Limitation of a single clinical data source for measuring physicians' performance on quality indicators.
Limitation of a single clinical data source for measuring physicians' performance on quality indicators.
复制标题
用于衡量医生质量指标表现的单一临床数据源的限制。
DOI：
10.1111/j.1532-5415.2006.00809.x
复制
发表时间：
2006
影响因子：
6.3
通讯作者：
Callahan,ChristopherM
中科院分区：
文献类型：
--
作者：
Weiner,Michael;Quwatli,Zakwan;Perkins,AnthonyJ;Lewis,JohnN;Callahan,ChristopherM
OBJECTIVES:To determine the extent to which relying on only one source of data leads to incomplete assessment of pneumococcal polysaccharide vaccine (PPV) or mammography.DESIGN:Cross‐sectional survey.SETTING:An urban Midwestern academic medical center in 1998/99.PARTICIPANTS:Medicare beneficiaries aged 65 and older with at least one health encounter.MEASUREMENTS:Completion of PPV and mammography was assessed using local and Medicare records. The study compared sources of records and assessed association between services and demographics and comorbidity.RESULTS:Adding Medicare data to local data increased the computed 1‐year PPV from 8.8% (264/3,002) to 15.0% and increased the 1998/99 mammography rate from 40% (343/847) to 67%. Local data sources missed 40% of PPV and 39% of mammography; Centers for Medicare and Medicaid Services sources missed 50% of PPV and 2% of mammography. The vaccinated were younger than the nonvaccinated (74 vs 76,P<.001). African Americans and those with more comorbidity were less likely to receive PPV over 8 years. Of 555 patients with a Medicare record of mammography, whites and those without Medicaid were significantly less likely to have a local record of mammography (P<.001).CONCLUSION:Neither administrative nor local clinical records provide a complete or accurate assessment of these quality indicators. Accurate assessment of quality indicators requires pooling data from multiple sources across a broad region.
