Reported decline in pneumonia deaths in U.S. may be false
Peter Lindenauer, the director of the Center for Quality of Care Research at Baystate Medical Center in Springfield, Mass., and his colleagues analyzed trends in hospital admissions and survival in patients with pneumonia between 2003 and 2009, along with two related illnesses - sepsis and respiratory failure - when combined with pneumonia, HealthDay reports.
"What we came to hypothesize was that a shift was taking place whereby patients who'd previously been the sickest pneumonia patients were increasingly being coded as having sepsis," Lindenauer said, according to HealthDay.
Sepsis is a life-threatening bacterial infection that gives hospitals a higher reimbursement than patients diagnosed with pneumonia. In addition, a national campaign was launched during the same time period to raise the awareness about sepsis and its treatment.
"There was probably a double-whammy of increased reimbursement and also an increase in physician awareness, so more were writing it in the chart and that allowed more hospitals to get reimbursed," Lindenauer said, according to HealthDay.
An accompanying editorial concurred that coding is complex and requires deeper analysis.
"You have to understand administrative data's strengths and limitations," Rohit Bhalla, the chief quality officer at Montefiore Medical Center in New York City, said, according to HealthDay. "You have to be careful and circumspect about implying that small changes in data relate to care."