I. Factors of Discipline Characteristics
(I) Factors of Way of Thinking. Way of thinking determines the existence and development of a country, a nation, a discipline. Chinese medicine from its birth, "Neijing", has been infiltrated with a strong Confucian and Taoist cultural colors, its entire theoretical system is full of macro (holistic view) and discursive (discursive treatment) features, the formation of its theory and its development mainly rely on the traditional Chinese system of thinking, this way of thinking and the traditional culture of the Chinese nation is closely related to each other, and the water and milk blended. The traditional way of thinking of Chinese medicine has influenced the development of Chinese medicine discipline: firstly, it is very easy to accept and absorb the advanced research results of humanities and philosophical sciences, Chinese medicine theory in its development process, transplanted and absorbed advanced humanities and philosophical scientific research results of all times, such as yin and yang, five elements, qi and yin and yang doctrine, etc., which are all absorbed from Chinese philosophy, and Chinese medicine embodies the medical and social sciences, Chinese medicine embodies a high degree of integration and unity between medicine and social sciences and humanities; secondly, the way of thinking of Chinese medicine influences the grafting of Chinese medicine with modern natural and technological civilization, and pays more attention to the cultivation and education of traditional cultural knowledge. This unique way of thinking of Chinese medicine has made a deep mark on the education of Chinese medicine, and its theory and its own development are not as rapid as that of Western medicine with the progress of modern science and technology, which not only slows down the pace of Chinese medicine towards modernization, but also has a far-reaching impact on the development of human resources in Chinese medicine.
(ii) Research methodology factors. Divided according to the research habits formed by national, regional, social, historical and other reasons, the methodology is broadly divided into two major systems. One of them is the research method with synthesis as the main tendency, that is, the method of grasping the object on the whole. It is mostly based on philosophical methods, systematic methods and the newly emerged fuzzy set and fuzzy identification methods. The holistic view and diagnosis and treatment of Chinese medicine in China are the application of this macro and comprehensive research method. The second is the research method with the main tendency of analysis, i.e., the reductionist research method that divides the whole into several parts to study, mostly based on the methods of physics, chemistry and mathematics. This is the research method that western medicine is accustomed to. Chinese medicine and western medicine due to the differences in their ways of thinking and research methods, resulting in the formation of two different life science theory system. The two theoretical systems are very different from each other, which in turn determines the difference between the two basic courses of education, and then form a different medical model. Western medicine to mathematics, physics, chemistry, biology as a basic course, focusing on training and cultivating students' logical thinking ability, increase their ability to acquire perceptual knowledge, its medical research method is relatively simple "biomedical" model; and Chinese medicine to literature, history, philosophy as a basic course, focusing on the training of students' thinking ability, cultivate their cognitive knowledge of rational knowledge. Since the middle of the 20th century, with the increasing development of science, human beings' understanding of the world has been deepening. Since the mid-20th century, with the increasing development of science, human understanding of the world has been deepening, relying solely on a certain method of scientific research, it is difficult to achieve the purpose of searching for the true meaning of science, so science in the high degree of differentiation at the same time a high degree of synthesis of the tendency to consciously synthesize the main tendency of the modern scientific methodology. The change in research methodology inevitably leads to the combination of the two medical models in theoretical research or clinical practice. This will have a major transformative impact on the formation and cultivation of human resources in Chinese medicine.
(3) Educational model factors. There are two modes of TCM education: one is teacher-training education; the other is college education. Both modes of education play a very important role in the cultivation of Chinese medicine talents. Teacher education is the earliest mode of Chinese medicine education, which is determined by the humanistic thought of Chinese medicine and its academic characteristics of empirical medicine, and has been y integrated into the academic system of Chinese medicine, and "teacher with apprentice" has become the key to the inheritance of Chinese medicine. Although the traditional education method of Chinese medicine teacher-training has played a dominant role in the survival, inheritance and development of Chinese medicine, the traditional teacher-training method is unable to adapt to the demands of modern large-scale, group and open college teaching due to the restriction of a small number of people and a small scope, which is not conducive to the integration of Chinese medicine into the system of large-scale education and large-scale health care, and it is difficult to adapt to the demands of social development in the long run. In the long run, the relative limitation and singularity of its inheritance may lead to the shrinkage of the position of Chinese medicine and the loss of the market. In addition, the characteristics of the traditional teacher education is difficult to bear the Chinese medicine career to cultivate diversified and complex talents heavy responsibility.
The factor of Chinese medicine education mode directly affects the quality of human resources of Chinese medicine, and the output of Chinese medicine and health manpower of too much or too little quantity, good or bad quality will not only affect the market of supplying Chinese medicine medical and health services, but also affect the market's recognition of Chinese medicine. Therefore, only by organically combining the two modes of education, namely, teacher education and college education, can the human resources of Chinese medicine be effectively deployed, and can also be adapted to the market competition in the discipline of Chinese medicine.
Two factors of supply and demand balance
The factors of supply and demand balance of human resources in TCM include two groups of supply and demand relationships: one is the supply and demand relationship constituted by the supply side of TCM health services and the social demand for TCM. In this group of supply and demand relationship, the amount of medical services provided by the supply side (total number of hospital beds, total number of outpatient clinics, bed utilization rate, etc.) is subject to various factors of the demand side of the society (including the total number of population, the proportion of the urban population, the aging and the proportion of the population of children under the age of 14 years) and other factors, and the amount of medical and health care services provided by the supply side is dependent on how much the society demands. If too much or too little medical service is provided, it will result in a waste of resources or fail to meet people's demand for medical and health care. Secondly, there is the supply side of Chinese medicine education and Chinese medicine and health services, which constitute the second group of supply and demand of human resources in Chinese medicine. Chinese medicine educational institutions are the producers of Chinese medicine and health care manpower. The scale, quality, structure and effectiveness of Chinese medicine education determine the basic situation of Chinese medicine and health care manpower; the level of Chinese medicine education determines the quality of Chinese medicine and health care manpower; and the quality of Chinese medicine and health care manpower will directly affect the output situation of the supply side of Chinese medicine and health care. The demand for Chinese medicine manpower on the supply side of Chinese medicine and health services is the basic basis for the establishment and optimization of the level, scale and structure of Chinese medicine education. Therefore, Chinese medicine education and the supply side of Chinese medicine and health services are complementary and mutually reinforcing. The output of Chinese medicine and health manpower from Chinese medicine education should meet and conform to the requirements of the demand side of Chinese medicine and health services, so that the two can be organically combined together, so that it will not result in a waste of talents and unnecessary losses, and will conform to the laws of the manpower market. However, the actual situation of the supply and demand relationship between TCM education and TCM services in China in recent years has violated the law of supply and demand operation in the manpower market. From 1999 to 2004, the actual number of Chinese medicine health technicians nationwide has been on a decreasing trend each year, with an average annual decrease of 5,729, or an average decrease of 0.75%. On the other hand, the number of graduates of various levels of education in TCM is increasing every year. This phenomenon shows that the number of talents trained by Chinese medicine universities did not match the demand for Chinese medicine manpower in accordance with the supply side of Chinese medicine and health manpower services, there is a large deviation from the law in accordance with the relationship between education and manpower market demand.
The output and demand of Chinese medicine and health manpower involves the market of Chinese medicine education, the market of Chinese medicine and health manpower and the market of Chinese medicine and health service supply, if the articulation and operation process of these three markets are not smooth, it will directly affect the quality and quantity of the Chinese medicine and health service provided by the supplier of Chinese medicine and health service, and it will result in the balance of supply and demand of the human resources of Chinese medicine, which will lead to the huge waste of resources. Waste.
Third, socio-economic factors
(a) Social factors affecting human resources in Chinese medicine. The scale, reserve and structure of human resources of Chinese medicine are determined by the demand of the supply side of Chinese medicine and health services. The amount of Chinese medicine manpower provided by the supplier of Chinese medicine health services, however, depends on the social demand for Chinese medicine. The social factors affecting the human resources of Chinese medicine are summarized in three main aspects: demographic factors, medical conceptual factors and health insurance system.
1. Demographic factors: The influence of demographic factors on the human resources of TCM is mainly reflected in several aspects - population size, age structure of the population (proportion of the elderly population and proportion of the child population), and proportion of the urban population.
(1) Population size. Population size is the most important influence on health services, and population growth is positively proportional to the demand for human resources for health, but how much does population growth affect the demand for Chinese medicine and health services? In order to examine the extent to which population growth affects the demand for Chinese medicine and health services, we compared the population growth from 1999 to 2004 with the growth in the number of Chinese medicine personnel. Taking into account the factors affecting the demand for Chinese medicine manpower caused by the uneven economic development of the regions, we compare the population growth and the growth in the number of Chinese medicine personnel in the three regions of the East, the Middle East and the West, excluding the unnatural factors of the statistical data on the population growth in 2002, and the results show that: the population growth of the East region is about 6 million, and the growth in the number of Chinese medicine personnel is 2, the population growth of the Middle East and the West is 3 million, but the growth in the number of Chinese medicine personnel is 3 million. million people, but the number of Chinese medicine personnel is negative growth.
(2) Population structure. Changes in the proportion of the population's age structure will also have a direct impact on the demand for health services, and age per capita is closely related to per capita medical expenses. According to the survey and analysis results of the "China Health Services Survey and Research - Third National Service Survey and Analysis Report", the hospitalization rate of the elderly group over 65 years of age is 80 per thousand, the hospitalization rate of the under 14 years of age group of children is 52 per thousand, and the hospitalization rate of the young and middle-aged group is 30 per thousand; in terms of the number of outpatient clinics, the two-week consultation rate of the over 65 years of age group is close to 300 per thousand, 430 per thousand for the group under 14 years old, and an average of 160 per thousand-180 per thousand for the young and middle-aged group. According to the latest population aging trend research results show that China's population in the next 15 years, the elderly increased by 5.9 million people per year, by 2020 China's aging population will reach 250 million people, population aging will certainly lead to an increase in demand for Chinese medicine and health services.
(3) Proportion of urban population. Due to the differences in economic level, cultural level, transportation conditions and medical concepts, the awareness of health care and utilization of health services of urban residents is higher than that of rural residents. With the continuous development of China's economy, the pace of urbanization is also accelerated, more and more people will become urban residents, according to the prediction, in the first 10 years of the 21st century, the proportion of urban residents in China will reach 50% -60%, for the current level of medium developed countries. Therefore, the forecast of human resource demand for TCM must consider the urbanization level of the population as an important factor.
2. Social medical concept. Social medical concepts include two aspects: one is the recognition of Chinese medicine; the other is the view of disease. Although social medical concept belongs to the category of cultural awareness, it also has a non-negligible impact on the demand for Chinese medicine health services. With the intensification of social competition, the psychological pressure generated by young people to adapt to social survival and development is increasing, resulting in many people's bodies in a state of sub-health, and Western medicine is not ideal for this effect, so people are paying more and more attention to diet and nutrition, food safety, beauty and body care, plastic surgery and skin care, fitness, health and other Chinese medicine health care, the elderly identity of Chinese medicine is higher than the rest of the population, the social healthcare Changes in social medical concepts will promote and drive the demand for Chinese medicine health services.
3. Medical insurance system. Medical insurance system is the state's macro intervention in the health care market, is a solution to the health care consumption system, because the medical insurance system is the use of social health insurance channels to organize the provision of medical and health services, which will inevitably change the allocation of medical and health resources and people's health care consumption in China, China's current health care system has a public medical care, medical care for the labor insurance, family members of the semi-labor insurance medical care, a variety of other Medical insurance, new rural cooperative medical care, etc., these medical insurance system not only reduces people's burden on medical care, but also to a large extent on China's medical human resources market plays an important role in regulating. With the recognition of some international countries on Chinese medicine treatment of diseases, Chinese medicine treatment is also gradually included in the scope of government and social health insurance, which plays a great role in promoting the human resources of Chinese medicine to the international market.
(2) Economic factors affecting the human resources of Chinese medicine. Comprehensive domestic and foreign health service research results over the years, the impact of economic factors on human resources in medicine and health broadly include the following three aspects: First, the level of economic development and the demand for health services for residents is not only a clear positive correlation, but also shows a certain incremental effect, per capita GDP per 1 percent increase in the consumption of health services is an increase of 1.04%; Second, among the many factors affecting the health care services. Secondly, among the many factors affecting health care services, the income level of the population is the first influencing factor in different age, occupation, gender, education level, marriage and employment status groups; Thirdly, economic factors not only affect the demand side of health services, but also play an important role in influencing the supply side of health services. On the demand side of health services, the economic level determines residents' willingness to seek medical treatment, their ability to seek medical treatment, and the location of medical treatment, etc. On the supply side of health services, the economic level determines the equipment, manpower, management level, and quality of medical treatment of health services. The macro-observable indicators of the influence of economic factors on human resources in TCM can be measured from the GDP per capita and the ratio of health costs to GDP.
In summary, the market factors affecting the development of human resources in Chinese medicine are both market supply and demand balance factors and socio-economic factors, which are in a relationship of mutual restriction, mutual promotion and mutual influence.
Fourth, the factors affecting the regional differences in human resources of Chinese medicine
(I) the factors of urban-rural differences. According to the statistics of China Rural Statistical Yearbook 2002, from 1997 to 2001, the proportion of the total health expenditure of national farmers to the total national health cost has been maintained at about 16%, i.e., 20% of the urban population occupies 80% of the health care resources and facilities, and 80% of the rural population occupies only 20% of the health care resources and facilities, and the urban and rural areas in the field of medical care and health care have formed a huge A huge "scissors gap" has formed between urban and rural areas in the field of health care. With the "New Rural Cooperative" health care pilot and the continuous promotion of Chinese medicine human resources appeared a huge demand for market, the government should take timely incentives to allow Chinese medicine and health manpower flow to the rural areas, training of human resources in traditional Chinese medicine institutions of higher learning to pay close attention to the rural health care market, and vigorously cultivate suitable for the rural areas of traditional Chinese medicine personnel.
(ii) Differences between East, Central and West. Regional differences in TCM human resources in the eastern, central and western regions have led to an imbalance in the regional distribution of China's TCM human resources and the population's possession of TCM and health manpower. 2002-2004, the number of TCM personnel in the eastern region increased dramatically, while in the western region there was a sharp decrease, and the data indicate that a large number of TCM human resources in the western region have flowed to the eastern region. The growth of urban population, level of economic development, income status of residents, TCM medical environment, and treatment of TCM personnel in the eastern region may be the main reasons for attracting TCM personnel from the western region. In order to minimize the impact of regional differences on TCM human resources, health reforms should be carried out and effective regional health planning and total health manpower control policies should be formulated to reconfigure the distribution of TCM human resources. The government should, on the basis of respecting the law of development of Chinese medicine and health manpower in all provinces and municipalities, through health reform and policy guidance, make the flow of Chinese medicine human resources from the areas of continued growth to the areas of continued decline, or reduce the increase in the provinces and municipalities where growth is likely to take place, and maintain a proper increase in the forecasted areas of possible decline in Chinese medicine manpower through the flow of talents, so that the Chinese medicine human resources among all provinces and municipalities of the country are maintained at a relatively reasonable development trend. In this way, the human resources of Chinese medicine among all provinces and municipalities in the country will be maintained in a relatively reasonable development trend.
In summary, only when we have a comprehensive understanding of the factors affecting the human resources of traditional Chinese medicine, can we target the policy, system and education sources to regulate and solve these influencing factors, so as to revitalize the national industry, so that China's traditional Chinese medicine industry is invincible in the international competition.