How China's healthcare system works

China's health system is not one network but three tiers that barely overlap in daily use. At the end of 2025 the country had 1,108,335 medical and health institutions: 38,159 hospitals, 1,056,534 primary-care institutions and 9,262 specialised public-health bodies. Those numbers explain why a Chinese patient can usually walk to a community clinic for a minor illness and be seen the same day, and why an international patient almost never touches the first two tiers at all. Hospitals hold 7.96 million of the country's 10.04 million beds — but more than half of all outpatient visits happen outside them, in village clinics, township health centres and community health centres.

China's hospitals are both, and the split is the opposite of what the hospital count suggests. Of 38,159 hospitals, 26,481 — 69% — are private and 11,678 are public. But private hospitals hold 30.1% of hospital beds, employ a quarter of hospital staff, and see 15.8% of hospital outpatient visits. They take 16% of hospital admissions, run at 64% bed occupancy against 83.7% in public hospitals, and their average patient stays 11.9 days against 8.0 in a public one. Private hospitals in China are, on the whole, small, often specialist, and sometimes very good in their field. The clinical volume of the country runs through public hospitals — and that is the tier an international patient is treated in.

Hospitals are graded on a three-level scale with a letter mark inside the top level. Grade III is the top tier, and 1,975 of China's 4,267 tertiary hospitals hold the highest mark, 3A. Grade II is the middle tier and Grade I the bottom. The grade is awarded by the health authority responsible for the hospital, and it is worth a patient's attention for two reasons. It decides what the hospital is equipped and staffed to do, and it predicts how busy it will be: in 2025 tertiary hospitals ran at 88.3% bed occupancy, secondary hospitals at 72.0% and primary-level hospitals at 50.6%. A tertiary hospital is where the country's concentrated specialist medicine sits; a Grade I hospital is usually a neighbourhood institution with a general department and a scanner.

At the end of 2025 China had 16.12 million health workers, of whom 13.46 million are health technical personnel — the clinical staff. 5.31 million of those are practising (assistant) physicians and 6.06 million are registered nurses. Per head of population that is 3.78 practising (assistant) physicians per 1,000 people, 3.25 practising physicians per 1,000 and 4.32 registered nurses per 1,000; there are 4.91 general practitioners per 10,000 people. The workload figures are the ones an international patient will feel: a doctor in a public hospital carries 7.3 outpatient visits and 2.1 inpatient bed-days a day, and in a tertiary hospital 7.4 visits and 2.1 bed-days.

In 2025 China's medical institutions handled 10.65 billion outpatient visits and 299.1 million admissions. 5.65 billion of those visits — 53% — went to primary-care institutions rather than to hospitals: village clinics, township health centres and community health centres. Hospitals took 4.67 billion visits and 248.1 million admissions, and 164.5 million of the admissions went to tertiary hospitals. That is the shape of the system. Everyday medicine happens close to home, the hospital concentrates on what is serious, and the places where serious medicine is concentrated are the tertiary hospitals in the large cities.

The communiqué reports three outcome measures for the population as a whole: life expectancy reached 79.25 years, infant mortality fell to 3.8 per 1,000 live births and maternal mortality to 13.4 per 100,000. These are averages over 1.4 billion people, and they say nothing about the result of any particular treatment or the standard of care in any one hospital. They are on this page because the question they answer — what the system produces — is a different question from the one a hospital ranking answers, and both are asked.

China spent 9.34 trillion yuan on health in 2025: 6.7% of GDP, and 6,637.9 yuan per person. The government paid 25.2% of it, social insurance funds 47.7%, and patients themselves 27.1%. That last figure is the one to hold on to if you are coming from outside the system. It is the share of national health spending that came straight out of households, and it buys care priced for Chinese incomes and Chinese insurance arrangements. An international patient is not in that pool at all: you are billed at the hospital's own international-department rate, which is a private price and not a national one.

Three things in the official data bear on a decision to be treated in China. One: the volume of serious medicine sits in the public tertiary hospitals, and the international department you deal with is inside one of them. Two: the private sector is large in number and small in substance, so a private hospital's marketing is not evidence of scale. Three: the doctors-per-capita figures are national averages that hide the concentration of specialists in the major cities — which is the same reason the hospitals worth travelling to are concentrated there too.