China expands family doctor contract services and referral systems

China's National Health Commission, National Administration of Traditional Chinese Medicine, and China Center for Disease Control and Prevention have issued a notice to deepen and implement family doctor contract services.

The plan sets specific timelines for physician involvement: by the end of 2026, practitioners in internal medicine, pediatrics, and traditional Chinese medicine at primary institutions should serve as family doctors. By the end of 2027, doctors from secondary and tertiary hospitals stationed at primary institutions for over one year should also participate in these services.

A key component is the advancement of the family doctor first-diagnosis responsibility system. Primary institutions are encouraged to prioritize appointments for contracted residents. The policy also establishes a structured referral system, where family doctors can refer patients to specialists within the same institution or utilize green channels for transfers to higher-level hospitals. Conversely, higher-level hospitals are expected to transfer patients in recovery or rehabilitation phases back to primary institutions for follow-up care.

The scope of services will expand from chronic disease management to include the joint management of infectious diseases. By the end of 2027, infectious disease prevention services should be integrated into the contract offerings. This includes health education, follow-up management, and vaccination services for vulnerable groups such as the elderly, children, and pregnant women.