Utilization of traditional Chinese medicine services and associated factors: a systematic review and meta-analysis

As global demand for healthcare rises and recognition of traditional medicine grows, traditional Chinese medicine (TCM) is receiving increasing international attention. Analyzing the utilization of TCM services and the factors influencing their use is essential for optimizing the service system, improving service quality, and supporting the preservation and development of TCM. A systematic search was conducted in PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang, VIP, and CBM databases. Studies published between January 1, 2015, and January 15, 2025, addressing the utilization of TCM services and their influencing factors were included. NoteExpress software was used for literature management. Literature quality was assessed using the Joana Briggs Institute critical appraisal checklist for cross-sectional studies. Data were extracted using Microsoft Excel software. Meta-analysis was performed using Stata software, and pooled utilization was estimated using random effects models. A total of 33 studies comprising 41,103 participants were included. The exploratory pooled utilization rate of TCM services was 41% (95% CI: 32%–52%, I 2 = 99.67%). Individuals aged over 60 years (OR = 1.933, 95% CI: 1.282–2.915, I 2 = 89.41%), those with a high school education or above (OR = 1.537, 95% CI: 1.229–1.923, I 2 = 86.26%), those with a demand of TCM services (OR = 6.568, 95% CI: 2.702–15.966, I 2 = 95.39%), those with a convenient access to community health service centers (CHSCs) (OR = 6.098, 95% CI: 3.902–9.530, I 2 = 0.00%), those who trust TCM (OR = 5.182, 95% CI: 2.938–9.138, I 2 = 88.86%), and those in poor health status (OR = 1.311, 95% CI: 1.004–1.713, I 2 = 70.68%) demonstrated an observed higher propensity to utilize TCM services. The utilization of TCM services remains limited. Targeted dissemination is recommended to enhance public knowledge and awareness of TCM. Policymakers should prioritize optimizing resource allocation and improving service accessibility.