Referral between hospitals in China: what English reports on national policy documents say

A report on the gov.cn English site, updated November 29, 2024, says the National Health Commission has stressed the need to consolidate the hierarchical diagnosis and treatment system in a circular.

The hierarchical system in the circular

The report says the system entails the first diagnosis at the grassroots level hospitals, the introduction of a two-way referral system, the separate treatment of acute and chronic diseases, and coordination between primary and tertiary hospitals.

The report says that, according to the circular, by the end of 2025, a smooth two-way referral system should be established within "compact medical alliances", such as urban medical groups and county medical communities.

The report says that by 2027, a smooth referral system for transferring patients between medical institutions within the province-level region will be established.

Who arranges a referral inside a hospital

The report says that under the hierarchical diagnosis and treatment system, the attending physician responsible for the initial consultation should decide whether there is a need for referral based on an assessment of the patient's condition and the medical institution's treatment capabilities.

The report says that once a referral is deemed necessary, the physician should contact the department responsible for referrals to assist in transferring patients to other departments within the medical institution or to other hospitals.

The report says Jiao Yahui, director of the medical administration department of the National Health Commission, said at a news conference that it is the job of the department in the medical institution responsible for referrals to facilitate the process, instead of leaving patients to handle it themselves.

The report says patients who need specialized diagnosis and treatment or require comprehensive medical capabilities, such as pediatric patients, patients diagnosed with cancer and complex or rare diseases, should be referred to tertiary hospitals, the most advanced hospitals in China's three-tier hospital system, or specialized hospitals.

The report says that for patients who need rehabilitation or care after the acute phase, the referral center of the tertiary hospital can coordinate with primary medical institutions in the same medical alliance to facilitate transferal.

Family doctors and referral

A report on the National Health Commission English site, updated 2026-08-26, says a circular outlines measures to further deepen and expand family doctor contract services.

The report says the circular calls for the orderly advancement of a family doctor first-contact responsibility system, under which contracted residents will be given priority access to consultations with their designated family doctors at primary healthcare institutions.

The report says that if a patient's condition exceeds the professional scope of a family doctor, the doctor should, with the patient's consent, first refer the patient to another specialist within the same institution.

The report says that when referral to a higher-level hospital is necessary, family doctors should make use of reserved appointment slots, hospital beds and fast-track referral channels available through closely integrated medical alliances to ensure timely treatment.

Referral procedures between tiers

A report on the National Health Commission English site, updated 2026-04-10, says a document released by the General Office of the State Council calls for streamlining referral procedures between different tiers of hospitals.

The report says secondary hospitals are expected to enhance their capacity to treat common diseases and serve as a bridge between community clinics and tertiary hospitals, which will focus on acute and complex conditions.

The report says national and provincial medical centers will target diseases with high regional mortality rates and high outbound referral rates, aiming to improve overall treatment capacity and reduce cross-regional patient visits.

Questions people ask

Who should facilitate a referral inside a hospital?

The gov.cn report says Jiao Yahui, director of the medical administration department of the National Health Commission, said at a news conference that it is the job of the department in the medical institution responsible for referrals to facilitate the process, instead of leaving patients to handle it themselves.

What does the circular say about referral within medical alliances?

The gov.cn report says that, according to the National Health Commission circular, by the end of 2025, a smooth two-way referral system should be established within "compact medical alliances", such as urban medical groups and county medical communities.

What does the family doctor report say about referral to a higher-level hospital?

The National Health Commission site report on family doctor services says that when referral to a higher-level hospital is necessary, family doctors should make use of reserved appointment slots, hospital beds and fast-track referral channels available through closely integrated medical alliances to ensure timely treatment.

Sources

Each source above was read on the date shown. This page is an unofficial summary of general administrative information. It is not published by the bodies named above, and it is not medical advice. If it differs from the official pages, the official pages prevail, and rules may change after the check date.