ArticleFrontiers in public health2026
A comparative analysis of traditional Chinese medicine health management services in Urban versus rural areas of Chongqing: implications for policy and practice.
Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Traditional Chinese medicine (TCM) health management plays an increasingly important role in China's public health system, particularly in community-based and geriatric care. However, significant disparities between urban and rural areas have emerged during the implementation of related policies. TCM services in many cities face multiple challenges at the grassroots, including a shortage of qualified TCM professionals, uneven distribution of healthcare resources, and low utilization rates of available services. Therefore, a comprehensive evaluation of the urban-rural gap in TCM health management services in Chongqing is essential to strengthen local service capacity and inform policy improvement. Methods: This study, guided by the Donabedian model, developed an evaluation framework for TCM health management services, comprising 19 tertiary indicators across three dimensions: structure, process, and outcome. This model was used to investigate TCM health management services in 10 counties of Chongqing. A total of 566 valid questionnaires were collected, and 30 TCM technicians were recruited to participate in the study. Results: The overall compliance rate of grassroots TCM health management services in Chongqing was low, with a mean score of 46.22 out of 100. Among the 10 sampled districts/counties, only Fuling District scored above 60. Three indicators (service agreement signing, S1; TCM professionals per 1,000 residents, S4; proportion of TCM professionals among service staff, S6) showed marked inter-district disparities, while the remaining nine indicators exhibited moderate variability. Within the Structure indicators, Fuling District (31.52 points) and Chengkou County (27.86 points) achieved top-tier performance, whereas Youyang County (4.11 points) lagged substantially behind the regional average. Among the P indicators, Xiushan County (20.81 points) and Shizhu County (18.07 points) ranked highest, while Nanchuan District (6.10 points) exhibited notable room for improvement. For the O indicators, Fuling District (22.74 points) and Wanzhou District (21.11 points) attained the strongest scores; in contrast, Xiushan County (6.58 points) recorded the lowest performance. Conclusion: To address the current challenges and balance the urban-rural gap in of TCM health management services in Chongqing, a multi-pronged strategy is recommended. This strategy should focus on four core areas: (1) earnestly implement the strategy for cultivating talents in TCM; (2) operationalize a "basic service guarantee that follows population mobility" model to dynamically align service availability with residential and occupational migration patterns; (3) strengthen process management and promote differentiated governance strategies between urban and rural areas; (4) enable districts and counties to make precise efforts to strengthen their strengths and address their weaknesses, thereby building a closed-loop management system with clearly defined rights and responsibilities that precisely matches the core needs of the population.
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