Analysis Of Traditional Chinese Medical Service Capability Of Medical Institutions And Training Needs Of Medical Staff In A County Of Shandong Province

BackgroundTraditional Chinese medicine is my country’s traditional medicine.It has precise curative effects,low prices,and flexible treatment methods.At the same time,it can provide integrated medical and health services of "prevention,medical treatment,health care,and rehabilitation".It plays an important role in my country’s basic medical and health service system.Under the vigorous promotion of national policies,my country’s traditional Chinese medicine medical service capacity has gradually increased,but there are still some weak links.Especially in primary medical institutions,the proportion of TCM diagnosis and treatment services has shown a downward trend in recent years.Therefore,it is necessary to explore the existing problems of TCM medical services and improve TCM service capabilities.A certain county in Shandong Province is an "National Advanced Unit for Grassroots Traditional Chinese Medicine Work" with a good foundation in Chinese medicine.Using it as a sample to conduct research can understand the current situation and needs of the county’s TCM medical service capabilities,and propose countermeasures for further improving the TCM medical service capabilities.ObjectiveThis study investigates the status quo of TCM medical service capabilities of medical institutions and medical staff at all levels in Q County,understands the current problems and training needs,and analyzes the reasons,so as to provide development suggestions for further improving the TCM medical service capabilities of Q County.MethodsThe research data mainly comes from literature analysis,policy documents,China Health Statistics Yearbook,and field survey data conducted in Q County.On-site surveys include questionnaire surveys and semi-structured interviews of medical institutions,medical staff,and institutional managers.The surveyed institutions included 1 county hospital of traditional Chinese medicine,14 township hospitals,and 30 village clinics.A total of 39 institutional questionnaires.249 questionnaires for doctors,and 138 questionnaires for nursing staff were collected.Descriptive analysis uses statistics such as mean,median,rate,and composition ratio to describe.Use χ2 test.U test,H test,etc.for statistical inference.For the relationship between medical staffs TCM service ability and training and other factors,Spearman correlation was used for correlation analysis,and multiple linear regression was used for regression analysis.Data sorting and analysis are mainly done using Excel 2016 and SPSS25 software.Results(1)TCM equipment configuration:The TCM equipment of Q County Hospital of Traditional Chinese Medicine can meet the current medical needs,but the overall scale of the hospital is too small.The county has only 3.86 TCM hospital beds per 10,000 population,which does not meet the policy requirement of 6.0 per 10,000 population.Each township health center is equipped with Chinese herbal medicine pieces and more than 6 kinds of Chinese medicine equipment,including acupuncture and cupping equipment.followed by electroacupuncture(92.86%),TDP therapy(85.71%),and moxibustion(71.43%).However,relatively expensive large-scale traditional Chinese medicine equipment such as traction equipment and traditional Chinese medicine fumigation equipment are less equipped.The village clinic is also equipped with basic Chinese medicine equipment,but the utilization rate of some equipment is not high.(2)Situation of Chinese medicine doctors:There are 32 Chinese medicine practitioners(assistant)doctors in Q County Hospital of Chinese Medicine,accounting for 39.51%of all practicing doctors,which is lower than the 60%requirement for county-level Chinese medicine hospitals in the policy document.There are 125 TCM practitioners in the county,and there are 2.01 TCM practitioners per 10.000 population,which is lower than the average level of 4.69 people per 10,000 population in Shandong Province in 2019.In terms of personnel structure,there is a significant gap between county hospitals of traditional Chinese medicine and primary medical institutions.TCM practitioners in the County Hospital of Traditional Chinese Medicine accounted for 62.5%of the total bachelor degree,and more than 90%of the primary-level TCM doctors had a specialist degree or below.66.67%of the TCM practitioners in the village clinics are all over 50 years old,there are almost no young doctors.and there is a gap in the age echelon.In terms of remuneration and work intensity,the income of traditional Chinese medicine doctors decreases progressively from county to village(H=21.74,P<0.001),and the number of working days per week increases progressively(H=55.13,P<0.001).(3)TCM service capabilities of medical staff:TCM doctors in county hospitals of TCM have a higher level of mastery of various TCM techniques than those in primary medical institutions(H=7.30,P=0.026),and village clinic doctors master TCM techniques.The type is lower than other medical institutions(χ2=314.68.P<0.001).The proportion and the degree of mastery of various TCM appropriate techniques in county hospitals of TCM are also higher than that of township hospitals(χ2=12.09.P=0.002;U=112.00,P<0.001).From the perspective of influencing factors,education and training quality are the influencing factors of TCM service ability of doctors(β=0.137,P=0.004;β=0.189,P=0.042),while training quality is the influencing factor of TCM service ability of nurses(β=0.466,P=0.001).(4)Current status and needs of TCM training for medical staff:From the perspective of TCM training,village clinic TCM doctors participate in TCM training more(χ2=46.691,P<0.001),but the satisfaction with training is the lowest.The frequency and satisfaction of nurses in township hospitals in participating in TCM training were significantly lower than those in county TCM hospitals(χ2=59.17,P<0.001;χ2=13.06,P=0.001).At present,the quality of TCM training for the grassroots is not high,and the formalization is serious,and it is difficult to meet the needs of grassroots medical staff to improve their service capabilities.Doctors and nurses believe that it is necessary to train in traditional Chinese medicine.Doctors hope to be able to learn techniques such as acupoint injection,filiform needles,acupotomy,three-sided acupuncture,and pediatric massage.Nursing staff are trained in techniques such as cupping,moxibustion,acupoint massage,warm acupuncture and moxibustion.The demand is higher.Conclusions and SuggestionsAt present,the total number of TCM personnel in Q County is insufficient,and the allocation structure is unreasonable.Basic-level doctors have low salaries and it is difficult to effectively guide the sinking of talents.Basic-level TCM practitioners are generally older,less educated,and not proficient in various TCM techniques.The frequency of TCM training in Q County is low,and the training content and training methods do not meet the needs of TCM practitioners to improve their abilities.Although medical institutions at all levels are equipped with basic TCM diagnosis and treatment equipment,some of the existing equipment is not fully utilized.Based on the above conclusions,this research suggests that we should continue to increase financial investment in traditional Chinese medicine services,pay attention to the construction of traditional Chinese medicine talents,establish and improve the continuing education system of traditional Chinese medicine personnel,and effectively improve the ability of medical staff in traditional Chinese medicine services.