With the increasing prevalence of chronic diseases, the demand for medical services from chronic disease patients has become diversified and personalized. The advantages and role of traditional Chinese medicine in the prevention and treatment of chronic diseases gradually emerging. The preferences and willingness to pay for traditional Chinese medicine services (TCMS) among patients with chronic diseases, as well as any disparities between urban and rural patients, have not been examined in past studies. This study aimed to investigate the preferences of chronic disease patients for TCMS, explore the value/importance that patients place on different treatment attributes, and evaluate whether there are urban-rural differences in their preferences and willingness to pay for TCMS. A total of 317 patients from Jiangsu Province, China participated in a discrete choice experiment that elicited the preferences for TCMS. The choice questions were constructed by six attributes: out-of-pocket (OOP) cost, institution, medical provider, treatment method, treatment duration, treatment efficacy. Mixed logit models were used to estimate the stated preference and marginal willingness to pay for each attribute. The choice preferences of chronic disease patients for TCMS in this study were influenced by the four attributes: institution, treatment method, and treatment efficacy, and OOP cost. Improvements in treatment efficacy were the most concerning, followed by being treated in traditional Chinese medicine (TCM) hospital. Patients were willing to pay more to get better treatment outcomes. Compared with primary care institutions, patients were willing to pay more for treatment in TCM hospitals. The preferences for economic attribute (OOP cost) varied between urban and rural areas, and rural patients tended to favor scenarios that imposed a lower economic burden on them. The chronic disease patients’ preferences for TCMS were determined mainly by treatment efficacy but also by institution, treatment method and OOP cost. The urban-rural difference in preference identified in this study highlights that effective policy interventions should consider the characteristics of patients’ demand in different regions.

Objectives: Although the relationship between socioeconomic status (SES) and health is well documented, the contributions of physical exercise (PE) and social-psychological stress (SPS) to this association remain insufficiently understood. This study aimed to explore the mediating roles of PE and SPS in the relationship between SES and self-rated health (SRH). Methods: This study included 1,507 participants (aged ≥ 16 years) from the Health Survey conducted in Hubei Province during the post-pandemic period of 2021. Structural equation modeling (SEM) was used to examine the mediating and interaction effects, with PE and SPS specified as mediators in the association between SES and SRH. Results: The average SES and SRH scores were 3.07 ± 1.12 and 2.93 ± 0.93, respectively. Significant pairwise correlations ( p < 0.05) were found among SES, PE, SPS and SRH. Low SES was associated with poorer SRH (β = 0.23), as were insufficient PE (β = 0.11) and higher SPS (β = –0.17). Both PE and SPS demonstrated significant mediating effects, accounting for 6.7% and 14.2% of the total impact of SES on SRH, respectively. The interaction between PE and SPS was statistically significant only among females ( p < 0.05). Conclusions: This study confirms that physical exercise and social-psychological stress play partial mediating roles in the association between SES and SRH. The findings suggest that limited physical exercise and higher levels of social-psychological stress may adversely affect health, particularly with low SES. Promoting healthy lifestyles and supportive social environments is therefore crucial for improving population health.