医在中国Q&A① | 中国医疗卫生服务体系的独特性是什么？ ...

柳晓生

【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 | 中国医疗卫生服务体系的独特性是什么？

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

全国医疗卫生机构遍布城乡，九成以上居民在15分钟内能够到达最近的医疗服务点；全国基本医保参保13.27亿人，基本医疗保险参保率稳定在95％以上；长期护理保险制度参保1.9亿人……织起覆盖14亿人口的庞大“医疗健康网”，中国为什么能做到？“全民健康全覆盖”背后的运行机制是怎样的？

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：中国医疗卫生服务体系的突出特点有哪些？

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

A：坚持中国医疗卫生事业的公益性方向，将人民健康置于优先发展的战略地位。基本医疗保险参保率稳定在95％以上。2024年，全国基本医保参保13.27亿人，长期护理保险制度参保1.9亿人，职工和居民住院费用目录内基金支付比例分别稳定在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.

以政府办医疗机构为主导，医疗、医保、医药协同发展，国家组织药品耗材集中带量采购，心脏支架等高值医用耗材价格大幅下降；创新药械上市审批和纳入医保，让患者用得上、用得起好药。

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.

坚持中西医并重，将中医药深度融入医疗卫生服务体系建设的各个方面。

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：“全民健康覆盖”如何实现？

Q2: How did China achieve universal health coverage?

A：中国建成了世界上规模最大的疾病预防控制体系、医疗服务体系和医疗保障体系，建立健全覆盖中央、省、地市、县四级疾病预防控制体系。

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.

高水平医疗服务“网状式”全覆盖。中国以国家医学中心、区域医疗中心为引领，以省级区域医疗中心为支撑，以地市级医院提质扩能、县级医院提质达标为衔接，以紧密型城市医疗集团、县域医共体和基层医疗卫生机构为基座，以巡回医疗、远程医疗为辅助，形成纵向贯通、区域均衡的高水平医疗服务扩容下沉路径。目前，已设置国家医学中心、国家区域医疗中心和省级医疗中心。2025年底，县域医共体将覆盖90％以上县域，优质医疗资源总量持续增加、布局更为均衡。

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.

就近就便服务明显提升。县域内常见病、多发病就诊率达到90％以上。87％的二级以上公立医院开展了预约诊疗服务，83％的三级公立医院开展了日间手术服务。2024年跨省异地就医医保直接结算突破1亿人次。互联网医院达3756所，全国70％以上的卫生院与上级医院建立了远程医疗协作关系，药品配送到家等服务广泛普及。居民个人卫生支出占卫生总费用的比例持续下降至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.

预防、治疗、康复、护理、临终关怀等服务有效衔接。当前，多学科一体化诊疗服务模式推广到2000多家二级以上医院，5500多家医院建立了“一站式”服务中心。各地积极发展家庭病床、上门护理、社区康复等接续性服务，探索慢病多病同防共治，探索医防协同、医防融合。整合孕前保健、孕期护理、产期监护、儿童保健、儿童预防接种等服务内容，为妇女儿童提供优生优育全程服务。针对老年人、残疾人等特殊群体，推进医养结合、康养结合服务模式，提供集医疗、康复、护理、养老于一体的综合服务。

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.

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：诸宏明、宋大平、江蒙喜（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: Hongming Zhu, Daping Song, Mengxi Jiang (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, Chunxi Jin, Qian Liu, Yao Chang, Xue Shen

翻译：郭峰

Translator：Feng Guo

编审：张艳玲 王月博

Managing Editor：Yanling Zhang, Yuebo Wang

                    【责任编辑：刘佳】