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Development of an Evaluation Framework for the Integration of Clinical and Preventive Medicine in Traditional Chinese
Wan-Hua Lu1,2, Pimporn Thongmuang1, Sarisak Soontornchai1
1Public Health Program, Graduate School, Suan Sunandha Rajabhat University, Bangkok, Thailand.
Background:
China healthcare system has undergone significant reforms in recent years. Promoting the integration of treatment and prevention, strengthening collaboration between medical institutions and preventive services, and consolidating medical and preventive resources have become key priorities in the healthcare sector. Traditional Chinese Medicine (TCM) offers distinct advantages in disease prevention, health maintenance and rehabilitation. Systematically incorporating TCM into the healthcare and prevention system can help extend and enhance the continuum of care, thereby improving overall service effectiveness. However, there remains a lack of a standardized and scientifically rigorous evaluation framework to comprehensively assess the actual impact of TCM within integrated healthcare and prevention practices.
Objective:
To establish a scientifically grounded evaluation framework for the integration of clinical and preventive medicine within Traditional Chinese Medicine (TCM), thereby supporting the enhancement of TCM's capacity and quality in healthcare delivery and disease prevention.
Methods:
From September 2024 to January 2025, an initial pool of indicators was developed based on policy analysis, literature review, and expert interviews. Between February and April 2025, a two-round Delphi expert consultation was carried out to finalise the indicator system. The Analytic Hierarchy Process (AHP) was then used to determine both individual and combined weights for all indicators.
Results:
A total of 19 experts participated in both rounds of the Delphi consultation. After two rounds of correspondence, the evaluation index system includes 6 first-level indicators, 17 s-level indicators and 57 third-level indicators. The expert authority coefficients for these rounds were 0.90 and 0.91, respectively, indicating a high level of expertise among the participating experts. Additionally, the Kendall's W of each index are, respectively, was 0.23 and 0.82 (p < 0.05). The consistency test was conducted using the AHP for all judgement matrices, with a consistency ratio (CR) for all levels of indicators < 0.10, indicating good consistency in the weight settings. The weights assigned to the first-level indicators were as follows: Resource Integration (0.3512), Technological Integration (0.2704), Service Integration (0.2146), Institutional Integration (0.0681), System Integration (0.0541) and Standardization Integration (0.0416). Together, Resource Integration and Technological Integration accounted for over 60% of the total weight. Among the second-level indicators, notable weights included TCM Information Platform (0.1476), Integrated TCM-Western Medicine Clinical Collaboration (0.1803) and Financial Resources for TCM (0.0943).
Conclusion:
This study developed a dedicated evaluation index system for Traditional Chinese Medicine (TCM) within the context of medical-preventive integration, filling an important gap in standardized assessment tools. The framework highlights the crucial role of resource allocation and technological collaboration in the integration process. It offers a practical framework for comprehensively assessing the integration of clinical and preventive medicine in Traditional Chinese Medicine and enhancing medical services quality.
