Hierarchical diagnosis and treatment system is essential for addressing the problem of 'difficult and expensive medical treatment'. But little research has focused on a sustainable perspective when evaluating the hierarchical diagnosis and treatment system performance. Using data from a total of 69 sample data in Fujian Province from 2018 to 2020 as representativeness, we explore the position of the hierarchical diagnosis and treatment policies, clarify the important restrictive factors presently, to better reflect the main contradictions in the Hierarchical Diagnosis and Treatment System in China. We find that the average value of the implementation performance of Hierarchical Diagnosis and Treatment System was > 0.5, which was at Level III. "Number of new technologies and new projects performed by hospitals and primary health technicians per 100 (B 3 )", "Number of people per 100 health technicians in the hospitals to the primary medical institutions for guidance (B 2 )", "Contracted coverage rate of family doctors (F 3 )" and "Proportion of master’s and doctor’s degrees of hospital health technicians (A6)" are important factors to promote the performance of Hierarchical Diagnosis and Treatment System at this stage. Our results suggest that policy makers need to smooth the communication and interaction channel of professional disciplines and fully play to the role of medical information technology, pay attention to the construction of family doctors and improve the service level of first diagnosis at the primary level, and improve the medical service capacity of the hospitals through supplement high-quality medical personnel.