医在中国Q&A②丨中国医疗卫生服务网如何“铺满”基层？

摘要：过去5年，中国医疗体系迎来深刻变革：中国人均预期寿命达到79岁，基本医保覆盖超13亿人，药品价格显著下降，远程医疗几乎实现县域全覆盖。即日起，中国网开设《医在中国Q＆A》系列问答栏目，聚焦医疗变革背后的制度创新，解读中国在分级诊疗、中医药发展、公共卫生应急等领

【医在中国Q＆A·开栏语】

Healthcare in China Q&A: Opening words

过去5年，中国医疗体系迎来深刻变革：中国人均预期寿命达到79岁，基本医保覆盖超13亿人，药品价格显著下降，远程医疗几乎实现县域全覆盖。即日起，中国网开设《医在中国Q＆A》系列问答栏目，聚焦医疗变革背后的制度创新，解读中国在分级诊疗、中医药发展、公共卫生应急等领域的实践，为全球公共卫生治理提供中国方案。

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.

医在中国Q&A丨中国医疗卫生服务网如何“铺满”基层？

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分钟内能够到达最近的医疗服务点，城乡居民医疗卫生服务全覆盖；医学影像、心电诊断等检查乡镇查完，县级诊断；电子健康档案、电子病历线上流通，远程医疗在家看病……“一般病在市县解决，日常疾病在基层解决”，中国基层医疗卫生服务网正在全面铺就。

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：中国医疗卫生服务网能到多基层？

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

A：截至2024年底，全国基层医疗卫生机构中，乡镇卫生院3.3万个，社区卫生服务中心（站）3.7万个，村卫生室57.1万个，基本实现城乡居民医疗卫生服务全覆盖。2023年全国第七次卫生服务调查显示，90.8%的家庭在15分钟内可以到达最近的医疗点。在新疆、西藏等地也实现卫生机构覆盖。

By the end of 2024, China's primary-level medical and health institutions comprised33,000 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 facilitywithin 15 minutes.Medical and health institutions have achieved full coverage in regions such as Xinjiang and Tibet.

全国2199个县（市、区）开展了县域医共体建设，基本实现县和县级市全覆盖。按照政策要求，每个乡镇卫生院（社区卫生服务中心）至少有一名牵头医院主治医师以上职称人员常年服务。2024年，县域影像、心电、检验等资源共享中心以及中心药房累计提供服务近1.9亿次，更多群众享受到“基层检查、上级诊断、结果互认”的便利。

The county-level medical consortium systemhas 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：如何让基层医疗卫生网真正“强”起来？

Q2: How Is China Strengthening Its Grassroots Healthcare Network?

A：持续推进软硬件设施升级。通过改善基层机构基础环境与设备条件，建设县域医学影像、检验、消毒供应等资源共享中心，实现“乡镇检查、县级诊断、结果互认”，优化群众就医体验。

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.

以数字化赋能基层医疗。建设统一健康信息平台，升级信息系统，扩展远程医疗网络，推广“互联网+医疗健康”服务，让群众就近享受优质医疗服务。推动电子病历、健康档案互联互通，支持处方流转与检查结果跨区域共享，提升资源利用效率。

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.

完善医务人员下沉基层服务制度。实施“县管乡用、乡聘村用”机制，推进大学生乡村医生专项计划。2010年至2023年，基层卫生技术人员数由191.4万增至387.7万，每万人口全科医生数由不足1人增长至3.99人。通过优化考核激励、缩小收入差距、完善医保资金分配机制，引导基层从“被动治病”转向“主动防病”。

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：基层医疗卫生网有哪些实实在在的成效？

Q3: What Tangible Outcomes Has the Grassroots Network Achieved?

A：基本公共卫生服务均等化水平稳步提高。从2009年起，实施基本公共卫生服务项目，由中央和地方财政共同出资，以基层医疗卫生机构为主，为城乡居民免费提供，建立起世界上覆盖人口最多的公共卫生干预项目，成为落实预防为主、保障居民健康的重要制度安排。人均基本公共卫生服务经费补助标准从2009年的15元提高到2025年的99元，重点围绕65岁及以上老年人、0—6岁儿童、孕产妇、高血压及2型糖尿病等慢性病患者等人群提供服务，有效推动了基层卫生服务模式由“以疾病为中心”向“以健康为中心”的转变。

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.

增强签约服务获得感。2022年起，中国明确提出签约服务由全科向专科、基层机构向二、三级医院、公立机构向社会办机构、团队签约向个人签约、固定签约周期向灵活周期、管慢病为主向慢病和传染病共管等“六个拓展”，稳步提升人群签约率。针对行动不便、失能失智的老年人等重点人群，提供上门治疗、随访管理、康复、护理、安宁疗护和家庭病床等服务。同时，加快数智家医平台建设，实现线上为签约居民提供签订协议。

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.

总策划：薛立胜

Executive Producer: Lisheng Xue

策划：蔡晓娟张运兴

Planning Director:Xiaojuan Cai,Yunxing Zhang

统筹：刘佳

Project Coordinator:Jia Liu

供稿：裘洁、张艳春（国家卫生健康委卫生发展研究中心、健康和人口发展战略研究院）

Content Provider:Jie Qiu, Yanchun Zhang(National Center for Health Development Research, NHC)

编辑：刘佳

Editor:Jia Liu

推广：杨岳巍金淳曦刘倩常瑶沈雪

Promotion:Yuewei Yang,ChunxiJin, QianLiu, YaoChang, XueShen