【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丨中國醫療衛生服務網如何“鋪滿”基層？

Healthcare in China Q&A | How China Wove a Vast Medical Safety Net for Its Grassroots Communities?

九成以上居民在15分鐘內能夠到達最近的醫療服務點，城鄉居民醫療衛生服務全覆蓋；醫學影像、心電診斷等檢查鄉鎮查完，縣級診斷；電子健康檔案、電子病歷線上流通，遠端醫療在家看病……“一般病在市縣解決，日常疾病在基層解決”，中國基層醫療衛生服務網正在全面鋪就。

Imagine a healthcare system where over 90% of the population can reach a clinic within 15 minutes. Where you can undergo medical imaging and ECG tests in your local town but have the results interpreted by specialists at county-level hospitals. Where your medical records are accessible online, enabling you to consult doctors directly from your home. This is the reality of China's expanding grassroots medical network, built on the principle that "Frequently occurring diseases are handled at county-level hospitals, while common diseases are treated at township and village clinics."

Q1：中國醫療衛生服務網能到多基層？

Q1: How Extensive Is China's Primary Healthcare Network?

A：截至2024年底，全國基層醫療衛生機構中，鄉鎮衛生院3.3萬個，社區衛生服務中心（站）3.7萬個，村衛生室57.1萬個，基本實現城鄉居民醫療衛生服務全覆蓋。2023年全國第七次衛生服務調查顯示，90.8%的家庭在15分鐘內可以到達最近的醫療點。在新疆、西藏等地也實現衛生機構覆蓋。

By the end of 2024, China's primary-level medical and health institutions comprised 33,000 township health centers, 37,000 community health service centers (stations), and 571,000 village clinics, essentially achieving universal coverage of basic medical and health services for both urban and rural residents. The Seventh National Health Service Survey in 2023 showed that 90.8% of households could reach the nearest medical facility within 15 minutes.Medical and health institutions have achieved full coverage in regions such as Xinjiang and Tibet.

全國2199個縣（市、區）開展了縣域醫共體建設，基本實現縣和縣級市全覆蓋。按照政策要求，每個鄉鎮衛生院（社區衛生服務中心）至少有一名牽頭醫院主治醫師以上職稱人員常年服務。2024年，縣域影像、心電、檢驗等資源共用中心以及中心藥房累計提供服務近1.9億次，更多群眾享受到“基層檢查、上級診斷、結果互認”的便利。

The county-level medical consortium system has been established in 2,199 counties (cities, and districts). According to policy requirements, each township health center (or community health service center) has at least one attending physician or higher from a leading hospital providing services year-round. In 2024, county-level shared resource centers for medical imaging, ECG, laboratory testing, and centralized pharmacy services provided nearly 190 million services, allowing more people to benefit from the convenience of "examination at the primary level, diagnosis at the higher level, and mutual recognition of results."

Q2：如何讓基層醫療衛生網真正“強”起來？

Q2: How Is China Strengthening Its Grassroots Healthcare Network?

A：持續推進軟硬體設施升級。通過改善基層機構基礎環境與設備條件，建設縣域醫學影像、檢驗、消毒供應等資源共用中心，實現“鄉鎮檢查、縣級診斷、結果互認”，優化群眾就醫體驗。

The Three Pillars for a Robust Grassroots Network: Modernized Infrastructure. Continuous upgrades of facilities and equipment, supported by county-level shared diagnostic centers, enable a system of "township-level testing, county-level diagnosis, and mutual recognition of results" to ensure a smoother patient journey.

以數字化賦能基層醫療。建設統一健康資訊平臺，升級資訊系統，擴展遠端醫療網路，推廣“網際網路+醫療健康”服務，讓群眾就近享受優質醫療服務。推動電子病歷、健康檔案互聯互通，支援處方流轉與檢查結果跨區域共用，提升資源利用效率。

Technology-Backed Shared Services. Digitalization serves as the cornerstone. A unified health information platform and expanded "Internet + Healthcare" services deliver quality care directly to local communities. Interconnected systems enable seamless sharing of medical records and prescriptions across regions, optimizing resource allocation efficiency.

完善醫務人員下沉基層服務制度。實施“縣管鄉用、鄉聘村用”機制，推進大學生鄉村醫生專項計劃。2010年至2023年，基層衛生技術人員數由191.4萬增至387.7萬，每萬人口全科醫生數由不足1人增長至3.99人。通過優化考核激勵、縮小收入差距、完善醫保資金分配機制，引導基層從“被動治病”轉向“主動防病”。

Empowered Frontline Workforce. Strategic staffing policies (such as the "county-managed, township-employed" model) and targeted recruitment have significantly expanded the primary-level health workforce. From 2010 to 2023, the number of primary health technicians more than doubled, while general practitioners per 10,000 population quadrupled. By optimizing performance incentives, narrowing income gaps, and improving the medical insurance fund allocation mechanism, the system is being guided to shift from passive treatment to proactive health preservation.

Q3：基層醫療衛生網有哪些實實在在的成效？

Q3: What Tangible Outcomes Has the Grassroots Network Achieved?

A：基本公共衛生服務均等化水準穩步提高。從2009年起，實施基本公共衛生服務項目，由中央和地方財政共同出資，以基層醫療衛生機構為主，為城鄉居民免費提供，建立起世界上覆蓋人口最多的公共衛生干預項目，成為落實預防為主、保障居民健康的重要制度安排。每人平均基本公共衛生服務經費補助標準從2009年的15元提高到2025年的99元，重點圍繞65歲及以上老年人、0—6歲兒童、孕産婦、高血壓及2型糖尿病等慢性病患者等人群提供服務，有效推動了基層衛生服務模式由“以疾病為中心”向“以健康為中心”的轉變。

Enhanced Equity in Public Health Services. Since its launch in 2009, the government-funded Basic Public Health Service Program has become the world's largest public health intervention by population coverage. Delivered mainly through primary institutions, it provides free services to all citizens. The per capita government subsidy has increased from ¥15 in 2009 to ¥99 in 2025. With a focus on key groups such as the elderly, children, and patients with chronic diseases, the program has successfully shifted the primary-level service model from disease-centered to health-centered.

增強簽約服務獲得感。2022年起，中國明確提出簽約服務由全科向專科、基層機構向二、三級醫院、公立機構向社會辦機構、團隊簽約向個人簽約、固定簽約週期向靈活週期、管慢病為主向慢病和傳染病共管等“六個拓展”，穩步提升人群簽約率。針對行動不便、失能失智的老年人等重點人群，提供到府治療、隨訪管理、康復、護理、安寧療護和家庭病床等服務。同時，加快數智家醫平臺建設，實現線上為簽約居民提供簽訂協議。

More Meaningful Family Doctor Contract Services. Since 2022, China has promoted the "Six Expansions" of contract services, for example, expanding from general practice to specialties and from fixed to flexible terms, to increase coverage. For vulnerable groups, such as homebound elderly individuals, services include home visits, rehabilitation, and hospice care. Concurrently, digital family doctor platforms enable online functions such as contract signing.

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：裘潔、張艷春（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: Jie Qiu, Yanchun Zhang (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

【“醫在中國Q&A”系列】

醫在中國Q&A① | 中國醫療衛生服務體系的獨特性是什麼？