An accompanying editorial published in the journal suggests coding nuances may also affect the way other diseases, such as heart disease, are evaluated.
Dr. Rohit Bhalla, chief quality officer at Montefiore Medical Center in New York City, who was not involved in the study, concurred that coding is complex and needs further analysis. He said new coding methods will soon be introduced that could complicate matters further.
"You have to understand administrative data's strengths and limitations," Bhalla said. "You have to be careful and circumspect about implying that small changes in data relate to care." He suggested it might be more accurate to use both administrative and clinical information from a patient's chart when studying disease trends, treatments and survival.
For more on pneumonia, see the U.S. National Library of Medicine.
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