Abstract
Background Traditional, complementary, and alternative medicine (TCAM) has attracted increasing attention in developed countries, but its mainstream status in China, the home of TCAM, is unclear. Over the period of 2004–2016, we analyze the health resources and health resource utilization of traditional medicine in traditional Chinese medicine (TCM) hospitals in China. Methods Over 2004–2016, we obtained data from all TCM hospitals in all Chinese provinces to create a hospital-based, longitudinal dataset. TCM health resources and their utilization were measured by two outcome variables: (1) primary outcome variables comprising the proportion of TCM physicians, TCM pharmacists, revenue from TCM drugs, and TCM prescriptions and (2) the secondary outcome variables, as proxies of westernization for TCM hospitals, comprising the number of medical equipment above RMB 10,000 and the proportion of surgery in inpatient visits. We used linear regression models with hospital-fixed effects to analyze time trends for the outcome variables. Results The number of public TCM hospitals remained stable from 2004 to 2016, while the number of private TCM hospitals increased from 294 in 2004 to 1560 in 2016. There was a small percentage increase in the proportion of TCM physicians (0.280%), TCM pharmacists (0.298%), and revenue from Chinese medicines (0.331%) and TCM prescriptions (1.613%) per hospital per year. Chinese drugs accounted for less than a half of the total drug prescriptions, and accordingly, just one-third of the drug revenue was from Chinese medicines at TCM hospitals. The proportions of physicians, pharmacists, revenue from Chinese drug sales, and traditional medicine prescriptions never reach the 60% benchmark target for mainstream in TCM hospitals. As proxies for Western medicine practices in TCM hospitals, the number of medical equipment above RMB 10,000 rapidly rose by over 13 percent per hospital per year, but the proportion of inpatient surgeries declined by 0.830 percentage points per hospital per year, reflecting a mixed trend in the use of Western medicine practices. Conclusion For the 2004–2016 period, traditional medicine, although making progress towards the mainstream benchmark of 60% TCM services, was still not mainstream at TCM hospitals.
Highlights
Traditional, complementary, and alternative medicine (TCAM) has attracted increasing attention in developed countries, but its mainstream status in China, the home of TCAM, is unclear
Based on data from over 3000 traditional Chinese medicine (TCM) hospitals during 2004–2016 (43,890 hospital-years), this longitudinal study analyzes the trends in TCM health resources and their utilization in China
TCM physicians accounted for 45.1% of all physicians, and TCM pharmacists accounted for 51.7% of the total pharmacists per hospital per year in TCM hospitals from 2004 to 2016. e average proportion of revenue from Chinese medicines in all drug revenue was 33.8%, and the mean proportion of TCM prescriptions in all prescriptions was 46.6%. e average number of medical equipment above RMB 10,000 was significantly smaller in private (19.5) than public (114.1) hospitals, and Chinese drug revenue and traditional medicine prescriptions formed a significantly larger share of all revenue and prescriptions in private compared to public hospitals. e average percentage of inpatients undergoing surgery was 21.8%
Summary
Traditional, complementary, and alternative medicine (TCAM) has attracted increasing attention in developed countries, but its mainstream status in China, the home of TCAM, is unclear. Over the period of 2004–2016, we analyze the health resources and health resource utilization of traditional medicine in traditional Chinese medicine (TCM) hospitals in China. Ere was a small percentage increase in the proportion of TCM physicians (0.280%), TCM pharmacists (0.298%), and revenue from Chinese medicines (0.331%) and TCM prescriptions (1.613%) per hospital per year. E proportions of physicians, pharmacists, revenue from Chinese drug sales, and traditional medicine prescriptions never reach the 60% benchmark target for mainstream in TCM hospitals. As a part of this growing trend, traditional Chinese medicine (TCM), which is one of the oldest alternative healing options around the world [10], has gained increased application in Western societies [11]. From 1991 to 2004, the percentage of people consulting TCM doctors in the formal health sectors declined from 25% to 20% in urban China and from 14% to 16% in rural China [14]
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