Township hospitals, which are an important link of the Chinese rural healthcare system, were affected by the successive socio-economic reforms since the 1980s. As a consequence, their utilization declined. From longitudinal data covering 9 years (2000-2008) and 24 township hospitals randomly selected in Weifang prefecture (Shandong province, China), this article analyses the environmental and supply-side determinants of township hospitals curative activities, measured by the number of outpatient visits and that of discharged patients. The Hausman-Taylor and the Fixed-Effect Vector Decomposition estimators are employed in order to cope with time-invariant variables. The New Rural Cooperative Medical Scheme, introduced in 2003, allowed increasing the activity of township hospitals even if financial barriers remain to the access to expensive medical services. The analyses underline that referral practices should be reinforced and the size of the township hospitals needs to be adequate as they seem to be over-sized.