Objective: This paper aims to analyze the development trend of Traditional Chinese Medicine (TCM) hospitals in China and explore the medical service innovation by TCM hospitals, in particular, how medical service of TCM and western medicine (WM) were treated and innovated at TCM hospitals. Methods: Integrated quantitative and qualitative methodologies were used. Quantitative data at macro level was collected from official databases of China Health Statistical Yearbook and Extracts of Traditional Chinese Medicine Statistics. Qualitative data at micro level was gathered through interviews and second-hand material collection at four of the most leading TCM hospitals. Findings: Development trend: TCM hospitals had realized rapid quantity increase in the past three decades and were trying to enlarge single hospital scale. Private, specialized and Class 1 TCM hospitals had realized fast growth. TCM hospitals developed themselves in the way of debt financing. Medical service: In both outpatient and inpatient services, drug fee accounted the biggest part of medical fee. Application of WM medical exanimation was increased in both outpatient and inpatient. In total, WM drugs were used more than TCM drugs. While the usage of WM drugs was much higher than TCM drugs in inpatient, TCM drugs had bigger percentage in outpatient. About half of the doctors were certificated TCM doctors; only about 30% assistant doctors were certified as TCM assistant professor. Qualitative investigation also showed that on medical service, they played special cards of TCM on the one hand and introduced WM advanced equipment and technology on the other hand. Specifically, TCM dominated outpatient medical service and WM dominated inpatient medical service. On drugs, they worked hard on home-made prescriptions and improving TCM formulation. In personnel, they adhered to apprenticeship model to train TCM personnel while used a combination of clinical and teaching model for medical students. Conclusion: In development trend, TCM hospitals had realized rapid quantity increase in the past three decades and were trying to enlarge single hospital scale in recent years. Private, specialized and Class 1 TCM hospitals had realized fast growth in these years. But they developed themselves in the way of debt financing. In medical service innovation, TCM hospitals in China kept continuous development through providing both TCM and WM medical service and tried to incorporate WM to support and strengthen their TCM medical service. In particular, they wanted to vi refer to WM to recreate TCM medical service. What is more, they worked hard on improving TCM drugs and innovated apprenticeship model to train TCM doctors.

目的：本研究分析了中醫院的發展趨勢以及中醫院的醫療服務情況，特別 是中醫院內中醫和西醫的服務情況。 方法：本研究運用了定量研究和定性研究相結合的方法。定量研究旨在從 宏觀上展現中醫院的發展趨勢和醫療服務情況，資料主要來自國家官方資料庫 的《中國衛生統計年鑒》和《全國中醫藥統計摘編》。定性研究旨在從微觀上 展現中醫院的醫療服務情況，特別是中西醫服務的情況。首先對廣東省中醫院、 四川省中醫院、江蘇省中醫院、上海中醫藥大學附屬龍華醫院這 4 所中醫院進 行多案例分析，然後為了進一步明確中醫院內的中西醫服務的情況，對四川省 中醫院的三位院領導和江蘇省中醫院的三位院領導進行半結構式的訪談。 發現：定量研究發現：在發展趨勢上，中醫院近 30 年來實現了數量上的快 速增長，近些年來中醫院的重心轉向擴大醫院規模上。在產業結構上也出現了 新的情況，民營中醫院、中醫專科醫院、一級中醫院出現了快速的增長。由於 一方面國家對中醫院的財政補貼日益相對不足，另一方面，中醫院在業務上處 於入不敷出的境地，導致近些年來中醫院整體上以負債籌資為主要手段來獲得 自身的發展。在醫療服務上，近些年來，無論是在門診還是在病房，藥品收入 是中醫院收入中最大的一塊。西醫診療設備越來越多的運用於門診和病房。總 體上來說，西藥的運用多於中藥，而中藥所占比例在不斷上升。門診上，中藥 的使用比例高於西藥，而在病房裡，西藥的使用遠高於中藥。中醫院人才方面， 首先在執業醫師上，中醫執業醫師和西醫執業醫師各占一半，而中醫助理執業 醫師只占 30%；在執業藥師上，中醫執業藥師占到了 55%。定性研究發現：在 醫療上，一方面大打中醫“特色牌”，另一方面引進現代醫學先進的儀器設備和 技術。具體來說，中醫院門診以運用中醫為主，西醫主要用於對病人的檢查上； 病房以運用西醫為主，中醫主要運用於對術後患者的康復上。在藥物上，一方 面努力研發自製的特色中藥方，另一方面不斷改良中藥劑型，推廣使用了小包 裝中藥飲片。在人才上，一方面堅持師徒傳承模式來培養中醫人才，另一方面 採用臨床與教學相結合的模式培養醫學生。 結論：發展趨勢上，中醫院由過去的小規模、單一性的醫療機構向多功能、 綜合性、深技術型的醫療機構轉變，民營中醫專科醫院近些年來實現了快速的 iv 發展，但也存在以負債籌資的方式來獲得自身發展的問題。醫療服務創新方面， 中醫院在堅持中醫特色的同時，不斷引進西醫的醫療技術和設備，通過提供中 西醫結合的服務來獲得自身的不斷發展，並嘗試利用西醫來完善中醫，從而在 更高的平臺上傳承中醫。同時，不斷研發和改進院內中藥製劑，創新傳統的師 徒傳承模式，在院內設立“名醫堂”、“名醫工作室”等新型模式來培養中醫 人才。