Purpose:　Hierarchical　diagnosis　and　treatment,　as　an　important　measure　and　direction　for　China＇s　medical　reform,　are　conducive　to　improving　the　capacity　of　medical　services　and　the　national　level　of　health.　In　this　study,　a　hierarchical　diagnosis　and　treatment　performance　evaluation　index　system　is　established　to　identify　the　effects　of　different　influencing　factors　on　developing　hierarchical　diagnosis　and　treatment.　Methods:　In　this　study,　samples　collected　from　23　representative　integrated　medical　institutions　in　nine　Fujian　cities　from　2018　to　2020　are　taken　as　subjects.　A　hierarchical　diagnosis　and　treatment　performance　appraisal　system　is　established　based　on　the　mechanism　of　research　on　the　operation　of　hierarchical　diagnosis　and　treatment.　This　is　combined　with　the　evaluation　index　system　established　by　the　Health　Development　Research　Center,　the　National　Health　Commission　of　the　People＇s　Republic　of　China　for　the　evaluation　of　hierarchical　diagnosis　and　treatment　and　the　construction　of　the　medical　treatment　alliance,　including　studies　carried　out　by　related　scholars.　The　weight　of　each　evaluation　index　is　determined　with　the　CRITIC　method,　and　the　hierarchical　diagnosis　and　treatment　effects　on　23　subjects　are　quantitatively　evaluated　by　the　Gray　correlation　method　based　on　the　weight　of　each　index.　Results:　The　hierarchical　diagnosis　and　treatment　performance　evaluation　index　system　is　established　from　three　aspects,　namely　allocation　of　hierarchical　diagnosis　and　treatment　resources,　establishment　of　the　hierarchical　diagnosis　and　treatment　management　system,　and　hierarchical　diagnosis　and　treatment　implementation　effect;　27　tertiary　indexes　are　formed　in　total.　The　Gray　correlation　of　each　year　in　Fujian　exceeds　0.5,　but　＜0.53.　Conclusion:　Gray　correlation　of　each　year　in　Fujian　has　gradually　increased.　But　there　is　still　room　for　improvement.　The　government　departments　must　improve　the　investment　in　medical　resources　with　measures　adjusted　according　to　local　conditions,　promote　a　balanced　allocation　of　resources　for　hierarchical　diagnosis　and　treatment,　increase　communication　and　interaction　between　upper　and　lower　medical　institutions,　and　optimize　the　allocation　of　resources　for　hierarchical　diagnosis　and　treatment.　Then　determine　the　types　of　disease　to　be　treated,　expand　the　coverage　of　chronic　disease　management,　establish　standardized　chronic　disease　health　management,　and　strengthen　training　of　health　management　staff.　Copyright　©　2023　Wu,　Zhao　and　Xie.