Pergamon 0277-9536(95)00429-7 Soc. Sci. Med. Vol. 43, No. 9, pp. 1329-1348, 1996 Copyright© 1996Elsevier ScienceLtd Printed in Great Britain.All rightsreserved 0277-9536/96 $15.00 + 0.00 THE PRACTICE OF CHINESE MEDICINE IN TAIWAN CHUNHUEI CHI, I JWO-LEUN LEE, 2 JIM-SHOUNG LAI, 2 CHIU-YIN CHEN, 2 SHU-KUEI CHANG 2 and SHIH-CHIEN CHEN 2 ~Department of Public Health, Waldo Hall 317, Oregon State University, Corvallis, OR 97331-6406, U.S.A. and :Department of Public Health, China Medical College, 91 Shue-Sbe Rd, Taichung, Taiwan Abstract--This paper examines the practice of Chinese medicine in Taiwan. Using a national sample survey of Chinese medicine physicians, supplemented by another national survey of Chinese medicine hospitals and government records, the authors study the education and training background of Chinese medicine physicians, their mode of practice, their productivity measured by patient visits, and the practice characteristics of Chinese medicine hospitals. Moreover, the authors investigate the relationship between the resource input, the public health insurance contract, and the number of patient visits Chinese medicine physicians provided. Results of this study are used to make several recommendations on the appropriate way of integrating the practice of Chinese medicine into the modern health care system. Many of these recommendations may also be applicable to other countries that are contemplating integrating traditional or alternative medicine into their health care systems. Copyright © 1996 Elsevier Science Ltd Key words---Chinese medicine, traditional medicine, traditional medicine providers, production of health care services, Zaiwan INTRODUCTION Traditional medicine provision, as an alternative source of health care, is vibrant around the world. Despite the modern Western medicine's challenge and subsequent dominance in most health care systems since the turn of the century, Chinese medicine, like many other traditional medicines, is alive and well. In East Asian countries, such as Taiwan, China, Hong Kong, Singapore, and Malaysia, providers of Chinese medicine play a significant role in providing health care services. Furthermore, some forms of Chinese medicine, such as acupuncture, are also practiced in many industrialized countries like Japan, the U.K., Canada, and the U.S., just to name a few. Besides practitioners of Chinese medicine, dispensaries of Chinese medicine also flourish in most East Asian countries. In countries like Malaysia, Singapore, and Taiwan, the Chinese medicine dispensaries out- number practitioners [1-3]. The steady and active role of Chinese medicine in these countries' health care systems was sustained long before the World Health Organization, together with its member nations, formally promoted integrat- ing traditional medicine into national health care systems in the Thirtieth World Health Assembly in 1977 [4]. Moreover, the sustained role of Chinese medicine in these countries is even more intriguing when one is aware of the restrictions, disregard, and, in some cases, repression that Chinese medicine practitioners have to endure and adapt to. The vitality of Chinese medicine suggests that there is a significant demand from the public that has nurtured the stable supply of providers to practice in an adverse environment. Inquiry into the dynamics between the practitioners and their environment motivated this paper. From this motivation we identified two objectives of this paper. The first objective is the exploration of how Chinese medicine is being practiced in Taiwan. For this purpose we shall examine how Chinese medicine practitioners are trained and licensed, and the mode of their practices. In addition, we examined several characteristics of Chinese medicine hospitals. Findings from this investigation will help us better understand the role that Chinese medicine prac- titioners and hospitals are playing in a modern health care system like Taiwan's. A second objective of this study is to investigate the process of producing health care services by Chinese medicine practitioners. For this purpose we shall look into the input and output of Chinese medicine practitioners' services, and develop an analytical model to study such relation- ships. Findings from this analysis may provide insight into the production of Chinese medicine health care services, which will have significant implications on health policy related to resource allocation and reimbursement. Also, understanding of the input and production process of Chinese medicine services can help the National Health Insurance agency to develop and refine a reasonable reimbursement mechanism and rates that are compatible to those of modern Western medicine. Furthermore, findings from this study may provide a model for studying the practice of traditional medicine in other societies. 1329