Core Viewpoint - The healthcare reform in Jinzhai County has significantly improved local medical services, reducing patient outflow and enhancing access to healthcare for residents [1][3]. Group 1: Healthcare Reform Implementation - Jinzhai County has transitioned from a situation where one-third of patients sought treatment outside the county to a model where healthcare is accessible at their doorstep [1]. - The county became a pilot for a tightly-knit county medical community in 2019, restructuring its medical system to facilitate better patient care and resource allocation [5]. Group 2: Patient Experience Improvement - A local resident, Hu Detian, previously faced high costs and long travel for dialysis, but now pays only 10 yuan per session due to the establishment of a blood dialysis center at the local health clinic [3]. - The local health clinic has expanded its capabilities to perform over 20 secondary surgeries, a significant improvement from its previous limitations [5]. Group 3: Expert Resource Allocation - Jinzhai County has implemented a policy to reimburse costs for surgeries and consultations with external experts, resulting in 90% of patients receiving care within the county [7]. - From 2019 to 2024, over 3,000 expert visits were facilitated at the county hospital, enhancing the quality of care available locally [7]. Group 4: Financial Health of the Medical System - The county's healthcare system has transformed from a deficit of nearly 80 million yuan before reforms to a surplus of 33.16 million yuan by the end of 2024 [7].

Core Insights - The article highlights the significant improvement in the medical service capabilities of county hospitals in China, with over 63% achieving tertiary hospital standards by the end of 2024 [2] - The implementation of county medical community systems has led to increased accessibility and efficiency in healthcare services, benefiting local populations [8][9] Group 1: County Hospital Capabilities - As of the end of 2024, 1,309 out of 2,059 evaluated county hospitals have reached tertiary hospital capabilities, representing 63.57% [2] - The proportion of county hospitals achieving secondary hospital capabilities has risen to 93.35% [2] - Over 98% of county hospitals can manage common diseases such as respiratory, digestive, cardiovascular, and pediatric conditions [2] Group 2: County Medical Community System - The county medical community system has resulted in a 10% decrease in outpatient and inpatient volumes at leading county hospitals, while grassroots diagnosis and treatment volumes have increased by 20% [8] - The system allows for a tiered referral model, with county hospitals dispatching experts to support grassroots medical institutions [6] Group 3: Financial Management and Cost Reduction - The use of surplus medical insurance funds in Jinzhai County has allowed for the hiring of external experts, reducing patient travel and keeping funds within the county [9][10] - Jinzhai County's hospital has invited 3,585 expert visits over four years, transforming a previous deficit of nearly 80 million into a surplus of 33.16 million [10] Group 4: Emergency Medical Services - The establishment of five major emergency centers in Renxiu County has improved the treatment of critical conditions, with the mortality rate for heart attacks dropping from 10% to 3.1% [15] - The county has invested 196 million yuan in infrastructure to enhance emergency medical capabilities [15] Group 5: Challenges in Grassroots Healthcare - Despite the increase in the number of grassroots medical institutions from 882,000 in 2009 to 1,040,000 in 2024 (a 17.9% increase), the proportion of diagnoses at these institutions has decreased from 61.8% to 51.7% [16][18] - Factors contributing to this decline include a lack of professional talent and outdated equipment in some grassroots facilities [18] Group 6: Community Health Services in Urban Areas - In Shenzhen, the establishment of community health service centers has facilitated the transfer of quality medical resources to grassroots levels [19] - Community health service centers offer various traditional Chinese medicine services and have extended their operating hours to accommodate urban workers [24]