Zhongguo quanke yixue (Jun 2024)
Discussion on the Current Situation and Development Path of Primary TCM Health Service System in China
Abstract
Background Primary traditional Chinese medicine (TCM) health service has been attracting continuously improving attention. However, primary TCM health service system still has problems, which have constrained the development of TCM in China. Objective To analyze the current situation of primary TCM health service system in China and explore the strategies to continuously improve the capacity of primary TCM health service. Methods In December 2022, data were retrieved from the China Health Statistics Yearbook, National Statistics of Traditional Chinese Medicine, the official websites of the National Bureau of Disease Control and Prevention and the National Center for Cardiovascular Diseases. The index system was constructed from the three levels of health input, service output and health needs, and the combination of rank-sum ratio method and the WHO health system performance module framework was used to comprehensively evaluate the current situation of primary TCM health service. Results In terms of health input, from 2017 to 2021, the number of primary healthcare institutions providing TCM health services except for township health centers has increased, and the number of TCM clinical departments beds in community health service centers (stations), township health centers, and outpatient clinics has shown an increasing trend, but the proportion of TCM clinical departments beds in outpatient clinics to the total number of outpatient departments has decreased; the proportion of TCM practicing (assistant) physicians in community health service centers (stations), township health centers and clinics has increased significantly, while the proportion of TCM practicing (assistant) physicians in village clinics remained stable, and the proportion of TCM practicing (assistant) physicians in outpatient clinics decreased by years; in the past five years, the absolute value of financial input for primary healthcare institutions has steadily increased, while the financial allocation for TCM organizations has fluctuatingly decreased. In terms of service output, from 2017 to 2021, the proportion of TCM consultations to the total consultations in various institutions has steadily increased according to a certain increase (except for TCM outpatient clinics), while the proportion of TCM consultations in village clinics alone has always remained above 30.0%; in addition to township health centers, the per capita burden of consultations of TCM practicing (assistant) physicians in other primary healthcare institutions was generally on a downward trend. The comprehensive evaluation found that 2017, 2018 and 2021 were in a suitable state of resource allocation, while 2019 and 2020 were in an unbalanced state of resource allocation. Conclusion At present, the construction of primary TCM health service system in China has been effectively implemented, but there are still some problems in the process of orderly promotion. Problems such as insufficient resources for primary TCM, unbalanced service and utilization, insufficient advantages of TCM, imperfect personnel training mechanism and low financial input have constrained the development TCM. In order to promote the continuous improvement of the health service capacity of primary TCM health service institutions, it is necessary to consolidate the functions of government, further promote TCM culture, establish incentive mechanism to optimize the training mode of talents, strengthen the close integration of TCM health services with health insurance policies, and build a TCM medical association supported by "information integration".
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