Association of Diagnostic Coding With Trends in Hospitalizations and Mortality of Patients With Pneumonia, 2003-2009

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Abstract
Pneumonia is a leading cause of morbidity and mortality among US adults, resulting in more than 1 million annual hospital admissions and accounting for more than $10.5 billion in aggregate costs.1,2 Given its public health significance, pneumonia has been the target of quality improvement activities for nearly 2 decades. This began with the publication of clinical practice guidelines in the early 1990s,3 was followed by a series of statewide and national quality improvement initiatives,4 and more recently has included public reporting and pay-for-performance programs led by the Joint Commission and the Centers for Medicare & Medicaid Services (CMS) and other payers.5,6

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