Additional file 1: Analyses on compliance rates for 5 conditions
Table S1
Analysis on Compliance Rate for Pneumonia Inpatient Care (n=151)†
Key process indicators
Percentage
N
Patient severity assessed
A
yes
B
no
Total
Severe patients (oxygen saturation <92%)
received blood gas analysis
A
yes
B
no
C
non-severe patient
Total
Timeliness of sputum and blood culture
A
within 24 hours
B
greater than 24 hours
C
no records
Total
Timely and appropriate use of antibiotics
A appropriate use within 4 hours
B appropriate use after 4 hours
Total
Appropriate treatment update at 72 hours
A maintaining original treatment or
changing to oral medicine if
effective treatment are shown at 72
hours
B taking pathological examination and
changing treatment scheme if
effective treatment are not shown at
72 hours
C no assessment on treatment
effectiveness at 72 hours
D no records
total
Antibiotic treatment is reasonable（7~14days）
A
reasonable
B
not reasonable
Total
Received health education
A
yes
B
no
Total
Appropriate length of stay
A
<=7 days
B
>7 days
Total
Overall
A
meeting all guideline
B
not meeting all guideline
Total
† ICD-10: J13、J14、J15、J18.
-1-
（%）
143
8
151
Rule
Missing
Compliance
A
Data
0
rate (%)
94.70
A+C
0
69.54
A
0
77.48
A
1
92.00
94.70
5.30
100.00
104
46
1
151
68.87
30.46
0.66
100.00
117
30
4
151
77.48
19.87
2.65
100.00
138
12
150
92.00
8.00
100.00
139
98.68
9
1.32
1
100.00
2
151
99.29
122
29
151
80.79
19.21
100.00
148
3
151
98.01
1.99
100.00
151
0
151
100.00
0.00
100.00
58
92
150
38.67
61.33
0
A+B
98.01
A
0
80.79
A
0
98.01
A
0
100.00
A
1
38.67
Table S2 Analysis on Compliance Rate for AMI Inpatient Care (n=97)†
Key process indicators
Percentage
（%）
N
Timely use of aspirin or clopidogrel in appropriate
dosage
A using aspirin or clopidogrel just after
arrival and with 300 mg
B using aspirin or clopidogrel just after
arrival
C using aspirin or clopidogrel with 300 mg
D using aspirin or clopidogrel not with
300mg
E
no record
Total
Evaluation of left ventricular function within 24 hours
of admission
A yes
B no
Total
Reassessment of patient condition within one week
before discharge
A yes
B no
Total
Reperfusion therapy
A reperfusion therapy for STEMI or LBBB
patients ‡
B no reperfusion therapy for non STEMI
and no LBBB patients
C no reperfusion therapy for STEMI or
LBBB patients
D reperfusion therapy for no STEMI and no
LBBB patients
Total
Thrombolytic therapy within 30 minutes of admission
A Implement within 30 minutes of
admission
B Implement 30 minutes later of admission
C No thrombolytic therapy because of no
indication
D No thrombolytic therapy because of
having contraindication
E
Improper treatment
Total
PCI within 90 minutes of admission
A Implement of PCI within 90 minutes of
admission
B Implement 90 minutes later of admission
C No PCI because of no indication
D No PCI because of having
contraindication
E
Improper treatment
Total
65
68.42
2
2.11
2
9
2.11
9.47
17
95
17.89
100.00
81
15
96
0
96
96
-2-
Rule
Missing
Data
A
2
Complian
ce rate
(%)
68.42
A
1
84.38
A
1
0
A+B
8
75.28
A+C+D
0
5.15
A+C+D
0
0.00
84.38
15.63
100.00
0.00
100.00
100.00
67
75.28
0
0.00
21
23.60
1
1.12
89
100.00
5
5.15
2
0
2.06
0.00
0
0.00
90
97
92.78
100.00
0
0.00
72
0
0
74.23
0.00
0.00
25
97
25.77
100.00
Key process indicators
Percentage
（%）
N
Use of β-blocker within 60 minutes of admission
A within 60 minutes
B within 24 hours
C no records
D have contraindications
Total
Use of aspirin during hospitalization
A yes
B no
Total
Use of β-blocker during hospitalization
A yes
B no
Total
USE of ACEI or ARB during hospitalization †
24
40
30
2
96
A
B
yes
no
Total
Use of statins during hospitalization
A yes
B no
Total
Cholesterol test and lipid lowering therapy
A Cholesterol test with high LDL
(>3.6mmol/L) and lipid lowering therapy
B Cholesterol test without high LDL and no
lipid lowering therapy
C Cholesterol test with high LDL and no
lipid lowering therapy
D lipid lowering therapy with no
cholesterol test or low LDL
Total
Advised to continue to use aspirin after discharge
A yes
B no
Total
Advised to continue to use β-blocker after discharge
A yes
B no
Total
Advised to continue to use ACEI or ARB after
discharge #
A yes
B no
Total
Advised to continue to use statin after discharge
A yes
B no
Total
-3-
Rule
Missing
Data
A
1
Complian
ce rate
(%)
25.00
A
1
93.75
A
0
73.20
A
0
73.20
0
92.78
A+B
0
26.80
A
0
80.41
A
1
61.46
A
3
64.89
A
0
78.35
25.00
41.67
31.25
2.08
100.00
90
6
96
93.75
6.25
100.00
71
26
97
73.20
26.80
100.00
71
26
97
73.20
26.80
100.00
90
7
97
92.78
7.22
100.00
21
21.65
5
5.15
0
0.00
71
73.20
97
100.00
78
19
97
80.41
19.59
100.00
59
37
96
61.46
38.54
100.00
61
33
94
64.89
35.11
100.00
76
21
97
78.35
21.65
100.00
A
Key process indicators
N
Advised to no smoking, having exercise, healthy eating, weight
control, proper treatment of recurrence or worsening, etc
A yes
82
B no
15
Total
97
Smoking cessation counseling
A yes
82
B no
15
Total
97
Provided with writen instruction on secondary
prevention in discharge summary
A yes
81
B no
16
Total
97
Overall
A meeting all guideline
0
B not meeting all guideline
80
80
Total
† ICD-10: I21.0I21.1I21.2I21.3I21.9;
Percentage
（%）
Missing
Data
A
82.00
84.54
A
0
84.54
A
0
83.51
A
17
0.00
84.54
15.46
100.00
84.54
15.46
100.00
83.51
16.49
100.00
0.00
100.00
100.00
‡ STEMI: ST elevation myocardial infarction; LBBB: left bundle branch block;
# ACEI:Angiotensin converting enzyme inhibitors，ARB：Angiotensin II receptor blockers.
-4-
Complian
ce rate
(%)
Rule
Table S3
Analysis on Compliance Rate for Heart Failure Inpatient Care (n=145)†
Key process indicators
Assessment of left ventricular function within 24
hours of admission
A yes
B no
Total
Assessment of left ventricular function one week
prior to discharge
A yes
B no
Total
Timely use of diuretics and potassium agents
A use of diuretics and potassium agents
immediately after arrival
B use of diuretics and potassium agents
within 60 minutes
C no use of diuretics and potassium agents
within 60 minutes
D having contraindications
Total
Timely use of ACEI or ARB ‡
A use of ACEI or ARB immediately after
admission
B use of ACEI or ARB within 60 minutes
of admission
C no use of ACEI or ARB within 60
minutes
D having contraindications
Total
Use of β-blockers only for patients with CHF #
A use of β-blockers for patients with CHF
B use of β-blockers for patients with AHF
C use of β-blockers for other patients
D no use of β-blockers for patients without
CHF or with AHF
E no use of β-blocker for patients with
CHF but without AHF
Total
Use of aldosterone receptor blockers only for
※
patients with severe health failure
A use of aldosterone receptor blockers for
patients with severe health failure
B no use of aldosterone receptor blockers
for patients with severe health failure
C non severe health failure
Total
Continued use of diuretics during hospitalization
A yes
B no
Total
N
103
30
133
Percentage
（%）
Compliance
A
Data
12
rate (%)
77.44
A
24
0.83
A+B+D
5
96.43
A+B+D
0
86.90
A+D
12
19.55
A+C
3
85.21
A
0
93.10
77.44
22.56
100.00
1
120
121
0.83
99.17
100.00
135
96.43
0
0.00
5
3.57
0
140
0.00
100.00
126
86.90
0
0.00
19
13.10
0
145
0.00
100.00
25
0
43
1
18.80
0.00
32.33
0.75
64
48.12
133
100.00
121
85.21
21
14.79
0
142
0.00
100.00
135
10
145
93.10
6.90
100.00
-5-
Missing
Rule
Key process indicators
Continued use of ACEI or ARB during
hospitalization
A yes
B no
Total
Continued use of β-blocker during hospitalization
A yes
B no
C contraindication
Total
Continued use of aldosterone receptor blockers
during hospitalization
A yes
B no
Total
Advised to use diuretics after discharge
A yes
B no
Total
Advised to use ACEI or ARB after discharge
A yes
B no
Total
Advised to use β-blocker after discharge
A yes
B no
Total
Advised to use aldosterone receptor blockers after
discharge
A yes
B no
Total
Record of heart failure education
yes
no
Total
Assessment of cardiac function and living ability,
and guidance activities after admission
A yes
B no
Total
Proper observation of patients (including
symptoms, vital signs, water balance, weight,
edema), provision of laboratory tests, and
advice on diet and body-position after
admission.
A yes
B no
Total
N
Percentage
（%）
125
19
144
86.81
13.19
100.00
69
58
2
129
53.49
44.96
1.55
100.00
117
22
139
84.17
15.83
100.00
114
25
139
82.01
17.99
100.00
106
34
140
68
58
126
145
0
145
100.00
0.00
100.00
-6-
Compliance
Data
rate (%)
A
1
86.81
A+C
16
53.49
A
6
84.17
A
6
82.01
A
5
75.71
A
19
53.97
A
11
77.61
A
0
100.00
A
0
100.00
A
1
99.31
53.97
46.03
100.00
77.61
22.39
100.00
144
0
144
Missing
75.71
24.29
100.00
104
30
134
145
0
145
Rule
100.00
0.00
100.00
99.31
0.00
99.31
Key process indicators
Assessment of tobacco and alcohol addiction after
admission and Patient advised to quit smoking
and to restrict alcohol consumption
A yes
B no
Total
Patient received psychological counseling
yes
no
Total
Patient advised on activity limitations after
discharge
yes
no
Total
Patient received dietary and body-position
guidance prior to discharge
yes
no
Total
Patient advised to quit smoking and to restrict
alcohol consumption prior to discharge
yes
no
Total
Overall
A meeting all guideline
B not meeting all guideline
Total
† ICD-10:I11,I12,I13;
N
Percentage
（%）
79
66
145
54.48
45.52
100.00
85
60
145
58.62
41.38
100.00
144
0
144
143
0
143
Rule
Missing
Compliance
Data
rate (%)
A
0
54.48
A
0
58.62
A
1
100.00
A
2
100.00
A
2
98.60
A
69
0.00
100.00
0.00
100.00
100.00
0.00
100.00
141
2
143
98.60
1.40
100.00
0
76
76
0.00
100.00
100.00
‡ ACEI:Angiotensin converting enzyme inhibitor, ARB：Angiotensin II receptor blockers Severe heart
failure refers to the New York Heart Association (NYHA) cardiac function proposed test (NYHA
functional) III, IV level of the patients;
# CHF: Chronic heart failure, AHF: Acute heart failure;
※ Severe heart failure refers to the New York Heart Association (NYHA) cardiac function proposed
test (NYHA functional) III, IV level of the patients;
-7-
Table S4
Analysis on Compliance Rate for Caesarean Inpatient Care (n=146) †
Key process indicators
N
Appropriate indication for planned C-section
A
Demand from pregnant women or their
relatives
B
Oligohydramnios
C
Fetal factors
D
Chronic fetal distress
E
Cephalopelvic disproportion
F
Complications that affect vaginal
delivery
G
Other appropriate indications
H
no appropriate indication
Total
Preoperative examination completed within 2
days
A
yes
B
no
Total
Prophylactic use of first generation
cephalosporin antibiotics
A
yes
B
no
Total
Withdraw of prophylactic antibiotics within 72
hours after delivery
A
yes
B
no
Total
The timeliness of operation time
A
≤2day
B
>2day
Total
Delivery within 2 days of admission
A
≤2days
B
>2days with reasons
C
>2days without reasons
Total
Appropriate anesthesia
A
Epidural or combined spinal epidural
B
Spinal anesthesia
Total
Appropriate use of oxytocin during procedure
A
10ug or 20ug
B
30ug or 40ug
C
>40ug
D
no use
Total
Post-operative length of stay
A
≤7day
B
>7day
Total
（%）
62
42.47
16
15
15
12
10
10.96
10.27
10.27
8.22
6.85
16
0
146
10.96
0.00
100.00
145
1
146
91
55
146
-8-
Percentage
Rule
Missing
Data
Compliance
A~G
0
rate (%)
100.00
A
0
99.32
A
0
62.33
A
0
86.30
A
0
61.64
A
0
82.88
A
1
65.52
A
0
80.82
A
3
99.30
99.32
0.68
100.00
62.33
37.67
100.00
126
20
146
86.30
13.70
100.00
90
56
146
61.64
38.36
100.00
91
30
25
146
62.33
20.55
17.12
100.00
95
50
145
65.52
34.48
100.00
118
19
8
1
146
80.82
13.01
5.48
0.68
100.00
142
1
143
99.30
0.70
100.00
Key process indicators
In accordance with discharge standard
A
yes
B
no
Total
Patient received health education
discharge
A
yes
B
no
Total
Overall
A
meeting all guideline
B
not meeting all guideline
Total
N
142
0
142
prior
Percentage
（%）
32
112
144
Missing
Data
Compliance
A
4
rate (%)
100.00
g
2
88.89
A
2
22.22
100.00
0.00
100.00
to
128
16
144
Rule
88.89
11.11
100.00
22.22
77.78
100.00
† ICD-10:the first diagnosis of underlying section of uterus caesarian operation, ICD-9-CM-3：
74.1Surgical coders.
-9-
Table S5
Analysis on Compliance Rate for Type-2 Diabetic Inpatient Care (n=137)†
Key process indicators
No
Routine examination within 24 hours after
admission
A yes
B no
Total
Blood glucose monitoring 7 times per day
A monitoring 7 times per day
B dynamic monitoring of blood glucose
C monitoring 4 times per day
D no monitoring
Total
HbA1c test
A yes
B no
Total
Glycosylated Serum Protein（Fructosamine）test
A yes
B no
Total
OGTT and insulin or C peptide release test‡
A accord with the standard test(5 points)
B only test fast and 2-hr blood glucose
C Arginine release test
D other type of tests
E no records
Total
Eye fundus examination
A yes
B no
Total
Nerve system examination
A yes
B no
Total
Renal function examination
A yes
B no
Total
Heart ultrasound examination
A yes
B no
Total
Carotid artery and lower extremity vascular
ultrasound examination
A yes
B no
Total
137
0
137
Percentage
（%）
51.09
12.41
33.58
2.92
100.00
125
12
137
91.24
8.76
100.00
75
61
136
55.15
44.85
100.00
17
63
17
27
13
137
12.41
45.99
12.41
19.71
9.49
100.00
85
52
137
62.04
37.96
100.00
54
83
137
39.42
60.58
100.00
114
23
137
83.21
16.79
100.00
98
39
137
71.53
28.47
100.00
-10-
Missing
Compliance
Data
A
0
rate (%)
100.00
A+B
0
63.50
A
0
91.24
A
1
55.15
A+B
0
58.39
A
0
62.04
A
0
39.42
A
0
83.21
A
0
71.53
A
0
72.99
100.00
0.00
100.00
70
17
46
4
137
100
37
137
Rule
72.99
27.01
100.00
Key process indicators
Blood glucose test analyzed
A yes
B no
Total
Evaluation at 72 hours after hypoglycemic
treatment
A yes
B no
Total
Record of drug selection reasons
A yes
B no
Total
Record of secondary prevention and health
education provided to patient
A yes
B no
Total
In accordance with discharge standard
A yes
B no
Total
Appropriate length of stay
A ≤14day
B >14day with reasons
C >14day without reasons
Total
Overall
A meeting all guideline
B not meeting all guideline
Total
† ICD-10: E11.2- E11.9;
No
133
4
137
Percentage
（%）
85.40
14.60
100.00
136
1
137
99.27
0.73
100.00
135
2
137
98.54
1.46
100.00
132
5
137
96.35
3.65
100.00
93
28
16
137
67.88
20.44
11.68
100.00
3
133
136
2.21
97.79
100.00
-11-
Missing
Compliance
Data
A
0
rate (%)
97.08
A
0
85.40
A
0
99.27
A
0
98.54
A
0
96.35
A+B
0
88.32
A
1
2.21
97.08
2.92
100.00
117
20
137
‡ OGTT：Oral glucose tolerance test.
Rule