title: Age, chronic non-communicable disease and choice of traditional Chinese and western medicine outpatient services in a Chinese population.
abstract: BACKGROUND
  In 1997 Hong Kong reunified with China and the development of traditional Chinese medicine (TCM) started with this change in national identity. However, the two latest discussion papers on Hong Kong's healthcare reform have failed to mention the role of TCM in primary healthcare, despite TCM's public popularity and its potential in tackling the chronic non-communicable disease (NCD) challenge in the ageing population. This study aims to describe the interrelationship between age, non-communicable disease (NCD) status, and the choice of TCM and western medicine (WM) services in the Hong Kong population.
  
  
  METHODS
  This study is a secondary analysis of the Thematic Household Survey (THS) 2005 dataset. The THS is a Hong Kong population representative face to face survey was conducted by the Hong Kong Administrative Region Government of China. A random sample of respondents aged >15 years were invited to report their use of TCM and WM in the past year, together with other health and demographic information. A total of 33,263 persons were interviewed (response rate 79.2%).
  
  
  RESULTS
  Amongst those who received outpatient services in the past year (n = 18,087), 80.23% only visited WM doctors, 3.17% consulted TCM practitioners solely, and 16.60% used both type of services (double consulters). Compared to those who only consulted WM doctor, multinomial logistic regression showed that double consulters were more likely to be older, female, NCD patients, and have higher socioeconomic backgrounds. Further analysis showed that the association between age and double consulting was curvilinear (inverted U shaped) regardless of NCD status. Middle aged (45-60 years) NCD patients, and the NCD free "young old" group (60-75 years) were most likely to double consult. On the other hand, the relationship between age and use of TCM as an alternative to WM was linear regardless of NCD status. The NCD free segment of the population was more inclined to use TCM alone as they become older.
  
  
  CONCLUSIONS
  In Hong Kong, most patients have chosen WM provided in the public sector as their sole outpatient service provider for NCD. Amongst TCM service users, middle aged NCD patients are more likely to choose both TCM and WM outpatient services. Meanwhile, older people without NCD are more likely to use TCM as their main form of care, but the size of this population group is small. These utilization patterns show that patients choose both modalities to manage their NCD and TCM should be considered within policies for supporting patients with NCD under the wider primary health and social care system that supports patient choice.
authors.affiliation: School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong SAR, PR China. vchung@cuhk.edu.hk
authors.forename: Vincent Ch
authors.initials: VCh
authors.lastname: Chung
authors.forename: Chun Hong
authors.initials: CH
authors.lastname: Lau
authors.forename: Eng Kiong
authors.initials: EK
authors.lastname: Yeoh
authors.forename: Sian Meryl
authors.initials: SM
authors.lastname: Griffiths
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D002755:Choice Behavior; D002908:Chronic Disease / Q000628:therapy*; D003469:Culture; D005260:Female; D006299:Health Services for the Aged / Q000706:statistics & numerical data*; D006723:Hong Kong; D006801:Humans; D008297:Male; D008516:Medicine, Chinese Traditional / Q000706:statistics & numerical data*; D008875:Middle Aged; D017150:Public Sector; D012044:Regression Analysis; D012111:Residence Characteristics; D055815:Young Adult