Interprovincial spatial distribution patterns and socioeconomic factors on traditional Chinese medicine (TCM) service utilization in China

The traditional Chinese medicine (TCM) industry in China exhibits significant regional disparities in health service utilization, the underlying reasons for which are yet to be fully explored. This study employs Geodetector models to analyze the factors affecting TCM service utilization, providing the first examination of spatial distribution patterns and influencing factors for both TCM outpatient (TCMOSU) and inpatient services (TCMISU). The findings of this study reveal spatial disparities across China 's provinces, showing a prevalence of TCMOSU in the east and TCMISU decreasing from southwest to northeast. Global Moran 's I autocorrelation analysis revealed a positive spatial correlation between TCMOSU and TCMISU across Chinese provinces, suggesting spatial clustering and the potential for interregional collaboration in the development of TCM services. Local Moran 's I autocorrelation analysis revealed clusters of TCMOSU in wealthier eastern provinces, such as Jiangsu and Tianjin, and clusters of TCMISU in the southwest. Factor detector analysis revealed that disposable income per capita was the most significant factor linking higher incomes with increased TCMOSU. In contrast, TCMISU was primarily influenced by demographic factors, such as the illiteracy rate and population urbanization rate, emphasizing traditional practices in lower education regions. Interaction detector analysis revealed the joint effects of these factors, demonstrating how regional economic status, health status, and healthcare resource indicators interact with other factors for TCMOSU and how demographic factors significantly influence the prevalence of TCMISU. This study highlights the importance of considering health status together with regional economic, demographic, and healthcare resources when formulating TCM healthcare policies and allocating such resources in China. Promoting the balanced and coordinated regional development of TCM services across the country requires the development of strategies that account for these varied regional characteristics.