Table 2 Some indicators of the program and their definition

General population

coverage of health record

residents with up-to-standard health record in the catchment / total residents in the catchment× 100%

Up-to-standard health record refers to the record with completely filled cover page and individual information form. Individual information of children aged 0~6, is filled in “postpartum newborn home visit form”, rather than the individual information form. The numerator should exclude those who are dead, move out or are not contactable by all means.

coverage of electronic health record (EHR)

residents with up-to-standard EHR in the catchment / total residents in the catchment×100%

Up-to-standard EHR refers to the record with complete cover page and individual information form in the electronic health record management system.

utilization rate of health record

number of those with dynamic updated information among the randomly sampled records/ total records sampled × 100%

Updated information refers to the information on the utilization of medical services and other health services compliant with service specifications within 1 year.

Specific population

rate of postpartum newborn home visit

number of newborn babies in the catchment who receive postpartum home visit or health management of 1-month-old infant for at least once in the year / total live births in the catchment in the year ×100%

Live births refer to the babies in the catchment born at and after 28 weeks’ gestation, or with birth weight of 1000 g and above, who shows any sign of life, including respiration, heartbeat, umbilical pulsation, or movement of voluntary muscles, from the beginning of the year to the data collection date.

coverage of health management among children aged 0~6

number of children aged 0~6 in the catchment who receive one or more follow-ups in the year/ total children aged 0~6 in the catchment in the year ×100%

Children aged 0~6 refer to the children in the catchment who have not got to their 7th birthday as of the data collection date. If real-time data are not available, the number of children aged 0~6 at the end of the previous year can be taken as proxy.

rate of registration in early pregnancy

number of pregnant women in the catchment who get registered and have 1st prenatal checkup in a hospital before 13 weeks’ pregnancy in the year/ number of live births in the catchment in the year ×100%

The number of pregnant women in the catchment who get registered and have the 1st prenatal checkup in a hospital before 13 weeks’ gestation refers to the number of pregnant women with live births, who get registered and have the 1st prenatal checkup in a hospital before the 13th week of pregnancy (12 weeks plus 6 days) from the beginning of the year to the date of data collection.

coverage of postnatal visit

number of postnatal women in the catchment who receive postnatal visit within 28 days after discharge from the hospital/ live births in the catchment ×100%

The number of postnatal women in the catchment who receive postnatal visit within 28 days after discharge from the hospital is the number of postnatal women in the catchment who receive postnatal visit within 28 days after discharge from the hospital from the beginning of the year to the date of data collection.

coverage of health management among the elderly

number of elderly residents in the catchment who receive health management services / total residents aged 65 or above in the catchment ×100%

The number of elderly residents who receive health management services refers to the number of permanent residents aged 65 or above who receive all of the four health management services, namely, establishment of health record, physical examination, health guidance and complete physical examination form, from the beginning of the year to the date of data collection.

percentage of hypertensive patients under standardized management

number of hypertensive patients in the catchment under management up to the standards of the specifications / total hypertensive patients under management in the catchment in the year ×100%

A patient is regarded as under standardized management, if in the Nth quarter of the year, the patient received N or more follow-ups from the beginning of the year to the date of the data collection report, or if the patient received 4 follow-ups and 1 physical examination annually in the previous two years.

The denominator is the number of hypertensive patients in the catchment receiving at least one follow-up from the beginning of the year to the date of data collection.

percentage of type 2 diabetic patients under standardized management

number of type 2 diabetic patients in the catchment under management up to the standards of the specifications / total type 2 diabetic patients under management in the catchment in the year×100%

The definition of standardized management is the same as that for hypertension management.

coverage of health management by TCM among the elderly

number of the elderly residents aged 65 or above in the catchment who receive TCM health management services in the year/ total residents aged 65 or above in the catchment in the year ×100%

TCM health management services refer to constitution identification by TCM, health guidance, and complete service record form in the health record of the resident, from the beginning of the year to date of data collection.

coverage of health management by TCM among children aged 0–36 months

number of children aged 0–36 months in the catchment receiving month-age-based TCM health management in the year/ total children aged 0–36 months in the catchment who should be under TCM management in the year × 100%