The independent legal entity reform of emergency medical centers in China: opportunities and challenges

By the end of July 2024, Beijing has completed the administrative approval process to establish all district-level emergency medical centers as independent legal entities 1 , marking a significant milestone in China’s ongoing reform of prehospital emergency medical services. By mid-2025, all of district-level emergency medical centers had completed the necessary administrative procedures and begun operating as independent legal entities. Beijing’s approach offers a valuable model for other regions in China. According to the China Health Statistical Yearbook , there were 345 major emergency centers in 2015, which increased to 526 by 2021 2 , reflecting a 52.5% growth over six years. This expansion demonstrates China’s ongoing commitment to strengthening the accessibility and responsiveness of prehospital care. While the reform aims to improve the management and service quality of emergency medical services, it also presents new challenges for ensuring long-term sustainability and maintaining high safety standards in service delivery. We analyze the advantages and disadvantages of the independent legal entity reform and examines its broader implications for other regions in China, along with considerations for future reforms.