Classification of Chinese hospitals

Within the health system, the Classification of Chinese hospitals is a 3-tier system according to the Ministry of Health of the People's Republic of China.^[1] Hospitals are classified in a system that recognizes a hospital's ability to provide medical care, medical education, and conduct medical research. Hospitals are designated as Primary, Secondary or Tertiary hospitals.^[2][3][4][5]

1. A primary hospital is typically a township hospital that contains less than 100 beds. They are tasked with providing preventive care, minimal health care and rehabilitation services – i.e. primary care. A primary hospital is similar to community hospitals in the West.
2. A secondary hospital is one that tend to be affiliated with a medium size city, county or district and contain more than 100 beds, but less than 500. They are responsible for providing comprehensive health services, as well as medical education and conducting research on a regional basis. A secondary hospital is similar to a regional hospital or district hospital in the West.
3. A tertiary hospital is a comprehensive, referral, general hospitals at the city, provincial or national level with a bed capacity exceeding 500. They are responsible for providing specialist health services, perform a bigger role with regard to medical education and scientific research and they serve as medical hubs providing care to multiple regions. The tertiary hospital is similar to a Tertiary referral hospital in the West.

Further, based on the level of service provision, size, medical technology, medical equipment, and management and medical quality, these 3 grades are further subdivided into 3 subsidiary levels: A, B and C (甲[jiǎ], 乙[yǐ], 丙[bǐng]). This results in a total of 9 levels. In addition, one special level, 3AAA (三级特等), is reserved for the most specialized hospitals, though no hospitals have yet been placed in this level.^[2] This system is hence referred to in Chinese as 三级十等 (sānjí shíděng), 3 Grades and 10 levels.

In 2015, the Ministry of Health's National Health and Family Planning Commission, used the terms community hospital and top level hospital in describing hospital planning.^[6]

History

A three-level classification of healthcare is present during the Mao era. The first level consisted of neighborhood, workplace, and village clinics; the second level was city district and village health centers; the final level was city and town-level hospitals.^[7]

The current classification took shape in November 1989.^[8] There was a long pause on hospital classification between 1998 and 2008, when a new guideline was produced. Hospital classification was officially restarted in 2010.^[9]

See also

• Medicine in China
• List of hospitals in China
• Public hospital § India

References

1. Guo ZH: Hospital Management. 1990, Beijing, People's Health Publishing House
2. Li, Xingming; Huang, Jianshi; Zhang, Hui (2008). "An analysis of hospital preparedness capacity for public health emergency in four regions of China: Beijing, Shandong, Guangxi, and Hainan". BMC Public Health. 8: 319. doi:10.1186/1471-2458-8-319. PMC 2567325. PMID 18803860.
3. Zhang, W.; Deng, Z.; Evans, R.; Xiang, F.; Ye, Q.; Zeng, R. (August 9, 2018). "Social Media Landscape of the Tertiary Referral Hospitals in China: Observational Descriptive Study". J Med Internet Res. 20 (8): e249. doi:10.2196/jmir.9607. PMC 6107732. PMID 30093370.
4. China's National Health and Family Planning Commission; China Health Statistical Yearbook, 2008
5. "Yunnan Public Health Insurance Information Service: Medicare FAQs". Archived from the original on April 25, 2012. Retrieved October 11, 2011.,
6. "China sets up new system to optimize medical resources". China Daily. September 16, 2015.
7. "医改进程（上）：曾经的全额公费医疗，为什么现在消失了？" [Process of Healthcare reform, part I: the free healthcare of old, why is it gone now?]. 中国网--网上中国. 2011. Archived from the original on 2022-01-27. 计划经济时期的医院全部由政府管控，建立了我们现在较为熟知的三级医院结构，即城镇由市、区两级医院和街道、厂矿门诊组成的三级医疗服务及卫生防疫体系；农村以县医院为龙头、以乡（镇）卫生院为枢纽、以村卫生室为基础的三级医疗预防保健网络。所有的医疗设备、医务人员均由国家统一分配管理。
8. Chinese minister of Health (November 1989). "s:cn:医院分级管理办法（试行草案） [Rules for classifying hospitals]"
9. 刘庭芳 (September 2019). "我国医疗机构评审的制度变迁与路径选择". 中国卫生质量管理. 第18卷 (第5期). Archived from the original on 2018-11-01. Retrieved 2018-11-01.