Limitation of a single clinical data source for measuring physicians' performance on quality indicators

Michael Weiner, Zakwan Quwatli, Anthony J. Perkins, John N. Lewis, Christopher M. Callahan

Research output: Contribution to journalReview article

5 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)1256-1260
Number of pages5
JournalJournal of the American Geriatrics Society
Issue number8
StatePublished - Aug 2006


  • Mammography
  • Medicare
  • Pneumococcal polysaccharide vaccine
  • Quality indicator

ASJC Scopus subject areas

  • Geriatrics and Gerontology

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