Use of Traditional Chinese Medicine in the Hong Kong Special Administrative Region of China

Objective: The role of Traditional Chinese Medicine (TCM) as a part of the Hong Kong health care system was not formally recognized until the handover of the city's sovereignty from the United Kingdom to mainland China in 1997. Population-representative data collected in a Thematic Household Survey (THS) in 2002 provided the first large-scale, cross-sectional study of utilization of TCM after 1997. Materials and Methods: Face-to-face interviews were conducted with 31,762 noninstitutional and institutional residents, a representative sample of Hong Kong's population of 6,504,255. Results: Among all respondents, 3.9% preferred TCM when they experienced medical problems. Of those reporting symptoms of medical problems in the 30 days preceding the THS, 1.8% had utilized TCM regularly in the past 6 months; 8.8% had consulted a TCM practitioner, and 2.7% had used TCM over-the-counter products. The utilization rate of TCM for respondents younger than 14 years was lower in all categories. Among patients who claimed to have medical benefits or insurance policies (N = 12,869), 14.5% were covered for TCM. Logistic regression analysis showed that preference for TCM was higher among women, older persons, and those with lower scores on the General Health Survey Short Form (SF-12), chronic disease, and higher education levels. Being single, institutionalized, and an older patient with a chronic disease were negatively associated with choice for and usage of TCM. Respondents with a higher education level and chronic disease patients were more likely to have insurance coverage for TCM, while those who were older, chronic disease patients, and single persons were least likely to have such coverage. Conclusion: Compared to the pre-1997 studies, the THS of 2002 made three novel findings. First, respondents of higher socioeconomic class emerged as a new class of TCM users. Second, there was a low rate of TCM utilization among institutionalized elderly persons. Lastly, older respondents were less like to be covered by TCM insurance. This paper discusses the issues raised by the THS of 2002 and suggests areas for future research, including a better understanding of TCM accessibility among the elderly and possible financing opportunities for community TCM services.