Rehabilitation medicine has become an integral component of both the Healthy China Initiative and a proactive national strategy in response to population aging. However, China's rehabilitation service system has long been plagued by imbalanced resource allocation, workforce shortages, and inadequate accessibility, with grassroots medical and health institutions being particularly vulnerable. In 2026, the rehabilitation nursing expansion and enhancement project has listed strengthening the grassroots foundation as its core task. Nevertheless, grassroots medical and nursing personnel are chronically overburdened by heavy non⁃medical administrative duties, resulting in severely strained service capacity, and the implementation of newly added rehabilitation services faces considerable practical difficulties. The improvement of primary⁃level rehabilitation service capacity in healthcare institutions should not be regarded as a mere superimposition of service items; rather, it must be predicated on systematic burden reduction, while simultaneously advancing workforce supply expansion, service system optimization, digital and intelligent technology empowerment, and quality evaluation assurance. Only through these integrated measures can a solid foundation be established for a tiered and stratified rehabilitation service framework. This paper systematically reviews the prevailing bottlenecks in primary⁃level rehabilitation services of healthcare institutions, analyzes their structural, mechanistic, institutional, and policy⁃related causes, and proposes a synergistic improvement strategies combining burden reduction and capacity enhancement. 

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