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Reported Decline in U.S. Pneumonia Deaths May Be False: Study
Date:4/4/2012

By Mary Brophy Marcus
HealthDay Reporter

TUESDAY, April 3 (HealthDay News) -- Recent reports showing a big dip in U.S. pneumonia cases and related deaths may be the result of a glitch in the way hospitals code for pneumonia and associated illnesses, rather than a treatment breakthrough, a new study suggests.

"We had observed that over a very brief period of time, between 2003 and 2009, the number of admissions to hospitals for pneumonia was decreasing rather dramatically and, at the same time, the mortality rate for patients hospitalized for pneumonia was also decreasing rather dramatically," said study author Dr. Peter Lindenauer, director of the Center for Quality of Care Research at Baystate Medical Center in Springfield, Mass.

"We don't have a new drug that might suggest the drop, so one of the things we thought we needed to investigate were changes in diagnostic coding choices," said Lindenauer, also an associate professor of medicine at Tufts University School of Medicine in Boston.

Pneumonia, one of the nation's top killers, causes more than a million hospitalizations a year in the United States.

For the study, published April 4 in the Journal of the American Medical Association, Lindenauer and colleagues analyzed trends in hospital admissions and survival in patients with pneumonia, and in patients diagnosed with sepsis or respiratory failure, two related illnesses, combined with pneumonia. Sepsis is a life-threatening bacterial infection.

The researchers calculated how many cases were coded as a principal diagnosis of pneumonia, and how many cases were given a principal diagnosis of sepsis or respiratory failure with a secondary diagnosis code of pneumonia.

"A physician's primary responsibility is to document a clinical diagnosis, impressions, and create a patient treatment plan," said Lindenauer. He said it's ultimately the job of the hospital coders (large staffs engaged in
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