Core Viewpoint - County-level hospitals play a crucial role in the integration of urban and rural healthcare, with over 60% of evaluated county hospitals reaching the level of tertiary hospitals, but there are still gaps in achieving the goal of "major illnesses not leaving the county" [1][4]. Group 1: Current Status of County Hospitals - In the past year, the average number of surgical services performed by each county hospital has decreased, despite an increase in the number of patients referred [1][4]. - The evaluation by the National Health Commission indicates that while the specialized departments and equipment in county hospitals are improving, there are still significant weaknesses, particularly in mental health and other specialized services [1][4][14]. - Approximately 42.40% of county hospitals have not performed basic standard-required surgeries, such as tracheal foreign body removal, and 71.15% cannot manage severe mental disorders [13][14]. Group 2: Evaluation Results - In 2024, 2059 county hospitals were evaluated, with a coverage rate of 98.93%. About 93.35% met the basic standards, and 63.57% met the recommended standards, showing an increase from 2023 [4][5]. - The average number of clinical pathways per county hospital increased to 152, indicating a strengthening of treatment capabilities for common diseases [6]. - The average annual revenue for each county hospital was approximately 354 million yuan, with medical service income rising to 33.59% of total medical income [9]. Group 3: Challenges and Recommendations - There is a phenomenon of "virtual obesity" in some county hospitals, where the service capacity does not match the number of beds, leading to a need for focused investment in specialized departments [2][11]. - The National Health Commission emphasizes the need to strengthen weak specialty construction and improve the treatment capabilities for common and local diseases [14]. - The issue of urban hospitals attracting patients from county hospitals remains a challenge, with a decrease in the proportion of surgical cases in county hospitals [11][13].

在此次评估中，2024年参评医院有2059家，县域覆盖率98.93%。根据国家卫健委2016年印发的县医院医疗服务能力基本标准和推荐标准，有近两千家 （1922家）符合基本标准，占比93.35％，有超一千三百家（1309家）符合推荐标准，占比63.57%，符合基本和推荐标准的县医院分别较2023年度增加28 家、146家。 2024年，全国县医院出院患者手术占比和平均每家县医院开展手术例数均较上一年减少 县级医院是统筹城乡医疗卫生发展的关键纽带，在县域医疗中起到龙头作用。根据国家卫健委最新统计，在过去的一年里，全国超六成、1300余家参评县医 院达到三级医院水平，平均每家县医院接受双向转诊人次较2023年涨超10％。 但距离"大病不出县"的目标仍有差距。当年，平均每家县医院开展的手术类医疗服务的数量出现下降。与此同时，全科医疗科、肿瘤科、精神科等13个专业 科室在县医院的设置率低于80%，超四成县医院的精神科、血液内科、病理科和胸外科的医疗服务能力没有达到二级医院能力水平，超七成县医院不能开展 严重精神障碍患者的规范管理和住院治疗。 国家卫健委19日发布的"关于通报2024年度县医院医疗服务能力评估情况的函" ...