Chung Vincent, Wong Eric, Woo Jean, Lo Sui Vi, Griffiths Sian
School of Public Health, Chinese University of Hong Kong, Hong Kong, China.
J Altern Complement Med. 2007 Apr;13(3):361-7. doi: 10.1089/acm.2006.6152.
The role of Traditional Chinese Medicine (TCM) as a part of the Hong Kong health care system was not formally recognized until the handover of the city's sovereignty from the United Kingdom to mainland China in 1997. Population-representative data collected in a Thematic Household Survey (THS) in 2002 provided the first large-scale, cross-sectional study of utilization of TCM after 1997.
Face-to-face interviews were conducted with 31,762 noninstitutional and institutional residents, a representative sample of Hong Kong's population of 6,504,255.
Among all respondents, 3.9% preferred TCM when they experienced medical problems. Of those reporting symptoms of medical problems in the 30 days preceding the THS, 1.8% had utilized TCM regularly in the past 6 months; 8.8% had consulted a TCM practitioner, and 2.7% had used TCM over-the-counter products. The utilization rate of TCM for respondents younger than 14 years was lower in all categories. Among patients who claimed to have medical benefits or insurance policies (N = 12,869), 14.5% were covered for TCM. Logistic regression analysis showed that preference for TCM was higher among women, older persons, and those with lower scores on the General Health Survey Short Form (SF-12), chronic disease, and higher education levels. Being single, institutionalized, and an older patient with a chronic disease were negatively associated with choice for and usage of TCM. Respondents with a higher education level and chronic disease patients were more likely to have insurance coverage for TCM, while those who were older, chronic disease patients, and single persons were least likely to have such coverage.
Compared to the pre-1997 studies, the THS of 2002 made three novel findings. First, respondents of higher socioeconomic class emerged as a new class of TCM users. Second, there was a low rate of TCM utilization among institutionalized elderly persons. Lastly, older respondents were less like to be covered by TCM insurance. This paper discusses the issues raised by the THS of 2002 and suggests areas for future research, including a better understanding of TCM accessibility among the elderly and possible financing opportunities for community TCM services.
直到1997年香港从英国回归中国主权交接时,中医药作为香港医疗保健系统一部分的作用才得到正式认可。2002年主题性住户统计调查(THS)收集的具有人口代表性的数据提供了1997年后首次大规模的中医药使用情况横断面研究。
对31762名非机构和机构居民进行了面对面访谈,这些居民是香港6504255人口的代表性样本。
在所有受访者中,3.9%在遇到医疗问题时更喜欢选择中医药。在主题性住户统计调查前30天报告有医疗问题症状的人中,1.8%在过去6个月中经常使用中医药;8.8%咨询过中医师,2.7%使用过非处方中药产品。14岁以下受访者在所有类别中的中医药使用率都较低。在声称拥有医疗福利或保险政策的患者中(N = 12869),14.5%的人中医药费用可报销。逻辑回归分析表明,女性、老年人以及在一般健康调查简表(SF - 12)中得分较低、患有慢性病且受教育程度较高的人对中医药的偏好较高。单身、住在机构里以及患有慢性病的老年患者与选择和使用中医药呈负相关。受教育程度较高的受访者和慢性病患者更有可能获得中医药保险,而老年人、慢性病患者和单身人士最不可能获得此类保险。
与1997年前的研究相比,2002年的主题性住户统计调查有三个新发现。第一,社会经济阶层较高的受访者成为一类新的中医药使用者。第二,住在机构里的老年人中医药使用率较低。最后,年龄较大的受访者不太可能获得中医药保险。本文讨论了2002年主题性住户统计调查提出的问题,并提出了未来研究的领域,包括更好地了解老年人获得中医药服务的情况以及社区中医药服务可能的筹资机会。