Driving Quality Improvement in Gynecology — A Quality Indicator System for China’s County-Level Hospitals

BACKGROUND: Gynecologic diseases are a significant yet often underrecognized global health burden, negatively impacting women's quality of life. In China, county-level public hospitals serve as the primary providers of care or first line of defense for managing these conditions, highlighting the urgent need for improved service quality. However, a systematic framework with specific quality indicators for gynecologic care remains underdeveloped both in China and internationally. Compared with obstetrics, progress in gynecologic care quality assessment has lagged, creating a gap between evidence and practice. The authors aimed to develop and preliminarily implement a quality indicator system to guide gynecologic care quality improvement efforts. METHODS: ]) for each hospital. CONCLUSIONS: The authors established mainland China's first validated indicator system for gynecologic care quality. National implementation across 178 hospitals demonstrates the framework's practical utility while revealing significant quality differences across hospital tiers and regions. This standardized evaluation framework provides a practical tool for targeted quality assessment and precision improvement in primary gynecologic care.