The research object of this report is prefecture-level city hospital（including general hospital，hospital of traditional Chinese medicine，hospital of district level，not including provincial capital city，city with separate list）. Among the top 100 hospitals in prefecture-level cities，the proportion of the top 3 and Top 1 hospitals is 100% respectively，and 98% of them are public hospitals. At the overall level of hospitals，this report analyzes medical geographical distribution，competitiveness and distribution. From the perspective of medical geography，Jiangsu and Guangdong maintain the leading position，and the number of institutions listed in the top 100 hospitals in Guangdong has increased for three consecutive years. In terms of competitiveness，jiangsu and Hubei are the provinces with high equilibrium indexes of top 100 and top 300 at the prefecture level，both of which are over 0.9. Twelve of the top 500 provinces have equilibrium indexes of 1，which is the same as 2019. This report mainly analyzes 17 specialties in prefecture-level cities from the perspective of resource allocation and operational efficiency. In terms of human resources，70.59% of the specialties have the ratio index≤0.3∶1. In the light of per capita load，per capita annual discharge rate of surgery was the highest in orthopedics（79%），but per capita discharge rate of medical oncology was the highest（306）. From the point of view of operational efficiency，the compound growth rates of bed utilization rate and per hospitalization cost were 0.73% and 0.70%，respectively，and the average length of stay was -1.70%.