Traditional Mongolian, Traditional Chinese, and Western Medicine Hospitals: System Review and Patient Survey on Expectations and Perceptions of Quality of Healthcare in Inner Mongolia, China

Table 1

Comparison of the TMM health system with TCM and WM health systems in Inner Mongolia based on the six building blocks framework.

Building block	Details	Traditional Mongolian medicine	Traditional Chinese medicine	Western medicine	References
History	Inherited by or introduced in Inner Mongolia	Inherited by Mongolia between the 13th and 16th centuries.	Originated in China about 3,000 years ago.	Introduced into China and Inner Mongolia in the early 19th century.	[12–16]
	Establishment of the first hospital	1940s	1900s	1830s	[12, 14, 15]
	Year of establishment of the first faculty (start of undergraduate program)	1958	1958	1956	[12, 17–19]
	Regulations	“Regulation of TMM and TCM in Inner Mongolia”, the first local laws and regulations about traditional medicine came in 2001. The new version came in 2010.	“Regulation of TCM of People’s Republic of China” came in 2003.	Drug Administration Law of China in 2008.; Regulations of Medical Institutions in 2005.; Regulations of Medical Accidents in 2008.	[14, 20, 21]
Service delivery	Percentage of hospitals providing this kind of medical service in 2015	16%	19%	74%
	Number of beds in 2015	15,649	14,146	84,280
	Level of coverage	Partial. In some areas, township and village levels are covered by neither TMM nor TCM		Complete (all levels)
	Number of outpatients in 2015 (million)	7.6	6.3	34
	Number of inpatients in 2015 (million)	0.3	0.3	2.1
	Clinical department	Modern medical science department classification; some TMM hospitals have a special clinical section, such as TMM therapy section.			[22]
	Language in service	Chinese or Mongolian	Chinese	Chinese	[23]
	Diagnostic and treatment process	Requires a deep communication with patients.		Accurate diagnosis by using advanced medical equipment and laboratory tests.	[24, 25]
	Acceptance by people	Generally accepted by most minority groups, 25% of Han people never used or never heard of TMM.	Accepted by most people but seen as a supplement of WM.	Accepted by most people as the main health service provider.	[26–28]
Health workforce	Health workforce in 2015 (thousand)	17	15	101
	Workforce per thousand population in 2015	0.7	0.6	4.05
	Educational model	(i) University only.; (a) 5-year Bachelor.; (b) 3-year Master or standardized training; (ii) Alternative apprentice training		(i) University only.; (a) 5-year Bachelor; (b) 3-year Master or standardized training.	[24, 29, 30]
	Number of schools	2	2	4	[31–34]
	Number of undergraduate students per year	500	500	1200	[17–19, 31–34]
	Pass rate of National Practicing Physician Qualifications Test	60%	60%	62%	[35]
Health information system	Information for planning, monitoring, and evaluation	By Health and Family Planning Commission and TCM and TMM Administration.		By Health and Family Planning Commission and Public Hospital Reform Office.	[36]
	Health information system outside the National Health Information System	Under the support and guidance of Health and Family Planning Commission; TMM and TCM information systems, including a unified translation standards of minority languages.		Under the support and guidance of Health and Family Planning Commission and Public Hospital Reform Office.	[36, 37]
	Library system	Library of Inner Mongolia University; National network.		National and international medical network of electronic link.	[36, 37]
Medical products and technologies	Number of medicaments used in China	More than 2,200 kinds, in which 1,342 are regularly used.	More than 2,500 kinds, including twelve large varieties of prescriptions and preparations.	More than 2,740 medical products normally used.	[22, 38]
	Evaluation of medicine	Good effect on many kinds of diseases, preeminent performance on orthopedics.	Becoming more prominent in the growing challenge of noncommunicable diseases. Slow in action but more thorough in “curing the root of the problem” with few side effects.	Good at diagnosis and treatment, especially for serious or urgent diseases, considered to be “more powerful and quick” but may cause significant side effects.	[22, 26, 39]
	Standardization	In 1986, 322 medicaments were put in the Medicine Standard of Inner Mongolia but only 57 in 1998.	Already had medicaments standard in China. Three medicaments were approved by the FDA to undergo further clinical trials before 2016.	FDA approved more than 10,000 drugs.	[12, 40–42]
	Market value (RMB)	Small market share with 3 billion yuan in 2010.	400 billion yuan in 2005 across the whole country.	More than 2,000 billion yuan in 2015 across the whole country.	[22, 43, 44]
Financing and sustainability	Total revenue in 2015 (million RMB)	4.8	3.6	30.2
	Government subsidy (%)	27.5	24.7	13.7
	Staff cost paid by the government (%)	100	80	0	[22]
	Proportion of reimbursement from health insurance from basic level to high level	Varies from 80%-30%		Varies from 60%-20%	[22, 45]
	Number of items listed in the Medicare Insurance Reimbursement Catalog 2017	88	1,238	1,297	[46]
Leadership/; governance	Administrative department of Health and Family Planning of Inner Mongolia	TMM and TCM Administrations were set up in the provincial and municipal levels from 2007.		Medical Reform Office; Public Hospital Reform Office.	[22]
	Items of autonomy of the Inner Mongolia Autonomous Region Government	Establish the standard for TMM drugs, technology, and hospitals. Establish and negotiate health insurance reimbursement catalog.	Province-specific health insurance reimbursement catalog.		[21]
	Research promotion priority	Biomedical	Biomedical	Clinical and Public Health, Public Hospital Reform	[22]

Calculated from Health Information Reporting System of Inner Mongolia in 2015.
See Table 3.
WM: Western medicine; TCM: Traditional Chinese medicine; TMM: Traditional Mongolian medicine; TM: Traditional medicine;
IMMU: Inner Mongolia Medical University; FDA: Food and Drug Administration