Grassroots medical and health institutions in our country are responsible for providing basic public health services and basic medical services to residents. However, there are still weak service capabilities in grassroots medical care, which cannot truly meet the medical needs of the people. The construction of county-level medical and health sub centers (hereinafter referred to as "sub centers") is an important step for the country to promote the development of grassroots healthcare. The study of whether the medical service capacity has been improved before and after the construction of sub centers has significant practical significance.

To evaluate the medical service capacity of county-level medical and health sub-centers in Sichuan Province, and to provide a reference for continuously promoting the service capacity of sub-centers and primary medical and health institutions.

Taking 135 county-level medical and health sub centers built in Sichuan Province in 2023 as the research object, they were divided into five major regions: Chengdu Plain Economic Zone, South Sichuan Economic Zone, Northeast Sichuan Economic Zone, Panxi Economic Zone, and Northwest Sichuan Ecological Economic Zone. In January 2024, relying on the Sichuan Provincial Health Commission, a survey questionnaire was conducted on each center to obtain the number of beds per thousand population, the number of health technicians per thousand population, the bed utilization rate, the annual number of outpatient and emergency visits, the annual number of traditional Chinese medicine diagnoses and treatments, the annual number of hospitalizations, and the number of common diseases that can be identified and initially treated from 2021 to 2023, in order to evaluate their medical service capabilities. Using TOPSIS and rank-sum ratio (RSR) methods to comprehensively evaluate the changes in medical service capabilities of sub centers from 2021 to 2023, and using multiple stepwise linear regression analysis to identify the influencing factors of medical service capabilities.

The TOPSIS results showed that the C_i values in all regions were the lowest in 2021 and the highest in 2023. Except for the Panxi Economic Zone, there was a significant gap in the ability levels between sub centers within other regions. The RSR results showed that in 2023, the sub center capacity level of Chengdu Plain Economic Zone was the best, followed by the Northeast Sichuan Economic Zone, and the other regions were relatively poor. The results of multiple stepwise regression analysis showed that seven factors, including the number of beds per thousand population, had a positive impact on the evaluation results (P<0.05). Among them, the number of beds per thousand population (B=0.667, t=26.170, P<0.001) and the number of emergency visits (B=0.628, t=21.162, P<0.001) had the most significant impact.

The construction of sub centers has achieved significant results, but there is a significant gap between regions and institutions. Efforts can be made to promote the sustainable development of sub center and grassroots medical service capabilities through reasonable allocation of beds, strengthening talent team construction, and actively guiding grassroots medical treatment.