If hospital do not use the ICD standards, there might be pros and cons. If the country has their own standard/ well defined data sets, it will be ok not to use ICD standards. If the country does not have their own standard data sets, should use ICD standards. Without any standards, there would be difficult to collect and analysis. It will not favorable for interoperability. Currently there is no reimbursement system in hospital of our country. Not sure standard is needed for reimbursement process.