The survey used a cross-sectional study design to survey hospitals in different regions of China. Respondents were all secondary and tertiary hospitals(the detail of hospital classification see in appendix) in the city of Beijing and provinces of Shandong, Guangxi, and Hainan. The selection of hospitals in these four regions is intended to represent a variety of regional economic status. Broadly speaking, Beijing and Shandong are economically well developed, Hainan moderately developed, and Guangxi developing [5] . According to the Hospital Classification Method issued by the National Bureau of Statistics of China, the surveyed hospitals included general hospitals, hospitals of traditional Chinese medicine (TCM), hospitals of integrated traditional Chinese medicine and western medicine (TCM-WM), specialized hospitals, community health center, and medical emergency center (the definition of community health center and medical emergency center see in appendix) [6] . Four hundred secondary and tertiary hospitals were surveyed. The study was approved by the Institutional Review Board (IRB) of the School of Basic Medicine, Peking Union Medical College in Beijing, China.