Core Viewpoint - The article discusses the evolving role of secondary public hospitals in China's healthcare system, emphasizing their importance in the hierarchical medical service structure and the need for improvement in clinical capabilities and operational efficiency to ensure sustainable development [1][2]. Group 1: Performance and Trends - The performance assessment of secondary public hospitals, known as the "National Examination," has shown significant improvements over the past five years, with increased percentages of minimally invasive surgeries and tertiary surgeries, reaching 15.2% and 41.8% respectively in 2023 [4][5]. - The number of secondary public hospitals participating in the performance assessment has decreased from 5,456 in 2021 to 3,607 in 2023, indicating a trend of hospital transformation and specialization [2][3]. - The average length of hospital stays has decreased to under 9 days, reflecting enhanced operational efficiency [1]. Group 2: Specialization and Transformation - Secondary public hospitals are increasingly focusing on common diseases and minimally invasive techniques, expanding their diagnostic and treatment capabilities [5][6]. - There is a notable shift towards specialization, with many hospitals transforming into rehabilitation, geriatric, or pediatric facilities to better meet local healthcare demands [12][13]. - The trend of "downgrading" or transforming into specialized hospitals is a common strategy among secondary public hospitals to adapt to the changing healthcare landscape [10][11]. Group 3: Regional Disparities - There are significant regional disparities in the capabilities of secondary public hospitals, with eastern regions showing higher performance metrics compared to central and western regions [9][10]. - The article highlights that while some provinces have made rapid advancements, others lag behind, indicating a need for targeted improvements in less developed areas [9]. Group 4: Challenges and Future Directions - Despite improvements, challenges remain, including a shortage of qualified medical personnel, particularly in pediatrics and nursing, which hampers the ability of secondary public hospitals to fully realize their potential [14]. - The article suggests that secondary public hospitals should focus on their unique regional healthcare needs and avoid unnecessary expansion of services that do not align with local demands [11][12]. - Future initiatives from health authorities aim to enhance collaboration between secondary and tertiary hospitals and promote the transformation of some secondary hospitals into rehabilitation facilities [14].

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].