This study collated, reviewed, and analyzed the data of general medical practice quality control in Yuzhong District from 2019 to 2022, with a view to optimizing the district’s quality control of general practice, improving the community healthcare capabilities in general medicine, and providing guidance for the development of grassroots general practice in the region.

In 2019, the Yuzhong District Health Committee established the Yuzhong District General Medical Quality Control Center (hereinafter referred to as "General Medical Quality Control Center" ). The "General Medical Quality Control Center" was affiliated to a primary community health institution (the Yuzhong District Shangqingsi Street Community Health Service Center) and took the lead in establishing the Yuzhong District General Medical Quality Control Committee, setting up the organizational structure, assigning the relevant personnel, and establishing a general medical quality control management grid system. Adopting a general medical quality control model of "organization structure-quality control process-quality control results-continuous improvement" , the center developed the three-stage quality control index system of "General Medical quality Control Assessment Rules of Yuzhong District Community Health Service Center" from 2019 to 2022. Progressing "from macro-level to micro-level" , it conducted gradual, progressive general practice quality control work annually across all 11 community health service centers.

Yuzhong District established a general medical quality control system from the ground up, transitioning from "broad-based" quality control to targeted assessments of outpatient medical records. The The initiative was implemented in three stages. The first stage (2019) was the quality control self-inspection stage, with an average score of 82.5,with 27.27% (3/11) of centers scoring <80. The second stage (2020) is the basic stage of quality control, focusing on the establishment and implementation of the core system, with 11 centers scoring more than 80 points and a pass rate being 100%. In the third stage (2022 and 2021) quality control target stage, the average pass rate of outpatient medical records was 80.45%, marking an increase of 18% (150/177), and 72.72% (8/11) of centers achieved a ≥ 80% pass rate, reflecting a 14.3% increase (7/8). The qualified rate of outpatientmedical records in 4 centers was 100% [36.4% (4/11)], while the qualified rate remained ≤80% in 3 centers (27.3%). The average score of main complaint and current disease assessment was 22.13 points (grade C), with grade A accounting for 18.19% (2/11), grade B 36.37% (4/11), grade C 18.18% (2/11), and grade D 27.27% (3/11), two-thirds of which were privately operated institutions. It can be seen that the advanced quality control of general practice promoted the improvement of the overall ability of general practice and the gradual improvement of risk awareness. However, persistent challenges included inconsistent focus among some institutions; weaknesses in outpatient documentation; insufficient legal and safety awareness among general practitioners, leading to higher medical risks and security vulnerabilities; and significant performance gaps between private and public institutions. Statistical analysis of the score assessment of general medical outpatient medical records showed that there was a statistical difference in HZ score (P<0.05).

The progressive quality control system for general practice in Yuzhong District’s community health centers has yielded preliminary successes, positioning the district as a leader in primary healthcare in Chongqing. The general practice quality control initiative has developed distinctive features, including: an "integrated" quality control system, "pain point-targeted" quality control management, "cross-type" quality control supervision, and "on-site resident" quality control training. These efforts have strengthened the synergy, branding, influence, and competitiveness of community-based general practice services in Yuzhong District. Moreover, they provide robust support for enhancing the quality of community general practice care, improving general practice clinical capabilities, and standardizing general diagnosis and treatment practices. This model holds significant reference value for primary healthcare quality improvement initiatives.