配送到家等服務廣泛普及。居民個人衛生支出佔衛生總費用的比例持續下降至27％左右。

The quality and accessibility of local medical services have significantly improved.Over 90% of common and frequently occurring diseases are treated within the county of residence. More than 87% of public hospitals at or above the secondary level offer appointment-based services, and 83% of tertiary public hospitals provide day surgery. In 2024, there were over 100 million instances of direct cross-provincial settlement of medical insurance expenses. There are 3,756 internet hospitals, and over 70% of township health centers have established remote medical collaboration with higher-level hospitals. Services like home drug delivery are widely available. The proportion of personal out-of-pocket health expenses has dropped to around 27% of total health expenditure.

預防、治療、康復、護理、臨終關懷等服務有效銜接。當前，多學科一體化診療服務模式推廣到2000多家二級以上醫院，5500多家醫院建立了“一站式”服務中心。各地積極發展家庭病床、到府護理、社區康復等接續性服務，探索慢病多病同防共治，探索醫防協同、醫防融合。整合孕前保健、孕期護理、産期監護、兒童保健、兒童預防接種等服務內容，為婦女兒童提供優生優育全程服務。針對老年人、殘疾人等特殊群體，推進醫養結合、康養結合服務模式，提供集醫療、康復、護理、養老于一體的綜合服務。

Integrated Services Spanning Prevention, Treatment, Rehabilitation, and Care. Multi-disciplinary integrated diagnosis and treatment models have been promoted in over 2,000 hospitals at or above the secondary level, and more than 5,500 hospitals have established "one-stop" service centers. Services such as family sickbeds, home-based nursing, and community rehabilitation are actively developing. These services are exploring integrated models for preventing and treating chronic and multiple diseases, while also strengthening coordination between medical treatment and public health initiatives. Integrated services covering pre-pregnancy, pregnancy, childbirth, childcare, and vaccination provide comprehensive support for women and children. For the elderly and persons with disabilities, integrated eldercare and disability support models provide a comprehensive suite of services, encompassing healthcare, rehabilitation, and daily living assistance.

總策劃：薛立勝

Executive Producer: Lisheng Xue

策劃：蔡曉娟 張運興

Planning Director: Xiaojuan Cai, Yunxing Zhang

統籌：劉佳

Project Coordinator: Jia Liu

供稿：諸宏明、宋大平、江蒙喜（國家衛生健康委衛生發展研究中心、健康和人口發展戰略研究院 ）

Content Provider: Hongming Zhu, Daping Song, Mengxi Jiang (National Center for Health Development Research, NHC)

編輯：劉佳

Editor: Jia Liu

推廣：楊岳巍 金淳曦 常瑤 沈雪

Promotion: Yuewei Yang, Chunxi Jin, Yao Chang, Xue Shen

翻譯：郭峰

Translator：Feng Guo

編審：張艷玲 王月博

Managing Editor：Yanling Zhang, Yuebo Wang