The prevalence, determinants, and mechanisms of traditional Chinese medicine service utilization among healthcare professionals: a study based on the Andersen Behavioral Model

Background As a cornerstone of China’s healthcare system, Traditional Chinese Medicine (TCM) contributed significantly to both public health outcomes and cultural preservation. Although perceived value was known to shape healthcare decisions, its specific impact on TCM utilization among medical professionals remained unclear. This study employed the Andersen Behavioral Model to examine how predisposing, enabling, and need factors influenced TCM utilization among healthcare workers, with a focus on the mediating roles of usage intention and loyalty. Methods A cross-sectional survey was administered to 1,483 healthcare professionals. We collected data on demographic profiles, TCM-related perceptions (perceived value, satisfaction, intention, and loyalty), and actual service usage over the preceding year. To identify predictors of utilization and test the hypothesized mediation pathways, we performed multiple logistic regression analyses and utilized the Model 4 macro in the SPSS PROCESS plugin. Results The survey revealed that 49.09% of participants had utilized TCM services, with massage and manual therapies being the predominant modalities. Logistic regression demonstrated that sex, officially budgeted post, physical pain or discomfort, and chronic conditions significantly predicted utilization. Perceived value (OR = 1.037, p 0.001) and satisfaction (OR = 1.149, p 0.001) emerged as strong positive drivers. Mediation analysis confirmed that utilization intention mediated the relationship between perceived value and actual behavior (indirect effect = 0.023, 95%CI: 0.007–0.041), while loyalty mediated the link between satisfaction and utilization (indirect effect = 0.056, 95%CI: 0.009–0.101). Conclusion TCM utilization among healthcare professionals was driven by a combination of predisposing factors (sex, officially budgeted post, perceived value, satisfaction) and need factors (chronic disease status, physical pain or discomfort) in the Andersen Model. The mediating effects of intention and loyalty highlighted the importance of psychological factors in service adoption. To boost TCM engagement, interventions should be implemented based on healthcare professionals’ clinical needs and educational level, while also fostering stronger loyalty and usage intention. These results offered actionable insights for optimizing TCM service delivery within the medical community.