Study On Development Strategy For Traditional Chinese Medicine Of Basic Medical Institution In The Backgroud Of Medical Reform

Objectives:On the background of deepening the medical and health system reform, this study is intent to promote the play of Traditional Chinese Medicine (TCM) in basic health institutions. Through the research of development status of TCM, we find out realistic problem of TCM in basic health institutions. Then we use SWOT to deeply analysis influencing factors of TCM development in basic health institutions. We design a system framework and model of extending TCM services in basic health institutions.Methods:(1) Literature:study and review literatures which related to the TCM development in basic health institutions from literature databases and websites of domestic and foreign government health departments.(2) On site survey and analysis:take a combination of typical investigation and sampling survey. The objects of survey include the basic institutions of Jiangbei District, Qianjiang District, Qingyang District, Hongshan district, Qinhuai District, Xiacheng District.(3) Interview:The Interviewees include chief TCM administrators in health bureau, the chief administrators and Chinese medicine doctors in basic health institutions. We want to know the present situation and the problems of TCM development in basic health institutions.(4) Experts consultation:We held two experts consultation conference, to get their advices of TCM development in basic health institution based on their own research and management experience.(5) SWOT analysis:The internal factors and external environment of basic TCM is integrated used. The SWOT analysis is useful to sort out problems, and make a more scientific and comprehensive strategic plan.Results:Through investigation, we found that:(1)Basic TCM resources are weak. The basic TCM resources can't meet the national standard of basic health institutions. The TCM service quantity is seriously shortage. Resource-rich areas are mainly due to institutional restructuring, and Chinese most areas do not have such conditions for TCM development.(2) Characteristic of TCM is not enough. Chinese medicine outpatient ratio did not reach more than 30% of total outpatient in all surveyed districts. Basic health institutions'TCM revenue is mainly from Chinese patent medicine.(3) Basic health institutions just provide very limited TCM service items. Most of surveyed institutions can't meet the national standard, providing at least 5 TCM items.(4) Medical personnel structure is not ideal.46 years or older is accounted to a higher proportion of medical staff,36-45 year old personnel is engaged in the proportion of at least in all age groups. This shows that the succession gap in TCM personnel.(5) TCM does not fully play role of preventive health care. TCM preventive health care is too low proportion.Conclusions:(1) Through literature and on site survey, we found that Chinese health policy always supports TCM, but basic TCM is still lack of resources, manpower. So TCM development strategy in basic health institutions is needed to be further.(2)This paper uses system theory and SWOT to deeply analysis the strength, weakness, opportunities and threats of basic TCM. It proves that basic TCM development is related its own factors, the social environmental factors, the health supply system and traditional Chinese culture. Then we propose different types of strategic plans.(3) we believe that the most important factors is both too low price of basic TCM services and basic institutions' profit trending. The stakeholders would give up providing TCM services; attach no attention to TCM development.Suggestions:This is the study in the context of health reform, so the actual policy proposals starting from the problem of development of TCM, with the work of health reform. The policy recommendations are as follows.(1) The basic institution's compensation and operation mechanism should be changed. The government would cut off the business income ties between institutions and doctors. (2) The government should adjust the pricing of TCM services, to reasonably reflect the labor service value. (3) Local government should attach more attention to TCM and design a system for local TCM. (4) The TCM recourses should be fulfilled in basic health service system. (5) The TCM personnel should be enriched. (6) The government makes the evaluation mechanism for TCM doctors, in which will be attach importance to services. (7)TCM services should be enriched to basic public health services package. (8) TCM services should be enriched to basic medical services package. (9) Basic medical insurance system should be inclined to TCM services. (10) The government should improve other supporting policies for TCM.Innovations and drawbacks of this study:1. Innovations of this study(1) The paper analysis TCM development in touch with health system reform. It be believed in this paper that the most important factor is compensation and operation mechanism for basic institutions.(2) This paper uses system theory and SWOT to deeply analysis the strength, weakness, opportunities and threats of basic TCM. It proves that basic TCM development is related its own factors, the social environmental factors, the health supply system and traditional Chinese culture. Then we propose different types of strategic plans.(3) This paper designs an overall policy strategy for TCM development. There are three dimensions for it, including policy environment for TCM, the operation mode of basic health institutions, TCM service technology in basic health institutions. The recommendation covers the three dimensions.2. Drawbacks of this studyThe study only detailed investigated the primary health care sector. But the demand side of TCM lacked in the surveys. The paper uses the main draw of other studies on the demand side.The paper mainly involves overall strategy of TCM, not enough depth in many ways. Further work on the future of Chinese medicine services will look for specific issues in depth.The study is in the context of health system reform. So the environment of basic health system will be changed soon. There will be many change in the several years. More found will be learned after comparision.