The analysis of disease spectrum of traditional Chinese medicine of outpatient visitor to the contracted family doctor in Shenzhen community health centers^☆

Abstract

Background: The development plan of traditional Chinese medicine (TCM) has been integrated into the national development strategy, with a focus on significantly enhancing the TCM service capabilities of primary care facilities. However, researches on the disease spectrum of TCM diagnosis and treatment in community health centers is lacking.

Objective: To understand the TCM diagnosis and treatment capabilities of Shenzhen's community health centers by analyzing the disease spectrum of TCM diagnosis and treatment among outpatients signed with family doctors at these centers.

Methods: From May to June 2022, records of family doctor-signed residents who visited the outpatient departments of community health centers in 10 districts of Shenzhen from January 1, 2021, to June 30, 2021, and incurred diagnosis and treatment costs were extracted from the “Hangchuang Community Health Service Center Business System,” a unified information platform of the Shenzhen Health Commission. Records for which TCM was the purpose for the visit, which had corresponding diagnosis and treatment costs, as well as a primary diagnosis coded according to the “Classification and codes of diseases and patterns of traditional Chinese medicine” (TCD) were included in the study (n=385,138). The disease spectrum was analyzed based on the TCD, mainly involving specialty category, sub-specialty system classification and TCM term of disease and pattern.

Results: Among the 385,138 records included, there were 170,077 male visits (44.16 %) with an average age of 37.5 ± 8.2 years; and 215,061 female visits (55.84 %), with an average age of 36.7 ± 9.4 years. The disease spectrum covered all seven specialty categories of TCD: internal medicine (219,445, 56.98 %), pediatrics (79,201, 20.56 %), otorhinolaryngology (47,965, 12.45 %), gynecology (30,620, 7.95 %), surgery (5,797, 1.51 %), orthopedics (1,407, 0.37 %), and ophthalmology (703, 0.18 %). The spectrum covered all sub-specialty system classifications under the seven specialty categories except for tumor diseases, cancer diseases in each specialty category, and certain eye disease classes such as diseases of the canthus, diseases of the cornea, pupil diseases, and traumatic eye diseases. In each specialty category, several diseases accounted for ≥90.00 % of the total diagnostic and treatment volume for that specialty category. The top five system diseases were respiratory system diseases (208,701, 54.19 %), musculoskeletal system diseases (73,369, 19.05 %), gynecological system diseases (30,620, 7.95 %), cardiovascular and cerebrovascular system diseases (27,539, 7.15 %), and digestive system diseases (19,162, 4.98 %). Patients under 15 and those aged 15 to 24 primarily had diseases related to the respiratory system and digestive systems. As age increased, the number of patients with paralysis, dizziness, headache, insomnia, and fatigue gradually increased; before the age of 45, the leading disease was the common cold, and after 45, it was muscle and joint pain caused by paralysis.

Conclusion: The TCM diagnosis and treatment disease spectrum at Shenzhen's community health centers is broad but concentrated and singular, predominantly involving internal medicine. The disease spectrum is mainly concentrated in five major systems: respiratory, musculoskeletal, gynecological, cardiovascular and cerebrovascular, and digestive systems. There is a need to further enhance and expand the TCM diagnosis and treatment capabilities of community health centers to better meet the diverse health needs of residents.

Keywords

Community health services / Traditional chinese medicine diagnosis and treatment / Diagnostic and treatment abilities / Classification and code of diseases and patterns of traditional chinese medicine / Disease spectrum / Contracted family doctor services

Declarations

Not applicable.

Authors' contributions

Conceptualization, Y.Z.; Methodology, K.C. and Z.X.; Data curation, K.C. and Z.X.; Formal analysis, K.C., Z.X. and W.Y.; Funding acquisition, Y.Z., L.C., H.Y. and F.Y.; Project administration, Y.Z., L.C., H.Y. and F.Y.; Resources, not applicable; Supervision, Y.Z.; Validation, G.W.; Writing—original draft, Y.Z.; Writing—review and editing, G.W. All authors have read and agreed to the published version of the manuscript.

Ethics approval and consent to participate

T he study received approval from Shenzhen University Health Science Center (IRB-PN-202,200,020).

Consent for publication

Not applicable.

Availability of data and materials

Not applicable.

Funding

This research was supported by grants from Health Commission of Shenzhen Municipality.

Authors' other information

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Acknowledgements

Not applicable.

References

[1] State Council of the People’s Republic of China. Several opinions of the State Council on supporting and promoting the development of traditional Chinese medicine. (Chinese). [2009-05-07]. Available from: http://www.gov.cn/zwgk/2009-05/07/content_1307145.htm.

[2] National Administration of Traditional Chinese Medicine. “Thirteenth Five-Year ” plan for the development of traditional Chinese medicine. (Chinese). [2018-03-24]. Available from: http://www.satcm.gov.cn/yizhengsi/gongzuodongtai/2018-03-24/2665.html.

[3] National Administration of Traditional Chinese Medicine. “Fourteenth Five-Year ” action plan for improving the service capacity of primary traditional Chinese medicine. (Chinese). [2021-05-07]. Available from: https://www.doc88.com/p-20287121126370.html?r=1.

[4] State Bureau of Technical Supervision. Classification and Code of Traditional Chinese medicine Diseases and syndromes: GB/T 15657-1995. (Chinese). Beijing: Standards Press of China; 1995.

[5] World Health Organization. International Statistical Classification of Diseases and Related Health problems: Tenth revision. (Chinese) . Beijing: People’s Medical Publishing House; 1997.

[6] Ge CH, Zeng ZY, Zeng LS. Analysis on the situation and characteristics of emergency patients in a third-class chinese medicine hospital during COVID-1. (Chinese). JETCM. 2021; 30(11):2044-2048. doi: 10.3969/j.issn.1004-745X.2021.11.045.

[7] Huang BY. Analysis of the spectrum of traditional Chinese medicine diseases in patients discharged from the geriatric rehabilitation department of a hospital from 2018 to 2020. (Chinese). Journal of Traditional Chinese Medicine Management. 2022; 30(1):22-23.

[8] Shi JW, Chi CH, Gong X, et al. Examining health disparities and characteristics in general practice utilization: based on outpatient data from 2014-2018 in Shanghai. BMC Fam Pract. 2020; 21(1):74. doi: 10.1186/s12875-020-01146-5.

[9] Huang YL. Community health centers’ capabilities for outpatient service provision:a study based on real-world diagnostic data. (Chinese). Chinese General Practice. 2021; 24(34):4336-4342 4355. doi: 10.12114/j.issn.1007-9572.2021.00.316.

[10] National Health and Family Planning Commission. National Standards For Basic Public Health Services. 3rd edition; 2017. (Chinese). [2022-12-01]. Available from: http://www.nhc.gov.cn/ewebeditor/uploadfile/2017/04/20170417104506514.pdf.

[11] Ministry of Health of the People’s Republic of China. China Health Statistical Yearbook 2012. Beijing: Peking Union Medical College Press; 2012 (Chinese).

[12] Wong W, Lam CLK, Bian XZ, et al. Morbidity pattern of traditional Chinese medicine primary care in the Hong Kong population. Sci Rep. 2017; 7(1):7513-7523.

[13] Huang QQ, Xu QF, Pang ZM, et al. Construction of the medical service system of traditional chinese medicine in guangdong province during "Thirteenth Five? Year Plan". (Chinese). Med Soc (Berkeley). 2021; 34(6):37-42.

[14] Wu JQ, Jiang LT, Wang AN. Inheritance and innovation of traditional Chinese medicine in primary health care services of Shenzhen City. (Chinese). Chinese Rural Health Service Administration. 2021; 41(9):654-657 670. doi: 10.19955/j.cnki.1005-5916.2021.09.010.

[15] Mi YL, Han HJ, Shi GS. Status of outpatients of changying community health service center of chaoyang district of beijing from 2011 to 2015. (Chinese). Chinese General Practice. 2017; 20(2):196-199 205.

[16] Pan L, He P, Deng FZ, et al. Job Duties of TCM general practitioners in primary medical institutions from chongqing, Yunnan and Guizhou, China. (Chinese). Chinese General Practice. 2019; 22(12):1468-1473.

[17] Yang L, Huang QX, Xu QF, et al. Research on resources of Traditional Chinese Medicine in primary medical and health institutions in Guangdong Province. (Chinese). The Journal of Practical Medicine. 2021; 37(17):2276-2281.

[18] Yue MX, Jia Y. Analysis of the top five key specialist inpatients at the Dongfang Hospital of Beijing University of Chinese Medicine from 2015 to 2019. (Chinese). Int J Traditional Chinese Med. 2021; 43(9):838-841.

[19] Yang HF, Cui ZW, Wang M, et al. Distribution and characteristics of dominant diseases in traditional Chinese medicine in China. (Chinese). J Tradit Chin Med. 2012; 53(4):285-287.

[20] Zhang YN, Lü W, Wang LZ, et al. Cluster Analysis of Hot Spot in Fire Needling Therapy for Skin Sexually Transmitted Diseases and Disease Spectrum Study. (Chinese). Chin J Dermato Venerol Integ Trad W Med. 2019; 18(5):385-390.

[21] Lu YZ, Chen YX, Qian Y, et al. Bibliometric analysis on the clinical researches of tumor treated with acupuncture-moxibustion on the base of PubMed database. (Chinese). Chinese Acupuncture & Moxibustion. 2021; 41(1):111-114.