Assessing the quality of gynaecological care in China: protocol for a nationwide survey using mixed-methods.

Abstract

The burden of gynaecological diseases is increasing globally, affecting women's health, quality of life and fertility. Improving the quality of gynaecological care will enhance patient recovery and improve outcomes of gynaecological diseases. However, comprehensive evaluation tools and nationwide data on the quality of gynaecological care are lacking. This study aims to develop a framework for evaluating gynaecological care quality in China, analysing disparities and proposing improvement strategies. This nationwide study employs a sequential explanatory mixed-methods design across three phases: (1) questionnaire development through a literature review, indepth interviews, expert consultation and pilot testing; (2) collection of cross-sectional survey data from gynaecology departments, healthcare providers and patients in public healthcare facilities across 31 provinces in mainland China; and (3) integration and interpretation of qualitative and quantitative results. The study collects data on organisational structure, care processes and outcomes. Analysis of quantitative data will include risk adjustment of key quality indicators, comprehensive evaluation of care quality and exploration of influencing factors using linear regression. Qualitative data will undergo thematic and content analyses. Joint displays will be used to integrate the mixed-method results. The study was approved by the Peking Union Medical College Hospital Ethics Committee (I-24ZM0003). All participants provided informed consent. Data were anonymised and participants retained the right to withdraw without penalty. A risk-benefit assessment was conducted, and no vulnerable groups were included without justification. These findings will be disseminated to healthcare policymakers through academic publications, scientific conference presentations and reports. The results are expected to provide methodological guidance for the quality evaluation of gynaecological care and inform policy development in China.