A Study on the Effects of the Current Regulatory Model on Both Supply and Demand Sides of Traditional Chinese Medicine Record-filing Clinics in a City of Jiangsu Province.

• 1、School of Public Health, Suzhou Medical College of Soochow University
• 2、Suzhou Center for Disease Control and Prevention,Suzhou Health Inspection Agency

Abstract：Objective This paper takes the SPO model as its analytical framework and approaches the issue from two angles-regulatory authorities and clinic practitioners. The aim is to assess how well the regulatory system is functioning in relation to record-filing TCM clinics in a prefecture-level city of Jiangsu Province, what the current state of practice looks like, and what the main problems are and how they have been shifting over time. Methods A questionnaire survey was administered across all 10 health inspection agencies in the city, along with 152 record-filing TCM clinics. For data analysis, we drew on chi-square tests, Spearman\'s rank correlation, and a modified coupled coordination degree model. Results (1) The results brought a few things to light. One is the notable spatial imbalance in regulatory resource allocation (X^2=73.206，P<0.001). There are no full-time TCM-specific inspector positions anywhere in the city, and the fit between inspector numbers and clinic counts across districts is generally weak. The coupled coordination analysis further grouped the unbalanced districts into three types: those where supply falls short of demand, those where supply exceeds demand, and those where both sides are weak. (2) Second, over the past five years the city\'s total clinic count rose by 77.7%, but the growth rates varied widely-one district surged by 268.0%, while another shrank by 6.3%. (3) Third, the composition of administrative penalty categories changed considerably from year to year (X^2=33.408，P<0.001), with regulatory attention moving progressively from medical waste management to entry qualifications, and then further on to treatment quality and more fine-tuned oversight. (4) Fourth, at the district level, legal awareness showed no clear link with the number of penalty cases (ρ=-0.275，P=0.441), though the coupling coordination degree D did show a moderate positive correlation with penalty counts (ρ=0.624，P=0.054). Conclusion The rapid growth in the number of record-filing TCM clinics and the mismatch in regulatory resources are difficult to ignore. How that mismatch manifests itself differs considerably from one district to another. What we see here, in effect, is a chain-structural deficiencies feed into procedural obstacles, and those in turn translate into constrained outcomes. Going forward, there is a case for moving away from reactive enforcement and toward more proactive forms of intervention. This would entail, among other things, adjustments in staffing, investments in professional development, and the adoption of more sophisticated regulatory instruments, all with a view to narrowing the gap between supply and demand across districts.

Keywords： Traditional Chinese Medicine clinics Regulatory enforcement Resource allocation Administrative penalties supply and demand sides