From Dark Daily
Pathologists and public health officials say the downward trend in autopsy rates is having far-reaching consequences for healthcare in the United States. The decline in the number of autopsies performed annually comes in spite of extensive literature documenting multiple benefits of the autopsy procedure
No less an authority than the American Medical Association is calling attention to this situation. The AMA just published a story titled, “Declining Autopsy Rates Affect Medicine and Public Health,” to call attention to the fact that the rate of autopsies has fallen significantly.
Recent data from the Centers for Disease Control and Prevention (CDC), demonstrates that, in 1972 the number of deaths autopsied was 19%. By 2007, that number had plummeted to just 9%.
Experts are concerned about this continuing trend. That’s because autopsies have historically played a crucial role in three ways:
- medical education;
- characterization of new diseases; and,
- advancing the understanding of disease pathogenesis.
The significance of autopsies as important to advancing medical science has been the subject of several television shows aired on PBS. On its website, PBS.org posted an article about autopsies that was titled: “Without Autopsies, Hospitals Bury Their Mistakes.” PBS reported the following data:
- Patients Who Died in Hospitals. Fifty years ago, autopsies were performed about 50% of the time. Today, according to CDC, that number is about 5%.
- Patients Who Died of Diseases Such as Cancer and Cardiovascular Disease. In 1972, the autopsy rate for such deaths was 17%. In 2007, the number was 4%.
- Teaching, Private and Community Hospitals. Teaching hospitals perform autopsies around 20% of the time, private and community hospitals’ autopsy rate is close to zero.
- Older Patients Who Died in Hospitals. CDC data show that, in 2008, 684,000 patients over the age of 60 died in hospitals. Although that represented more than 25% of all deaths in the country that year, just 2.3 % were autopsied. Experts note the lost opportunity to learn about age-related diseases.
- Some Hospitals Performing Zero Autopsies. One survey found that in a given year, 63% of hospitals in the state of Louisiana performed no autopsies.
About 50% of autopsies produce medical findings that were unsuspected before the autopsy, reported the AMA. A 2002 report by the Agency for Healthcare Research and Quality found that autopsies revealed major errors related to the principle diagnosis or underlying cause of death 25% of the time. In 10% of the cases, the error appeared severe enough to have led to the patient’s death.
In 1999, the Medicare Payment Advisory Commission (MedPAC) issued a report stating that increasing the rate of clinical autopsies could improve healthcare and reduce errors. However, despite the data, industry organizations, such as Institute for Healthcare Improvement, National Quality Forum, and The Joint Commission have not pushed to increase the use of autopsies.