Are you kidding? There are all sorts of ways for hospitals and doctors to manipulate this stuff, e.g., attract healthier patients (less compromised immune systems) or ones who are wealthier, younger, and more likely to follow instructions; give more prophylactic antibiotics; classify more patients as palliative http://news.nationalpost.com/news/canada/canadian-hospitals-... ; slant cause-of-death classification when there is ambiguity.