# Implementation outcomes of a VTE prevention and management system within the close-knit county medical alliance model

## TL;DR

A VTE prevention system improved detection and management rates in Chinese county and township hospitals using a close-knit medical alliance model.

## Contribution

Demonstrates successful implementation of a VTE prevention system in grassroots hospitals using a county medical alliance model.

## Key findings

- VTE risk assessment rates increased significantly in county and township hospitals after the intervention.
- Pharmacological and mechanical prophylaxis implementation rates improved in both hospital types.
- In-hospital VTE detection/diagnosis rates rose in the observation group compared to the control group.

## Abstract

Venous thromboembolism (VTE) prevention and management has been identified as a key priority area for healthcare quality and safety in Chinese hospitals. The National Health Commission has incorporated “improving the standardized prophylaxis rate for venous thromboembolism” as one of the national medical quality and safety improvement goals for China from 2021 to 2025. While large tertiary hospitals in China have actively implemented VTE prevention and management systems with notable success, significant challenges persist at the grassroots level, including insufficient VTE prevention capabilities and low awareness in county-level and township hospitals.

Inpatients from the consortium (comprising 1 county-level hospital and 6 township hospitals) between July 2023 and June 2025 were selected as the study population. July 2024 was designated as the project initiation timepoint. The period from July 2023 to June 2024 was defined as the pre-intervention phase serving as the control group (CG), while the period from July 2024 to June 2025 was defined as the post-intervention phase serving as the observation group (OG). The analysis focused on trends in changes of indicators such as in-hospital VTE detection/diagnosis rate, risk assessment rate, bleeding risk assessment rate, mechanical prophylaxis implementation rate, and pharmacological prophylaxis implementation rate before and after the initiation of the VTE prevention and management project.

In the county-level hospital, the observation group comprised 30,863 cases and the control group 31,382 cases. Across the six township hospitals, the observation group included 35,204 cases and the control group 34,751 cases. There were no statistically significant differences in gender, age, or body mass index between the two groups in either the county-level or township hospitals (p > 0.05). In the county-level hospital, the observation group showed significantly higher rates than the control group in VTE risk assessment (99.47% vs. 67.42%), in-hospital VTE detection/diagnosis (1.42% vs. 0.64%), bleeding risk assessment (79.76% vs. 46.76%), mechanical prophylaxis implementation (46.15% vs. 20.96%), and pharmacological prophylaxis implementation (48.10% vs. 21.71%), with all differences being statistically significant (p < 0.05). Similarly, in the township hospitals, the observation group demonstrated significantly higher rates than the control group in VTE risk assessment (98.43% vs. 23.15%), in-hospital VTE detection/diagnosis (0.55% vs. 0.26%), bleeding risk assessment (81.25% vs. 41.15%), mechanical prophylaxis implementation (29.28% vs. 14.37%), and pharmacological prophylaxis implementation (8.49% vs. 2.54%), with all differences being statistically significant (p < 0.05).

Under the close-knit county medical alliance model and with the application of computer-supported technology, improvements were observed in VTE risk assessment rates, in-hospital VTE detection/diagnosis rate, bleeding risk assessment rates, mechanical prophylaxis implementation rates, and pharmacological prophylaxis implementation rates in both county-level and township hospitals.