Objective To investigate the hospitalizing intention of residents in Shanghai, and put forward policy suggestion. Methods Three thousand and six hundred residents were selected by random stratified sampling from 2 urban districts, 2 rural-urban fringe districrts and 2 suburban districts. Four hundred outpatients (200 from hospitals and 200 from community health centers) and 200 inpatients (from hospitals) were selected from each district for a questionnaire-based survey, which included basic information of patients, level of preferred hospital and reason for the choice of hospitals. Results A total of 3 244 questionnaires were recovered, with the recovery rate of 90.1%. For outpatients, 56.3% preferred community health centers, and 34.0% superior hospitals. For inpatients, 38.3% preferred community health centers, and 42.9% superior hospitals. For outpatients, 44.8% made the choice for close distance, 31.2% for high-quality medical care, 10.3% for friendly service, and 5.2% for low cost. For inpatients, 49.9% made the choice for high-quality medical care, 27.2% for close distance, and 7.6% for friendly service. Conclusion A new type of medical and health service delivery model should be constructed for residents in Shanghai. Much attention should be paid to the 2-level medical service system of regional medical service center and primary health care institution.