The traditional Chinese medicine health-care workforce in mainland China: 10-year trend analysis of nationwide data. Issue 1 (October 2019) - Liu, Yue
Abstract: Background: China's most recent and ambitious national health-care system development strategies have explicitly emphasized the importance of strengthening traditional Chinese medicine (TCM) health-care services. This study aims to provide new insights into the current situation and challenges in TCM in China by evaluating 10-year trends in the nationwide TCM health-care workforce in China. Methods: We extracted health-care statistics on the numbers of board-certified TCM and non-TCM physicians and annual population demographic data from the National Health Commission of China and annual population demographic data from the Chinese National Bureau of Statistics. Data covered all of the 31 provincial-level (also known as first-level) administrative divisions in mainland China, except for Hong Kong, Macau, and Taiwan. Findings: From 2007 to 2016, the number of board-certified non-TCM physicians per 10 000 residents increased (from 13·66 to 19·59 nationwide; 15·30 to 21·55 in eastern China; 12·99 to 18·90 in central China; and 12·93 to 17·56 in western China). However, the number of board-certified TCM physicians per 10 000 residents increased from 1·57 to 3·49 nationwide, a growth that outpaced that of physicians of all other specialties. Regional variation was observed, with greater growth in western China (1·35 to 3·93) than in eastern and central China (1·78 to 3·57, and 1·59 to 3·00, respectively). The nationwide number of board-certified TCM physicians working in primary health-care settings per 10 000 residents increased (0·39 to 1·34) with a growth rate that was higher than that of primary health-care physicians of all other specialties together (5·12 to 6·94). Interpretation: Tasks that strengthen the TCM service capacity are a vital component of the ambitious blueprint for Healthy China 2030 and for China's ongoing long-term medical reform. Our findings reveal a continued strong 10-year growth in the ratio of board-certified TCM physicians to residents in both overall and primary health-care systems across all regions of China, indicating potential for substantial improvement in nationwide TCM health-care access. The regional variation in the distribution of the TCM health-care workforce is less than that of other specialties. The TCM primary health-care workforce has been greatly strengthened over the past decade, but the much slower relative increase in non-TCM primary health-care physicians compared with TCM primary health-care physicians merits attention. Funding: None.