Several studies have shown that China's CT and MRI inventory, measured per capita, has long been below the OECD median, with a pronounced "high in the east, low in the middle, and even lower in the west" pattern. Equipment allocation is positively correlated with GDP, the number of hospitals, beds, and the number of health workers, suggesting that economic and supply factors are driving the concentration of high-end imaging resources in developed regions. Although the Gini coefficient for CT and MRI declined overall and distribution improved between 2005 and 2013, the concentration index remained positive (≤ 0.30), indicating that relative disparities have persisted. More recent data show that the number of imaging devices per million people has increased rapidly over the past two decades, but regional disparities persist.
Insufficient primary care diagnostic and continuity of care capacity is confirmed by multiple sources of evidence. Based on nationally representative tracking data (2011–2018), the probability of visiting village clinics decreased by 44%, with patients shifting to county-level hospital outpatient clinics (+ 56%) and self-medication (+ 20%), reflecting the dual constraints of primary care accessibility and service capacity/trust. Comprehensive reviews also point to structural issues within the primary care system, such as uneven infrastructure development, declining medical insurance funding, and insufficient incentives. Multi-center measurements in 2025 show that the quality of primary care (PCAT) at primary care facilities remains low, particularly in dimensions such as "community orientation." These evidences collectively point to rising demand for imaging and chronic disease management at the grassroots level, but the supply (including personnel, equipment, and processes) has not kept pace.
Currently, China has entered a period of rapid aging: in 2019, the population aged 60 and above was approximately 254 million; by 2040, it is expected to be approximately 402 million, accounting for approximately 28% of the total population; in 2021, the proportion of people aged 65 and above reached 14.2% and continues to rise. Aging will significantly increase the demand for diagnosis and follow-up related to chronic diseases, rehabilitation, long-term care, and cognitive impairment, placing continuous pressure on the entire medical system.
Relevant literature shows that the application of AI in China's medical field can make up for resource imbalances, improve efficiency and affordability; regulatory authorities have also approved a few AI medical devices, providing a path for clinical implementation. In summary, it is understandable why China needs to increase its investment in AI in the medical and healthcare fields. Against the backdrop of uneven spatial distribution of high-end imaging resources, insufficient grassroots service capabilities, and a surge in demand driven by aging, AI can serve as a "supply-side enhancer": first, imaging AI assists in triage and quality control, alleviating bottlenecks in film reading, shortening waiting times, and reducing misdiagnoses; second, through AI-enabled remote consultations, follow-up, and screening in grassroots scenarios, accessibility and consistency can be improved; third, process and resource optimization (such as intelligent scheduling and predictive capacity management) can improve system efficiency.