Objective To explore the overall situation and development trend of the hierarchical diagnosis,to provide reference for further research direction.Methods Following databases,such as CBM,CNKI,Wanfang Database and VIP,were used to search for publications on this topic from the establishment of database to September 30th,2016.Bibliometric method was used to analyze these literatures,for instance periodical distribution,years,authors and regions;key words were taken into consideration.Results 243 literatures in total were included,the a number of publication is keep increasing every year.These papers were published in 91 kinds of journals,43.2 ％ of which were statis tical source journals.There were 221 first authors from 149 institutions distributed in 26 provinces and municipalities.There were only 18 core authors.The active regions of research were Beijing,Hubei,Sichuan and Shanghai.The research content mainly focused on two-way referral,utilization of medical service and medical insurance.Conclusions The quality of papers is low,research authors are widely distributed,the research strength is not strong enough.The research should be strengthened in extent and depth to transform the research outcomes to guide the actual practice.