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Varicella and zoster generally occur many years apart, with hospital episodes coded for both diseases concurrently implausible.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>We aimed to describe varicella-zoster virus-related hospital episodes coded for both varicella and zoster or postherpetic neuralgia (\u2018dual-coded\u2019) in Australia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method:<\/jats:title>\n                    <jats:p>Hospital episodes with ICD-10-AM code for varicella, zoster or postherpetic neuralgia between 2002 and 2021 were included and examined for dual-code assignment of both varicella and zoster or postherpetic neuralgia code, by principal diagnosis, age group and state\/territory. Trends over time were assessed with segmented linear or negative binomial regression models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The proportion of hospital episodes with principal diagnosis varicella that were dual-coded increased substantially between 2009 and 2015 (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001; proportion &lt;4% until 2009, 22.5%\u201328.8% from 2015 onwards), and with age (&lt;15\u2009years:&lt;13%, \u2a7e65\u2009years:&gt;40%, from 2015 onwards). The proportion of hospital episodes with principal diagnosis zoster that were dual-coded also increased over time (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001), though was lower than observed in hospital episodes with principal diagnosis varicella. Hospital episodes with principal diagnosis post-herpetic neuralgia were rarely dual-coded.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>After 2009, hospital episodes with principal diagnosis varicella, particularly in older age groups, frequently and increasingly have an additional zoster or postherpetic neuralgia code. Increased availability of real-time polymerase chain reaction testing and inadequate documentation in hospital medical records may have contributed to this.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications for health information management practice:<\/jats:title>\n                    <jats:p>As hospitalisation data are extensively used to estimate disease burden and inform public health policy, the dual-coding issues identified require further investigation and mitigation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/18333583251364580","type":"journal-article","created":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T07:57:46Z","timestamp":1756108666000},"page":"337-347","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Varicella-zoster-virus-related hospital episodes increasingly coded concurrently for varicella and zoster, Australia, 2002\u20132021"],"prefix":"10.1177","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-4876-5406","authenticated-orcid":false,"given":"Nicole","family":"Sonneveld","sequence":"first","affiliation":[{"name":"National Centre for Immunisation Research and Surveillance, Australia"},{"name":"The University of Sydney, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joanne","family":"Jackson","sequence":"additional","affiliation":[{"name":"National Centre for Immunisation Research and Surveillance, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7178-8606","authenticated-orcid":false,"given":"Aditi","family":"Dey","sequence":"additional","affiliation":[{"name":"National Centre for Immunisation Research and Surveillance, Australia"},{"name":"The University of Sydney, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2709-193X","authenticated-orcid":false,"given":"Stephen B","family":"Lambert","sequence":"additional","affiliation":[{"name":"National Centre for Immunisation Research and Surveillance, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9151-4781","authenticated-orcid":false,"given":"Frank H","family":"Beard","sequence":"additional","affiliation":[{"name":"National Centre for Immunisation Research and Surveillance, Australia"},{"name":"The University of Sydney, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,8,25]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.9.3.361"},{"key":"e_1_3_3_3_1","unstructured":"Australian Institute of Health and Welfare (n.d.) 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