Zhang Jiarui, Zhou Sheng, Feng Yujie, Liu Huaijin, Li Chengcheng
School of Public Health and Management, Guangzhou University of Chinese Medicine, Guangzhou, 511495, The People's Republic of China.
Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong, China.
Sci Rep. 2025 May 25;15(1):18224. doi: 10.1038/s41598-025-02615-6.
The uneven distribution of human resources for health (HRH) in China, particularly within the realm of traditional Chinese medicine (TCM), has long posed a significant challenge. Although prior studies have examined regional disparities in overall HRH, limited research has specifically addressed the spatial and temporal dynamics of HRH in TCM and their underlying determinants. This study employs a multiscale geographically weighted regression (MGWR) model to explore the spatial and temporal dynamics of HRH in TCM across 31 Chinese provinces from 2008 to 2021. MGWR allows each explanatory variable to operate at its optimal spatial scale, capturing localized patterns of spatial heterogeneity. The results reveal that although HRH in TCM has generally increased over time, substantial disparities persist, with eastern and central regions exhibiting a higher degree of resource agglomeration while western regions continue to lag behind. Economic factors such as wage income, the number of TCM institutions, and education funding emerge as the most significant and spatially heterogeneous determinants. These localized effects suggest that region-specific policy interventions are needed-such as financial incentives and infrastructure support for underserved western regions, and institutional integration and quality standardization in eastern areas-reflecting the differentiated roles and development contexts of TCM across regions. By leveraging the advantages of MGWR in capturing multiscale spatial patterns, this study provides empirical evidence to support more targeted and sustainable planning for HRH in TCM development. Enhancing the accessibility of TCM services not only addresses current regional imbalances but also strengthens the healthcare system's capacity to respond to the needs of an aging population and future public health emergencies. The findings offer valuable insights for policymakers aiming to improve health equity in China and may inform similar efforts in other countries facing spatial disparities in traditional medicine resources.
中国卫生人力资源（HRH）分布不均，尤其是在中医药（TCM）领域，长期以来构成了重大挑战。尽管先前的研究考察了整体卫生人力资源的区域差异，但针对中医药卫生人力资源的时空动态及其潜在决定因素的研究有限。本研究采用多尺度地理加权回归（MGWR）模型，探讨2008年至2021年中国31个省份中医药卫生人力资源的时空动态。MGWR允许每个解释变量在其最优空间尺度上运行，捕捉空间异质性的局部模式。结果显示，尽管中医药卫生人力资源总体上随时间有所增加，但仍存在巨大差异，东部和中部地区资源集聚程度较高，而西部地区仍落后。工资收入、中医药机构数量和教育经费等经济因素是最显著且空间异质的决定因素。这些局部效应表明，需要针对不同地区制定政策干预措施，比如对服务不足的西部地区提供财政激励和基础设施支持，在东部地区进行机构整合和质量标准化，这反映了中医药在不同地区的不同作用和发展背景。通过利用MGWR在捕捉多尺度空间模式方面的优势，本研究提供了实证证据，以支持中医药发展中更具针对性和可持续性的卫生人力资源规划。提高中医药服务的可及性不仅能解决当前的区域不平衡问题，还能增强医疗系统应对人口老龄化需求和未来突发公共卫生事件的能力。这些发现为旨在改善中国卫生公平性的政策制定者提供了有价值的见解，并可能为其他面临传统医学资源空间差异的国家的类似努力提供参考。
