健康发展与政策研究2026，Vol.29Issue(1)：105-112,8.DOI:10.12458/HDPR.202505040
我国分级诊疗体系建设进展、问题与对策研究
Progress,problems,and countermeasures of China's graded diagnosis and treatment system
摘要
Abstract
Objective This study aims to evaluate the progress and effectiveness of China's graded diagnosis and treatment system,investigate existing problems,and explore countermeasures for system improvement.Methods Data from statistical yearbooks,government reports,and relevant literature were comprehensively collected and analyzed.The effectiveness of the system was assessed from four aspects:resource allocation,medical service provision,healthcare-seeking behavior,and vertical collaboration.Results As of 2023,regarding resource allocatation,China had 3.40 practicing(assistant)physicians and 4.00 registered nurses per 1 000 population,while the number of general practitioners reached 3.99 per 10 000 population.Despite these improvements in health workforce capacity,visits to primary healthcare institutions accounted for less than 65%of the total diagnosis and treatment volume and exhibited a declining trend.Correspondingly,fewer than 70%of patients in most regions chose primary healthcare institutions for two-week illness episodes.Nevertheless,the overall medical treatment rate within counties reached 94%,and the contract rate of family doctors exceeded 30%.In terms of vertical integration,more than 18 000 medical consortia had been established nationwide by the end of 2023,and a total of 30.321 7 million two-way referrals were recorded,including 15.559 7 million upward and 14.722 0 million downward referrals.Conclusions Since the implementation of the graded diagnosis and treatment policy,the overall availability of medical resources in China has increased,accompanied by improved downward allocation and a more balanced distribution of high-quality resources.However,challenges remain,such as the relatively low diagnosis and treatment volume and first-visit rate at primary healthcare institutions,as well as the need to enhance vertical collaboration.Future efforts should focus on strengthening the vertical integration of medical institutions and improving the supporting policy system.关键词
分级诊疗/医疗服务体系/建设进展/问题与对策Key words
graded diagnosis and treatment/medical service system/construction progress/problems and countermeasures分类
医药卫生引用本文复制引用
张丙岳,段磊,李阳,段光锋..我国分级诊疗体系建设进展、问题与对策研究[J].健康发展与政策研究,2026,29(1):105-112,8.基金项目
国家社会科学基金项目(22BGL312) （22BGL312）
