How hospitals in China actually work
Tiers, grades, public vs private, and how to tell a serious hospital from a billboard. Start here.
If you are thinking about getting treated in China, the hospital system is the first thing to understand. It does not work like the US, the UK, or most of Europe. Here is the five-minute version, with the jargon decoded.
The tier system: what "sanjia" means
Every Chinese hospital has an official tier: Tier 3 (三级) for large regional hospitals, Tier 2 (二级) for city and district hospitals, Tier 1 (一级) for community facilities. Within a tier there are grades, A/B/C (甲/乙/丙).
The phrase you will hear constantly is sanjia (三甲) — Tier 3, Grade A. It is the top of the official classification, and for Chinese patients it is shorthand for "a real, full-service hospital."
Scale check: in the government's 2023 performance-monitoring round, 2,168 tertiary public hospitals took part — 1,588 general hospitals and 580 specialty hospitals, with traditional Chinese medicine hospitals counted separately.¹
One important caveat: sanjia is a floor, not a ranking. A sanjia in a provincial capital and a sanjia in Beijing can be very different animals. The government's own data shows this: the median case-mix index (a measure of how complex a hospital's cases are) across tertiary public hospitals was 0.88 in 2023, while hospitals at provincial level and above averaged 1.14.¹ Same badge, harder cases. More on this in our rankings article.
Public vs private: count is not share
Two facts that sound contradictory but are both true:
- By count, most hospitals in China are private. [2024 official figures pending verification]
- By patient volume, public hospitals dominate — the overwhelming majority of care, and almost all complex care, happens in public hospitals. [2024 official figures pending verification]
The reason: most private hospitals are small or single-specialty. The giant teaching hospitals — the ones with the famous surgeons, the rare-disease caseloads, the research programs — are public, and usually attached to a university. When a hospital's name contains "附属" (affiliated), as in "West China Hospital of Sichuan University," that is a university teaching hospital. That word is a quality signal.
There is serious private healthcare in China too — international hospitals, insurer-built hospitals, doctor-founded specialty groups. We cover them in the private healthcare guide.
The kinds of hospitals you will meet
| Type | What it is | Example |
|---|---|---|
| General (综合) | Full-service, all departments | West China Hospital, Chengdu |
| Specialty (专科) | One field, often nation-leading | Fuwai (cardiac), Tiantan (neuro), Jishuitan (orthopedics) |
| Children's (儿童) | Pediatric general hospitals | Beijing Children's Hospital |
| TCM (中医) | Traditional Chinese medicine, state-run tier system of its own | — |
| Military (军队) | Run by the PLA, open to civilians | The 301 Hospital, Beijing |
The military ones surprise foreigners: the PLA General Hospital ("301") in Beijing is one of the country's most respected hospitals and treats ordinary civilian patients.
How to tell a hospital is serious
A quick checklist, in rough order of weight:
- Is it sanjia? Minimum bar for anything complex.
- Is it a university teaching hospital? Look for 附属 in the name.
- How does it score in the national performance exam? The government grades tertiary public hospitals A++ down to C. Hospitals proudly announce good grades. See rankings.
- Is it a national or regional medical center? A state designation that concentrates the hardest cases. See national centers.
- If you want international-standard service: check JCI accreditation — but check whether it covers the whole hospital or only the international department. Our hospital database tags exactly this distinction for 53 hospitals.
- Red flag: heavy online advertising, "miracle cure" language, aggressive follow-up calls. A cluster of ad-driven private hospitals (often called the "Putian system" after the hometown of many founders) has a poor reputation in China. Big public hospitals do not need to advertise.
What this means for you
For anything serious — cancer, cardiac, neuro, transplants — the default answer in China is a large public university hospital or a national specialty center. Private internationals are excellent for comfort, language, and coordination, and many now host top public-hospital surgeons part-time. The trick is knowing which building the medicine you need actually lives in. That is what this site is for.
Sources & verification status
- National Health Commission et al., "关于印发2023年度全国三级公立医院绩效监测分析情况的通报" (国卫医政函〔2025〕55号), March 10, 2025. https://www.gov.cn/zhengce/zhengceku/202503/content_7016208.htm (accessed September 8, 2026). — hospital counts in monitoring, CMI figures.
- China Medical Index hospital database (JCI scope tags): compiled from accreditation listings; official JCI directory re-verification in progress.
- Pending verification: 2024 national totals of public vs private hospital counts and visit shares (National Health Commission statistical bulletin — to be added with exact figures; search-tool outage at time of writing).