Trends of increase in western medical services in traditional medicine hospitals in china

Background: Compare changes in types of hospital service revenues between traditional Chinese medicine (TCM) hospitals and Western-medicine based general hospitals. Methods: 97 TCM hospitals and 103 general hospitals were surveyed in years of 2000 and 2004. Six types of medical service revenue between the two types of hospitals were compared overtime. The national statistics from 1999 to 2008 were also used as complementary evidence. Results: For TCM hospitals, the percentage of service revenue from Western medicine increased from 44.3% to 47.4% while the percentage of service revenue from TCM declined from 26.4% to 18.8% from 1999 to 2004. Percentages of revenue from laboratory tests and surgical procedures for both types of hospitals increased and the discrepancy between the two types of hospitals was narrowed from 1999 to 2004. For TCM hospitals, revenues from laboratory tests increased from 3.64% to 5.06% and revenues from surgical procedures increased from 3.44% to 7.02%. General hospitals\u27 TCM drug revenue in outpatient care declined insignificantly from 5.26% to 3.87%, while the decline for the TCM hospitals was significant from 19.73% to 13.77%. The national statistics from 1999 to 2008 showed similar trends that the percentage of revenue from Western medicine for TCM hospitals increased from 59.6% in 1999 to 62.2% in 2003 and 66.1% in 2008 while the percentage of revenue from TCM for TCM hospitals decreased from 18.0% in 1999, 15.4% in 2003, and 13.7% in 2008. Conclusion: Western medicine has become a vital revenue source for TCM hospitals in the current Chinese health care environment where government subsidies to health care facilities have significantly declined. Policies need to encourage TCM hospitals to identify their own special and effective services, improve public perception, increase demand, strengthen financial sources, and ultimately make contributions to preserving one of the national treasures

Acupuncture or low frequency infrared treatment for low back pain in Chinese patients: a discrete choice experiment

Acupuncture is a popular but controversial treatment option for low back pain. In China, it is practised as traditional Chinese medicine; other treatment strategies for low back pain are commonly practised as Western medicine. Research on patient preference for low back-pain treatment options has been mainly conducted in Western countries and is limited to a willingness-to-pay approach. A stated-preference, discrete choice experiment was conducted to determine Chinese patient preferences and trade-offs for acupuncture and low frequency infrared treatment in low back pain from September 2011 to August 2012 after approval from the Department of Scientific Research in the study settings. Eight-six adult outpatients who visited the ‘traditional medicine department’ at a traditional Chinese medicine hospital and the ‘rehabilitation department’ at a Western medicine hospital in Guangdong Province of China for chronic low back pain during study period participated in an interview survey. A questionnaire containing 10 scenarios (5 attributes in each scenario) was used to ask participants' preference for acupuncture, low frequency infrared treatment or neither option. Validated responses were analysed using a nested-logit model. The decision on whether to receive a therapy was not associated with the expected utility of receiving therapy, female gender and higher out-of-pocket payment significantly decreased chance to receive treatments. Of the utility of receiving either acupuncture or low frequency infrared treatment, the treatment sensation was the most important attribute as an indicator of treatment efficacy, followed by the maximum efficacy, maintenance duration and onset of efficacy, and the out-of-pocket payment. The willingness-to-pay for acupuncture and low frequency infrared treatment were about $618.6 and$592.4 USD per course respectively, demonstrated patients' demand of pain management. The treatment sensation was regarded as an indicator of treatment efficacy and the most important attribute for choosing acupuncture or low frequency infrared treatment. The high willingness-to-pay demonstrated patients' demand of pain management. However, there may be other factors influencing patients' preference to receive treatments

A Well-Being Approach to Soil Health—Insights from Aotearoa New Zealand

This paper explores the concept of soil health from a human well-being perspective in Aotearoa New Zealand. Globally, soils play an integral role in wider society and the environment by maintaining a large range of ecosystem services and benefits. As populations and resource constraints increase and food production and food security become growing issues globally, there is a recognition of the importance of defining soil condition or soil health for sustaining all ecosystems, including services and benefits to humans, plants, animals, and micro-organisms. While the ecosystem services approach has helped to illuminate the varied services soils provide, an understanding of the complex human–soil relationships and values has been missing. Those seeking to understand and form concepts about soil health have concentrated on the more inherent biochemical, physical and economic (e.g., productivity) aspects of soils, but not on the human, social or cultural dimensions. It is argued in this paper that soils form an integral part of our social and cultural fabric and are fundamentally important to human and societal well-being. The way humans interact with, value and use soil is a critical part of determining the health and sustainability of soil ecosystems. We discuss how a well-being approach can improve understanding of soil health with respect to societal goals and needs. We believe this type of approach, which includes social and cultural dimensions, provides a more diverse and inclusive knowledge base and perspective to better inform the development of integrative policy. This would lead to improved management and decision-making of land resources and soils in Aotearoa New Zealand and globally

Ethnic and Immigrant Differences in Environmental Values and Behaviors

We report results from a decade of nationwide surveys of New Zealand registered voters and an application of the Natural Area Value Scale that identify differences between a limited set of ethnic groups and between people born in New Zealand and immigrants. Ethnicity and birthplace were important determinants of environmental orientations as measured by Natural Area Value Scale factor scores, perceptions of the state of a large number of environmental domains, and engagement in pro-environmental behaviors. Our analysis highlights the importance of including interaction effects between ethnicity, immigrant status, and sociodemographic attributes. Results are consistent across environmental domains and activities, supporting the existence of fundamental interethnic differences in environmental perceptions, orientations, and behaviors