Chronic diseases impose a substantial health and economic burden in China, particularly among its rapidly aging population. Traditional Chinese Medicine (TCM) has been integrated into primary healthcare through national policies and is considered a promising approach for chronic disease management. However, utilization of community-based TCM services among older adults remains limited, and the determinants of service utilization have not been systematically examined within a theoretical framework. Guided by the Andersen Behavioral Model, this study examined factors associated with community-based TCM service utilization among older adults with chronic diseases and quantified their relative importance. A multi-stage stratified random sampling design was applied to survey 1,385 participants from community health service centers in Zhejiang Province and the Guangxi Zhuang Autonomous Region between July and September 2022. Data were collected via structured questionnaires covering TCM service utilization and predisposing, enabling, and need factors. Complex survey logistic regression models were applied to identify factors associated with the utilization of TCM treatment services and public health services, respectively. Overall, the utilization rates of TCM treatment and public health services were 14.2% and 15.7%, respectively. Predisposing factors (education, TCM health literacy, and familiarity with TCM services) and enabling factors (perceived competence of TCM physicians) were consistently positively associated with utilization of both service types (all p < 0.05). Accessibility to community health centers and need factors (particularly chronic disease severity and pain) were positively associated, whereas age (≥ 80 years) was negatively associated with utilization of TCM treatment services. In contrast, no significant associations were observed for public health service utilization. Utilization of TCM services in CHC among older adults with chronic diseases remains low. Predisposing and enabling factors are the main drivers. While need factors significantly predict treatment service use but not public health services. Enhancing health literacy, building provider trust, and adopting service-specific strategies are key.
Gao et al. (Thu,) studied this question.