患者小病在社区、大病去三甲，二级公立医院如何突破“夹缝”

Core Viewpoint - The transformation of secondary public hospitals into specialized institutions such as rehabilitation and pediatric hospitals is a key direction for their development, addressing the challenges of patient distribution and operational efficiency [1][11]. Group 1: Performance and Trends - The performance assessment of secondary public hospitals has shown significant improvements over the past five years, with enhanced operational mechanisms and increased patient satisfaction [1]. - In 2023, the proportion of minimally invasive surgeries and tertiary surgeries among discharged patients reached 15.2% and 41.8%, respectively, marking a year-on-year increase [3][6]. - The number of secondary public hospitals participating in performance monitoring decreased to 3,607 in 2023, down from 3,633 in 2022, indicating a trend of hospital reduction [2][12]. Group 2: Specialization and Transformation - Many secondary public hospitals are transitioning from comprehensive services to specialized care, focusing on common diseases and enhancing their clinical capabilities [1][11]. - The shift towards specialized hospitals is supported by government policies aimed at promoting nursing and rehabilitation services, as well as addressing the needs of aging populations [11][12]. - The average length of hospital stays has decreased to under 9 days, reflecting improved operational efficiency [1]. Group 3: Regional Disparities - There are significant regional disparities in the capabilities of secondary public hospitals, with hospitals in Eastern and Central China showing stronger performance compared to those in Western regions [8][10]. - The CMI (Case Mix Index) and the proportion of tertiary surgeries exhibit a decreasing trend from East to West, highlighting the uneven distribution of healthcare resources [8]. Group 4: Challenges and Future Directions - Despite improvements, secondary public hospitals face challenges such as talent shortages, particularly in pediatrics and nursing, which may hinder their ability to specialize effectively [12][13]. - The government emphasizes the need for better integration of healthcare services and the extension of quality medical resources to secondary public hospitals [13].