Spatial-temporal distribution and associated factors of traditional Chinese medicine utilization among middle-aged and elderly patients with chronic diseases in China: focusing on the development of traditional Chinese medicine hospitals

Currently, the development of traditional Chinese medicine (TCM) is strongly supported by the Chinese government and has garnered widespread attention across various sectors of society. The development of TCM is viewed as a crucial means to enhance China’s health service capacity and promote Chinese culture. Policy support makes it necessary to pay attention to the vertical development of the use of TCM. The differences in regional culture and health system development are associated with differences in the use of TCM in horizontal regions. Therefore, this study aims to explore the factors influencing the utilization rate of TCM among middle-aged and elderly patients with chronic diseases from spatial and temporal perspectives. This study analyzed follow-up data from the first four waves of the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2011, 2013, 2015, and 2018. The spatial and temporal distribution characteristics of TCM utilization rates were examined using spatial correlation analysis. Geographically and temporally weighted regression models were employed in multiple regression analyses to investigate the factors influencing TCM utilization rates. Overall, the utilization rate of TCM among middle-aged and elderly patients with chronic diseases in China showed an upward trend. The cold spot areas of utilization rates are primarily located in the southeastern coastal provinces. GDP and the prevalence of chronic diseases negatively associated with the utilization rate, whereas the prevalence of multiple chronic diseases and financial allocation to TCM institutions per capita were positively associated with higher utilization rates. Most of the relevant health resources of TCM hospitals were not significantly positively associated with TCM utilization rates. The Chinese government should continue to support and focus on the development of TCM. Relevant departments should adopt appropriate measures to scientifically promote TCM services to enhance public trust. Policy strategies should prioritize demand enhancement rather than solely focusing on supply expansion. TCM hospitals need to return the focus of development to TCM related projects.