Traditional Health Practitioners in Indonesia: Their Profile, Practice and Treatment Characteristics.

BACKGROUND: The demand for traditional health care is rising. The study aims to investigate the profile, practice and treatment characteristics of traditional health practitioners who participated in the Indonesia Family Life Survey (IFLS-5) in 2015. METHODS: A national community facility cross-sectional survey was carried out with a probability sample of 4,461 traditional health practitioners in Indonesia. RESULTS: Traditional health practitioners were typically female, over 50 years old, had no or lower levels of education, worked only as a healer, saw 8 patients a week and consulted for 60 min per patient. The most common treatment types provided included massage for babies (71.4%), followed by massage (reflexive massage) (25.6%), herbal remedies (23.4%), and delivery (22.0%). Many claimed to cure or solve the problems of stomachache or diarrhea (67.7%), flu or headache (64.7%), pain during pregnancy (52.0%), rheumatism (36.4%), and insomnia, stress or nervousness (35.5%). In adjusted logistic regression analysis, younger age, being male, having completed grades 1-6, urban residence, more years of practice, lower average consultation time, using tools or equipment, providing herbal remedies, and charging service fees were associated with high patient throughput. CONCLUSIONS: Our analysis provides insights into the profile, practice and treatment characteristics of traditional health practitioners in Indonesia. Sociodemographic, practice and treatment characteristics are accountable for a high patient throughput.

Cross-national differences in the holistic use of traditional East Asian medicine in East Asia.

Complementary and alternative medicine (CAM) has been one of the popular strategies for health promotion. Traditional East Asian medicine (TEAM) is one of the most popular CAM practices in the world and there are suggestions that its holistic utilization is important for users to gain its effects for health promotion. In this context, this study investigates the extent to which TEAM users in East Asian countries utilize various modalities of TEAM holistically. It provides a model that explains cross-national differences in the extent of the holistic use of TEAM between China, Japan, Korea and Taiwan. Using the 2010 East Asian Social Survey, regression models specify the relationship between the holistic use of TEAM and the geographical location (country). The presence of TEAM doctors who hold the comprehensive and exclusive practice rights over TEAM is found to be conducive to the holistic utilization of various TEAM modalities. Thus, Taiwanese and Koreans use TEAM more holistically than Chinese and even more so than Japanese. The result suggests that the manner in which TEAM is institutionalized affect the extent to which TEAM users utilize various TEAM modalities together and potentially the health promotion effects of TEAM.

The association between the use of biomedical services and the holistic use of traditional East Asian medicine: a national survey of outpatients in South Korea.

OBJECTIVES: The holistic use of a system of complementary and alternative medicine (CAM) is potentially linked to its treatment outcomes. This paper examines how the use of biomedicine is associated with the holistic use of CAM, focusing on traditional East Asian medicine (EM) that is uniquely integrated in the medical system in South Korea. DESIGN/SETTINGS: A representative national sample of EM outpatients in South Korea. PARTICIPANTS: 3861 survey respondents. METHODS: By using the 2011 Korean National Survey of EM patients, ordered logistic regression models specify the relationship between EM outpatients' use of biomedicine and their holistic use of EM modalities. RESULTS: Among EM outpatients who used at least one EM modality in the past 3 months, people who used two (33.3%) or three (29.4%) modalities together are the two highest proportions, followed by users of four (18.1%), five (7.2%), six (2.1%) and seven (0.6%) modalities. The odds for EM users to use EM holistically are 17% greater among EM users who used biomedicine as well, compared with EM users who did not use biomedicine. CONCLUSIONS: The healthcare community should recognise that CAM use likely becomes holistic as people use biomedicine concomitantly, when the practice rights over a CAM system are comprehensively and exclusively entitled to a group of CAM professionals who are independent from practitioners of biomedicine.

Utilization Patterns of Korean Medicine: An Analysis of the National Health Insurance Cohort Database from 2002 to 2013.

OBJECTIVES: Although Korean Medicine (KM) is an important part of the Korean healthcare system and plays a significant role in chronic and incurable diseases, there is insufficient information about KM utilization. The aim of the study was to identify KM utilization patterns using a national representative sample data. METHODS: KM users aged 0-80 years and older from the nationally representative sample in the National Health Insurance Service-National Sample Cohort of 778,506 KM users between 2002 and 2013 (were analyzed. Annual changes in utilization patterns were analyzed by sex, nine age groups, five income levels, and numbers of visits and hospitalizations. Utilization patterns by the type of healthcare institution and the top 10 major diseases were studied. RESULTS: Frequencies of KM use differed according to analyses of patients and claims. Women used KM 1.5 times more than did men. Patients in their 40s and 50s made up one third of KM users. In contrast to other studies, high-income groups used KM more than did low-income groups. More than 96% of ambulatory patients used mostly KM clinics, and more than 76% of inpatients used KM hospitals. Musculoskeletal disorders were the main disease treated, which conformed to the results of previous studies. CONCLUSION: The results suggest that women, people in their 40s and 50s, and people with a relatively high income use KM more often than other patients. Further comparison studies of both Western medicine in Korea and other countries should be conducted.

The Relationship Between the Use of Complementary and Alternative Medicine and the Use of Biomedical Services: Evidence From East Asian Medical Systems.

To provide East Asian evidence to the relationship between the use of complementary and alternative medicine (CAM) and the use of biomedicine, this article examines the institutionalization of traditional East Asian medicine (EM) in China, Korea, and Japan and how it affects the relationship between EM use and biomedicine use. It uses the 2010 East Asian Social Survey. Logistic regressions specify the statistical association between EM use and biomedical physician visits. These models show that the high institutional acceptance of EM promotes the concurrent use of EM and biomedicine. In addition, since these countries feature different ways of institutionalizing EM (unification in China, equalization in Korea, and subjugation in Japan), the concurrent use is more obvious under the Chinese and the Korean system than the Japanese system. It concludes that the CAM use can be complementary to biomedicine, depending on how CAM and biomedicine are institutionalized in medical systems.

The role of complementary indigenous Malay therapies: perspectives from palliative care patients.

Although the popularity of complementary indigenous Malay therapies (CIMT) in general healthcare is undeniable in the Malaysian context today, their usage within the palliative care scenarios remains unexplored. Our study was specifically embarked to determine CIMT's usage pattern, reasons, attitudes, beliefs, perceptions and health-related quality of life (HRQoL) differences (users vs. non-users) in a sample of hospice-based palliative patients in Selangor, Malaysia. From the 39 consenting patients (mean age = 56 years; female = 56.4 percent; Malay = 53.8 percent), 38.5 percent were users of CIMT. Dried medicinal roots, herbs and sea cucumber products were the most preferred types of CIMT (53.3 percent). The most common reason cited for usage was because these were "easier and simpler to be administered" (46.7 percent). Although users' attitudes, beliefs and perceptions were more favourable than the non-users, between 30.0-73.3 percent of users remained unsure or had no knowledge regarding CIMT. They also exhibited significantly poorer Physical Symptoms than the non-users (p=0.006), a probable motive for seeking CIMT in the first place. Despite the small sample size, the findings provided some insight into the role of CIMT especially with regard to usage trends and overall well-being among the terminally-ill, of which healthcare professionals should constantly be vigilant of amidst their routine care responsibilities.

Use of traditional and complementary medicine in Malaysia: a baseline study.

BACKGROUND: The increasing popularity and use of traditional and complementary medicine (TCAM) in both developed and developing countries, including Malaysia, have raised significant public health policy issues. However, currently, there is a paucity of baseline data on such usage by the Malaysian community. OBJECTIVE: This study was conducted to identify and describe the prevalence and frequency of various TCAM modalities that are being used by the Malaysian population by age, gender, marital and working status, educational level and ethnic group for health issues and maintenance. DESIGN: A nationwide interviewer-administered questionnaire survey was conducted in August 2004. An open-ended questionnaire pertaining to TCAM modalities was used to increase the probability of capturing maximum data. This survey implemented a multistage design, stratified by state and urban/rural random sampling, proportionate to the size of the state population and was representative of the Malaysian population. Post-survey classification of modalities was done accordingly. Complex data analysis was carried out using SPSS 13.0. RESULTS: Various TCAM modalities that were used by the Malaysian population were identified and categorised. Biological-based therapies, which included herbal therapy, were most commonly used for health problems (88.9%) and for health maintenance (87.3%). Under this category, herb-based application/herb-based beauty product/herb-based hygiene product group was most commonly used for health issues (23.6%) while pure herbs were the ones most commonly used for health maintenance (29.6%). There was no significant difference across all groups in the usage of biological-based therapies for health issues. CONCLUSION: The study showed that there is a high prevalence of TCAM use by the Malaysian population, particularly in the use of herb-based therapies for both health issues and health maintenance. Thus, a strict guideline for herbal commercialisation as well as public education is important.